Intakes/Discharges
What does MDM stand for?
Who is the person ultimately responsible for the clinical chart and all documents within that chart?
Who is YOU! The primary clinician!
When is the appropriate time for a Care Plan Review?
What is the new form taking place of the CCAR?
True or false: The HRSN is only for adults
What is FALSE!
What diagnosis code should be used prior to completing the full intake?
What is Z03.89
When is the appropriate time for a Comp Assessment Review?
What is every 6 months, change in level of care, change in diagnosis, significant changes in client’s life/environment
What does SMART stand for?
What is Specific, Measurable, Attainable, Relevant, Timely
What is the % target for note timeliness each month?
What is 90%
How old does a client need to be to self consent?
What is 12years+
BONUS: If client is in middle school, who must approve self consenting clients before it is accepted?
If the client is self consenting, does a MDM form need to be completed?
Name 3 prompts in the presenting problem section of the Comp Assessment.
What is chief complaint, onset, duration, changes in functioning, impact on daily life, previous efforts to address problems, collaterals present
True or False: The care plan needs to match a service delivery date
True or false: The CO-BHRM has to be completed yearly?
What is FALSE!
Who is your chief clinical officer at AMHR?
Which 3 screeners that are required for each client at intake?
What are HRSN, PEARLS, CSSRS (12+), (18+ Infectious Disease)
What is the golden thread?
What is a clear, consistent, and traceable link of information that runs throughout all all documents in the chart related to their treatment and reason for services.
True or False: You can complete a care plan review before your comp assessment update
What is FALSE! You MUST complete the comp assessment update first for the care plan review to flow correctly.
If parents are separated/divorced and share custody, who needs to sign the MDM document?
What intake forms need a signature from an AMHR staff on them?
What are mandatory disclosure, consent to treat, school-based agreement
When do you use program vs. agency discharge?
What is program d/c is used when your client is moving to another program and agency discharge is used when they leave AMHR.
Name 3 reasons you may put a flag in the client’s chart?
What is denied use of AI, self consenting, pronouns/preferred name, SCP, anything important for a provider to know immediately
What are the 3 different methods you can obtain client/guardian signatures?
What are Docusign, physical copy/paper, electronically in SC
Name at least 3 different services you can provide without a care plan.
What is crisis, wellness, BHO, BHS, etc...
Name 3 prompts in the cultural considerations section of the Comp Assessment.
What is ethnic/race, age, values/beliefs, language/communication, socioeconomic, gender, familial, location, religion/spiritual orientation