CORRECTION OF DEFICIENCIES

PURPOSE:

To ensure that all deficiencies are corrected within ten (10) days of review.

DEFINITION:

A "deficiency" is the absence of a required element needed to meet a pre-established standard.

PROCEDURE:

A. Correction of deficiencies for active Medical Records

 
 

1. The Monthly Chart Audit Checklist is used to document deficiencies.

2. A memo will be sent within five (5) days of the noted deficiency to the responsible department head indicating deficiencies that need to be corrected. A copy of the memo will be maintained in the Medical Records Office. The date the deficiency was noted and the date the memo was sent is to be documented on the resident's index card in the "Tickler File."

3. Deficient charts will be reviewed within (10) days to ensure that all deficiencies are properly corrected.

4. A copy of the memo and the index card in the "Tickler File" will be dated by the auditor when the deficiency is corrected.


B. Correction of deficiencies for Medical Records of discharged/deceased residents.

Refer to the procedure for "Completion of Medical Records."

 


MEDICAL RECORDS  - 35-03-010

 

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