Dosing Time Arrangement Analysis

D- The patient arrived on time for her session and reports being stable on dose and haven't used any illicit drugs. This writer advised the patient that this writer was in fact in receipt of missed phone call about coming to the session at 10:30 am rather than 10 am due to her mother in the process of selling the house. This writer addressed with the patient about letter from CHR from her counselor, Jade Bray stating about the patient non-compliance with her appointment due transportation barrier. According to the patient, she is going through hardship as her mother is no longer taking her to her appointment as the patient says, " She's tired of bringing me everyone, Charlene. She complains about bringing me here and does not understand why I can't even get a bottle...:Like c'mon. What do I have to do?" This writer explained to the patient about TEAM decision, at which the patient disagree with the decision. This writer asked the patient about her "judgement." According to the patient, she feels she is making judgement by not engaging any further altercation with patient at the clinic, dosing daily, coming to her counseling session, and trying to get help from Chrysalis for

This writer met with the patient to address the conflicting issue with his medication. According to the patient, his PCP was prescribing him with his benzodiazepine medications; however, the patient says, " I had to seek a psychiatrist because it was only temporary." This explains the conflicting issues with the Rx Scripts on file. The patient started his treatment with his now psychatrist on 6/12/2017 and signed an ROI. Addressing picking up his medication from two different pharmacy, the patient was advise that he needs to be pick up his medication with only one pharmacy as it is required. The patient agreed to the terms and said, " I like CVS better than Walgreens. Sometimes they would my refill to Walgreens or whatever is closer to me,

The patient self-admits that she was not always compliant with her appointments due to changes to her work schedule since the month of December of 2016, but shared this information with her counselor. The patient is requesting to be reassigned to another counselor as she reports of not having a positive rapport with Cherron. Cherron was advised based on the patient complaint that it will be addressed with the Clinical Director based on her request to be

The patient did not hesitate to sign the tx violation and was very understanding as to why due to non-compliance, but again, this writer gave the patient credit for his efforts, but appointment needs to be established with proof of documentation. This writer strongly urges the patient to still follow through with team recommendation and obtain a documentation of his scheduled intake, at which the patient agreed to do.

At this time, the patient is referred to attend three group sessions. Due to the patient's non-compliance with attending the most recent TEG group yesterday and missed the cocaine group last week, it is required for the paitent to attend the non-compliance group today at 11:30am, which upset the patient. The writer explained to the patient about why the non-compliance group was developed and advises the patient to comply with keeping all of his clinical

D-The patient was advised that her bottles are in fact suspended due to the incident that occurred on 02/08/2017 of which the patient needs to accountability of taking a second dose of her methadone even though she has taken her methadone at home. The patient admits her accountability of her actions of taking the second dose. The patient then asked about how she can regained her take home bottles of which this writer explained the policy of take home bottles, referring to the reinstatement process. The patient is referred to attend the Take Home Bottle Group on 03/9/2017 to have her bottles reinstated. Then the patient shared that she wrote a grievance letter and still plans to submit it for the Program Director to review. Furthermore, this

D-This writer agreed to meet with the patient as he was placed hold to attend group. Reported stability on his current dose and denies the need for a dose increase when offered by this writer. This writer reviewed the patient's record and learned that he obtained his 3rd take home bottle on 01/04/2017. The patient is aware that he in order for him to obtained the 4th take home bottle, he must attend the take home bottle group. Addressing his medication, this writer noticed that the patient has not refilled the following medications:

The patient expressed about feeling that she is self-sabatoge her recovery for no apparent reason and currently thinking about going into an inpatient treatment- more so, a treatment that is spiritual. The patient shared that lately she's been feeling down and haven't been to going to church for the past two weeks. In addition, the patient shared about having homocidial thoughts with regards to her daughter's DCF case as she expressed frustration with the custody battle. This writer advises the patient about this writer's role as a mandated reporter and based on the patient comment of having homocidal thoughts, she recanted her statement and says," So, you are telling me that I cannot vent and express how I feel.....I am going to keep my mouth

The patient arrived on time for her counseling session. Reported doing okay with her dose, but wishes she can have an increase as she still experiencing some cravings, but is trying not to relapse. The patient vented about her transportation issues with Logisticare and her ex-husband. Patient says, " I need my rides to be reinstated because I can't keeping back and forth with him.......Did you get my discharge summary?.... Please send it to Logisticare." This writer showed the patient about a recent fax from Hartford Dispensary, referring to her discharge summary and a statement on the clinic's letterhead stating the date of the patient discharge and when she was medically taper off on her dose. According to the patient, she does not want her previous counselor statement to be sent to Logisticare,

Patient is a 46 year old male who presented to the ED via LEO from Daymark for anxiety and depression over relationship issue, and financial issues.Patient reports a lot going on in his life right now and he went to Daymark seeking outpatient therapy. However, he was agitated that he was brought to the hospital for further evaluation. The patient reports that he was speaking with a worker at Daymark about his experience last year and was told to wait in the waiting room. The patient stated, " I fell like I was tricked into staying until the police came and brought me to the hospital. During the assessment the patient expressed that he has been feeling some anxiety, depressive symptoms, and aggression due to his situation. Further, the patient

After we received a report, we had to call doctor to clarify order on one patient, because the insulin was ordered Q4 HRS and finger sticks were ordered 4 times a day. Rasheeda called Dr.Krejci and attempted to explain the situation, but after a few minutes she just gave me the phone and stated “he does not understand, you explain”. When I completed a conversation

(S): Writer met with the consumer on Tuesday, 1/9/18 at 1:40pm at his home. The consumer report that the stress test went good. The consumer states that his heart rate was low and he was told to continue to take his medication. The consumer states that he is working on ways to handle stress. The writer discuss with the consumer about some coping skills which should help him to deal with the stress. The consumer is schedule for medication review appointment on Wednesday, 1/10/18 at 10:00am. The consumer denied any sleep and appetite problems.

D-The patient arrived on time for her scheduled appointment to meet with this writer. The patient reports she is stable at her current dose and haven't used any illicit drugs. The patient reports that she is currently prescribed with Xanax and her psychatrist hasn't lower her dose with Xanax because of the patient's panic attack. The patient reports she is still engaging in therapy and is willing to bring in a letter to address her progress and attendance with treatment to assist with the take home bottle application.

Brown showered independently. On 02/05/17, Case Manager was helping Mr. Brown search for his missing cell phone when Case Manager came across a pack of Newport cigarette and a lighter. Case Manager took the pack of Newport Cigarette and light and placed it on Manager’s table. Case Manager warned Mr. Brown about the hazard of sneaking cigarette in his room, because of his oxygen gas and the implication smoking has on his health. Staff noted in the communication log that consumer showered twice on 02/05/17, the consumer diaper was covered in feces. Mr. Brown asked for Zofran medication at 7:30 p.m... Mr. Brown was prompted and assisted with personal care on 02/06/17. He was compliant. Mr. Brown refused to eat lunch on 02/06/17; staff encourage the consumer, but did not respond. On 02/08/17, staff noted in the communication log that if Mr. Brown did not have his proof of his divorce certificate by February 23; his Long Term Care application will be denied to move to a Nursing Home. On 02/08/17, when Mr. Brown was prompted to come out for his medication; it took him 15mins before coming out. Staff stated that on 02/09/17, Mr. Brown showered immediately when he returned from dialysis treatment at 4:50 p.m. Mr. Brown nose was bleeding while receiving his 5pm medication on 02/19/17; he reportedly told the Nurse that his nose has been bleeding for the past few weeks and staffs knew about his nose bleed. Jody a Nurse from Christina Care called concerning Mr. Brown medication. Jody stated that she will visit the following day at 8:00 am and would like to speak with the Nurse in charge of Mr. Brown’s medication. Mr. Brown showered independently in the morning on

D-The patient arrived on time for her appointment. Reported stable on her dose, but requested to decrease her current methadone to 49mgs as she wishes to be stabilized at a lower dose. This writer completed the dose change request. The patient asked this writer about the status of her take home bottle because she need her bottle in order to apply for a travel bottle as she is getting married next month. This writer then informed the patient, this writer had sent a message to the clinic's TEAM about the urgency of her request to take into consideration for approval, at which the patient thanks this writer for her efforts. Then the patient shared about her husband's friend, who had passed away and his funeral is this weekend.