1. (a) Progress notes shall chronologically describe the services provided by date and, for timed treatment sessions, time of service, and the consumer's progress in treatment.
2. (b) Progress notes must be signed by the service provider and include the service provider's credentials.
3. (c) Outpatient staff must document each visit or transaction, except for assessment completion or service plan development, including missed appointments.

4. (d) Compliance with 450:65-3-4.1 may be determined by a review of the following:

   1. (1) Policies and procedures;
   2. (2) Consumer records;
   3. (3) Progress notes;
   4. (4) Interviews with staff; and
   5. (5) Other facility documentation.

Added at 39 Ok Reg 2012, eff 9-15-22