12-4 Vt. Code R. 205:14 - Clinical records under the Agency of Human Services regulations

“Clinical records under the Agency of Human Services regulations”

A home health agency must maintain a clinical record for each patient and retain the record for five years.  If the patient is transferred to a healthcare facility, the home health agency must send a copy the record with a patient.

A home health agency must maintain the confidentiality of all clinical records and safeguard clinical record information against loss or unauthorized use.  The agency must develop written procedures governing the use of proposal of records the conditions for release of information according to state and federal law.  The home health agency must obtain the written consent of a patient for release of information not authorized by law. Upon an oral or written request, each patient must be given access to all current records pertaining to him within 24 hours or 5 business days if the records are archived. A home health agency may charge a patient a reasonable copying fee if the patient requests photocopies of the records.

A home health agency must develop written policies and procedures for electronic information systems which address data integrity, confidentiality of patient records, security, authentication, non-repudiation, encryption, and the ability to be audited.