Follow the steps to successfully complete your discharge note.

1. Use the ‘Get Form’ button to access the discharge note and open it in an online editor.
2. Enter today's date at the start of the form to indicate when the discharge note is being completed.
3. Provide the contact information for the member, including their name, member ID number, date of birth, phone number, and the referral source.
4. Fill in the details of the facility, including its name and NPI or provider number.
5. Document the date of admission and the discharge information, indicating if the member was discharged to home, shelter, etc.
6. Specify the date of discharge and include the discharge address and phone number.
7. If the member is a minor or dependent adult, input the name and contact information of the parent or guardian.
8. Detail the ICD-10 discharge diagnoses related to psychiatric, chemical dependency, and medical issues.
9. Indicate if the discharge was against medical advice (AMA) by selecting 'Yes' or 'No'.
10. State whether discharge information was sent to the primary care provider (PCP) or psychiatrist.
11. Confirm if the discharge plan was discussed with the member.
12. For minors or dependent adults, indicate if informed consent for psychotherapeutic medication was completed and given to the parent or guardian.
13. Complete the ASAM rating for each dimension at the time of discharge, providing explanations as needed.
14. State whether the member was transitioned to a lower level of care and provide specifics if applicable.
15. List all discharge medications, including dosage, frequency, and condition for which they are prescribed, and indicate if they are on the formulary.
16. Assess the member's stability at discharge, noting any risks for suicide, homicide, or psychosis.
17. Record the details for aftercare appointments, including provider name, contact number, date, and time, ensuring one is scheduled within seven calendar days.
18. Include any other providers involved in the aftercare plan, listing them with contact information.
19. Sign the form at the bottom, providing the name and phone number of the person submitting the form along with the date of submission.
20. Once all information is accurately filled, save changes and choose to download, print, or share the completed discharge note.

Start filling out the SC Select Health Substance Abuse Discharge Note online to ensure a successful discharge process.