Recovery Facility

Weekly accountability report

Resident: Resident 04
Reporting period: Oct 5–Oct 11, 2026 W41
Generated: Fri, Oct 9, 2026, 11:40 AM

Notice to accompany disclosure — 42 CFR §2.32(a)

This record which has been disclosed to you is protected by Federal confidentiality rules (42 CFR part 2). These rules prohibit you from using or disclosing this record, or testimony that describes the information contained in this record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against the patient, unless authorized by the consent of the patient, except as provided at 42 CFR 2.12(c)(5) or as authorized by a court in accordance with 42 CFR 2.64 or 2.65. In addition, the Federal rules prohibit you from making any other use or disclosure of this record unless at least one of the following applies: (i) Further use or disclosure is expressly permitted by the written consent of the individual whose information is being disclosed in this record or as otherwise permitted by 42 CFR part 2. (ii) You are a covered entity or business associate and have received the record for treatment, payment, or health care operations, or (iii) You have received the record from a covered entity or business associate as permitted by 45 CFR part 164, subparts A and E. A general authorization for the release of medical or other information is NOT sufficient to meet the required elements of written consent to further use or redisclose the record (see 42 CFR 2.31).

67%Non-compliant10 of 15 required tasks met

No clinical narrative was recorded for this week.

Tracking requirements

House Chore Done Daily7 of 7100%

Staff notesNo notes recorded

IOP Group Sessions1 of 333%

Staff notesNo notes recorded

AA/NA Outside Meetings2 of 450%

Staff notesNo notes recorded

Sponsor0 of 10%

Staff notesNo notes recorded

Recovery

Home groupNot recorded

Home group day / timeNot recorded

Active sponsorNo

Doing step workNo

Holds a service positionNo

Service roleNo service role recorded

Outpatient groups

No group recorded in this slot
No group recorded in this slot
No group recorded in this slot

Legal

Appointments and court datesNothing recorded

Issues and concerns

Issues or concernsNone recorded

Medication narrative

Medication changes or concernsNone recorded

Weekly schedule

MondayNothing recorded

TuesdayNothing recorded

WednesdayNothing recorded

ThursdayNothing recorded

FridayNothing recorded

Saturday / SundayNothing recorded

Goals

Weekly goalNot recorded

Short-term goalNot recorded

Long-term goalNot recorded

ProgressNo progress narrative recorded

Transitional plan

Recovery housing planNot recorded

Target locationNot recorded

Employment verification

Currently employedNo

EmployerNot recorded

PositionNot recorded

AddressNot recorded

Point of contactNot recorded

Contact phoneNot recorded

Work scheduleNot recorded

School verification

SchoolNot recorded

ProgramNot recorded

Volunteer verification

OrganizationNot recorded

PositionNot recorded

AddressNot recorded

Point of contactNot recorded

Contact phoneNot recorded

Scheduled work hours

MondayNot scheduled

TuesdayNot scheduled

WednesdayNot scheduled

ThursdayNot scheduled

FridayNot scheduled

SaturdayNot scheduled

SundayNot scheduled

Total scheduled: 0 hrs

Recovery Facility

Medication administration record

Resident: Resident 04
Reporting period: Oct 1–Oct 31, 2026
Generated: Fri, Oct 9, 2026, 11:40 AM

Notice to accompany disclosure — 42 CFR §2.32(a)

This record which has been disclosed to you is protected by Federal confidentiality rules (42 CFR part 2). These rules prohibit you from using or disclosing this record, or testimony that describes the information contained in this record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against the patient, unless authorized by the consent of the patient, except as provided at 42 CFR 2.12(c)(5) or as authorized by a court in accordance with 42 CFR 2.64 or 2.65. In addition, the Federal rules prohibit you from making any other use or disclosure of this record unless at least one of the following applies: (i) Further use or disclosure is expressly permitted by the written consent of the individual whose information is being disclosed in this record or as otherwise permitted by 42 CFR part 2. (ii) You are a covered entity or business associate and have received the record for treatment, payment, or health care operations, or (iii) You have received the record from a covered entity or business associate as permitted by 45 CFR part 164, subparts A and E. A general authorization for the release of medical or other information is NOT sufficient to meet the required elements of written consent to further use or redisclose the record (see 42 CFR 2.31).

Adherence — October 2026

6%2 of 35 scheduled doses given0 complete days, 9 with gaps

As-needed (PRN) doses are recorded below but are excluded from this figure, and days that have not yet been reached are excluded from both halves of it. Medication adherence does not affect the weekly compliance score.

Scheduled medications

2 given, 1 documented missed, 32 not recorded, of 35 scheduled

✓Given✗Not given, reason documented?Scheduled, nothing recorded—Not due·Day not yet reached

Sertraline100 mgDaily, 1 dose a day (AM 8:00 AM)No prescriber recordedfrom Mon, Aug 24, 2026On hand ~60

AM 8:00 AM1 of 9 given

Dose	1T	2F	3S	4S	5M	6T	7W	8T	9F	10S	11S	12M	13T	14W	15T	16F	17S	18S	19M	20T	21W	22T	23F	24S	25S	26M	27T	28W	29T	30F	31S
AM 8:00 AM	?	?	?	?	?	?	?	?	✓	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·

No documented missed doses for this medication.

Lisinopril10 mgDaily, 1 dose a day (AM 8:00 AM)No prescriber recordedfrom Mon, Aug 24, 2026On hand ~45

AM 8:00 AM1 of 9 given

Dose	1T	2F	3S	4S	5M	6T	7W	8T	9F	10S	11S	12M	13T	14W	15T	16F	17S	18S	19M	20T	21W	22T	23F	24S	25S	26M	27T	28W	29T	30F	31S
AM 8:00 AM	?	?	?	?	?	?	?	?	✓	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·

No documented missed doses for this medication.

Naltrexone50 mgDaily, 1 dose a day (AM 9:00 AM)No prescriber recordedfrom Mon, Aug 24, 2026On hand ~30

AM 9:00 AM0 of 9 given

Dose	1T	2F	3S	4S	5M	6T	7W	8T	9F	10S	11S	12M	13T	14W	15T	16F	17S	18S	19M	20T	21W	22T	23F	24S	25S	26M	27T	28W	29T	30F	31S
AM 9:00 AM	?	?	?	?	?	?	?	?	✗	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·

Fri, Oct 9, 2026 AM 9:00 AMClient refused

Vitamin D1000 IUDaily, 1 dose a day (PM 8:00 PM)No prescriber recordedfrom Mon, Aug 24, 2026On hand ~90

PM 8:00 PM0 of 8 given

Dose	1T	2F	3S	4S	5M	6T	7W	8T	9F	10S	11S	12M	13T	14W	15T	16F	17S	18S	19M	20T	21W	22T	23F	24S	25S	26M	27T	28W	29T	30F	31S
PM 8:00 PM	?	?	?	?	?	?	?	?	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·	·

No documented missed doses for this medication.

As-needed (PRN) medications

Listed for the record. As-needed doses are not scheduled, so they are counted in neither half of the adherence figure above.

Ibuprofen200 mgAs needed (PRN) — not counted toward adherenceNo prescriber recorded

No as-needed doses were logged this month

Physical pill counts

4 counts recorded, 0 did not match (0 short, 0 over, net 0)

Fri, Oct 9, 2026Sertraline60 tablets countedFirst count — nothing to compare yetNo explanation required
Fri, Oct 9, 2026Lisinopril45 tablets countedFirst count — nothing to compare yetNo explanation required
Fri, Oct 9, 2026Naltrexone30 tablets countedFirst count — nothing to compare yetNo explanation required
Fri, Oct 9, 2026Vitamin D90 capsules countedFirst count — nothing to compare yetNo explanation required

Recovery Facility

Resident summary report

Resident: Resident 04
Reporting period: Aug 24–Oct 11, 2026 W41
Generated: Fri, Oct 9, 2026, 11:40 AM

Notice to accompany disclosure — 42 CFR §2.32(a)

This record which has been disclosed to you is protected by Federal confidentiality rules (42 CFR part 2). These rules prohibit you from using or disclosing this record, or testimony that describes the information contained in this record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against the patient, unless authorized by the consent of the patient, except as provided at 42 CFR 2.12(c)(5) or as authorized by a court in accordance with 42 CFR 2.64 or 2.65. In addition, the Federal rules prohibit you from making any other use or disclosure of this record unless at least one of the following applies: (i) Further use or disclosure is expressly permitted by the written consent of the individual whose information is being disclosed in this record or as otherwise permitted by 42 CFR part 2. (ii) You are a covered entity or business associate and have received the record for treatment, payment, or health care operations, or (iii) You have received the record from a covered entity or business associate as permitted by 45 CFR part 164, subparts A and E. A general authorization for the release of medical or other information is NOT sufficient to meet the required elements of written consent to further use or redisclose the record (see 42 CFR 2.31).

Resident

ResidentResident 04

Admission dateMon, Aug 24, 2026

Clean dateNo clean date on file

BedHouse A · Room 2 · Bed B

Roster statusActive

Period coveredAug 24–Oct 11, 2026

Weekly compliance, admission to date

Week	Dates	Score	Band	Tasks	Record
2026-W35	Aug 24–Aug 30, 2026	—	Not logged yet		Nothing recorded
2026-W36	Aug 31–Sep 6, 2026	60%	Non-compliant	9 of 15 required tasks met	Recorded
2026-W37	Sep 7–Sep 13, 2026	100%	Compliant	15 of 15 required tasks met	Recorded
2026-W38	Sep 14–Sep 20, 2026	100%	Compliant	15 of 15 required tasks met	Recorded
2026-W39	Sep 21–Sep 27, 2026	87%	Compliant	13 of 15 required tasks met	Recorded
2026-W40	Sep 28–Oct 4, 2026	67%	Non-compliant	10 of 15 required tasks met	Recorded
2026-W41	Oct 5–Oct 11, 2026	67%	Non-compliant	10 of 15 required tasks met	Recorded

Current tracking requirements

House Chore Done DailyTarget: 7 per week

IOP Group SessionsTarget: 3 per week

AA/NA Outside MeetingsTarget: 4 per week

SponsorTarget: 1 per week

Requirement history

House Chore Done DailyCurrently tracked

2026-W350 of 70%
2026-W364 of 757%
2026-W377 of 7100%
2026-W387 of 7100%
2026-W396 of 786%
2026-W405 of 771%
2026-W417 of 7100%

IOP Group SessionsCurrently tracked

2026-W350 of 30%
2026-W362 of 367%
2026-W373 of 3100%
2026-W383 of 3100%
2026-W393 of 3100%
2026-W402 of 367%
2026-W411 of 333%

AA/NA Outside MeetingsCurrently tracked

2026-W350 of 40%
2026-W363 of 475%
2026-W374 of 4100%
2026-W384 of 4100%
2026-W393 of 475%
2026-W403 of 475%
2026-W412 of 450%

SponsorCurrently tracked

2026-W350 of 10%
2026-W360 of 10%
2026-W371 of 1100%
2026-W381 of 1100%
2026-W391 of 1100%
2026-W400 of 10%
2026-W410 of 10%

Medication history

Ibuprofen200 mgCurrent

PrescriberNo prescriber recorded

ScheduleAs needed

StartedMon, Aug 24, 2026

EndedStill in force

As-needed: no fixed dose times

Lisinopril10 mgCurrent

PrescriberNo prescriber recorded

ScheduleEvery day

StartedMon, Aug 24, 2026

EndedStill in force

InventoryOn hand ~45

AM8:00 AM1 tablet

Naltrexone50 mgCurrent

PrescriberNo prescriber recorded

ScheduleEvery day

StartedMon, Aug 24, 2026

EndedStill in force

InventoryOn hand ~30

AM9:00 AM1 tablet

Sertraline100 mgCurrent

PrescriberNo prescriber recorded

ScheduleEvery day

StartedMon, Aug 24, 2026

EndedStill in force

InventoryOn hand ~60

AM8:00 AM1 tablet

Vitamin D1000 IUCurrent

PrescriberNo prescriber recorded

ScheduleEvery day

StartedMon, Aug 24, 2026

EndedStill in force

InventoryOn hand ~90

PM8:00 PM1 capsule

Goal progression

No goals were recorded during this admission

Supplies held

No supplies are recorded as held

Recovery Facility

Facility roster

Resident: All active residents
Reporting period: Oct 5–Oct 11, 2026 W41
Generated: Fri, Oct 9, 2026, 11:40 AM

Notice to accompany disclosure — 42 CFR §2.32(a)

This record which has been disclosed to you is protected by Federal confidentiality rules (42 CFR part 2). These rules prohibit you from using or disclosing this record, or testimony that describes the information contained in this record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against the patient, unless authorized by the consent of the patient, except as provided at 42 CFR 2.12(c)(5) or as authorized by a court in accordance with 42 CFR 2.64 or 2.65. In addition, the Federal rules prohibit you from making any other use or disclosure of this record unless at least one of the following applies: (i) Further use or disclosure is expressly permitted by the written consent of the individual whose information is being disclosed in this record or as otherwise permitted by 42 CFR part 2. (ii) You are a covered entity or business associate and have received the record for treatment, payment, or health care operations, or (iii) You have received the record from a covered entity or business associate as permitted by 45 CFR part 164, subparts A and E. A general authorization for the release of medical or other information is NOT sufficient to meet the required elements of written consent to further use or redisclose the record (see 42 CFR 2.31).

13 Active residents

81% Facility compliance

6 Compliant

4 Marginal

3 Non-compliant

Medication counts are for Fri, Oct 9, 2026

Active roster

Resident 01House A · Room 1 · Bed A100%Compliant

Tasks met15 of 15

WorkingNo

Medications today0

Doses taken today0 of 0

House Chore Done Daily7 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings4 of 4Sponsor1 of 1

Resident 02House A · Room 1 · Bed B79%Marginal

Tasks met11 of 14

WorkingNo

Medications today1

Doses taken today1 of 1

House Chore Done Daily5 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings3 of 4

Resident 03House A · Room 2 · Bed A100%Compliant

Tasks met14 of 14

WorkingNo

Medications today0

Doses taken today0 of 0

House Chore Done Daily7 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings4 of 4

Resident 04House A · Room 2 · Bed B67%Non-compliant

Tasks met10 of 15

WorkingNo

Medications today5

Doses taken today2 of 4

House Chore Done Daily7 of 7IOP Group Sessions1 of 3AA/NA Outside Meetings2 of 4Sponsor0 of 1

Resident 05House A · Room 3 · Bed A93%Compliant

Tasks met14 of 15

WorkingNo

Medications today0

Doses taken today0 of 0

House Chore Done Daily6 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings4 of 4Sponsor1 of 1

Resident 06House A · Room 3 · Bed B80%Marginal

Tasks met12 of 15

WorkingNo

Medications today1

Doses taken today0 of 2

House Chore Done Daily6 of 7IOP Group Sessions2 of 3AA/NA Outside Meetings3 of 4Sponsor1 of 1

Resident 07House A · Room 4 · Bed A53%Non-compliant

Tasks met8 of 15

WorkingNo

Medications today1

Doses taken today0 of 1

House Chore Done Daily4 of 7IOP Group Sessions2 of 3AA/NA Outside Meetings2 of 4Sponsor0 of 1

Resident 08House A · Room 4 · Bed B100%Compliant

Tasks met14 of 14

WorkingNo

Medications today0

Doses taken today0 of 0

House Chore Done Daily7 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings4 of 4

Resident 09House B · Room 1 · Bed A80%Marginal

Tasks met12 of 15

WorkingNo

Medications today1

Doses taken today0 of 1

House Chore Done Daily5 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings3 of 4Sponsor1 of 1

Resident 10House B · Room 1 · Bed B100%Compliant

Tasks met15 of 15

WorkingNo

Medications today0

Doses taken today0 of 0

House Chore Done Daily7 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings4 of 4Sponsor1 of 1

Resident 11House B · Room 2 · Bed A40%Non-compliant

Tasks met6 of 15

WorkingNo

Medications today0

Doses taken today0 of 0

House Chore Done Daily3 of 7IOP Group Sessions1 of 3AA/NA Outside Meetings2 of 4Sponsor0 of 1

Resident 12House C · Room 1 · Bed A73%Marginal

Tasks met11 of 15

WorkingNo

Medications today1

Doses taken today0 of 1

House Chore Done Daily5 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings3 of 4Sponsor0 of 1

Resident 13House C · Room 1 · Bed B93%Compliant

Tasks met14 of 15

WorkingNo

Medications today0

Doses taken today0 of 0

House Chore Done Daily7 of 7IOP Group Sessions3 of 3AA/NA Outside Meetings4 of 4Sponsor0 of 1

Recovery Facility

Accounting of Disclosures (45 CFR §164.528)

Resident: Resident 04
Reporting period: Mon, Aug 24, 2026 to Thu, Oct 8, 2026 (all entries on record)
Generated: Fri, Oct 9, 2026, 11:40 AM

Notice to accompany disclosure — 42 CFR §2.32(a)

This record which has been disclosed to you is protected by Federal confidentiality rules (42 CFR part 2). These rules prohibit you from using or disclosing this record, or testimony that describes the information contained in this record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against the patient, unless authorized by the consent of the patient, except as provided at 42 CFR 2.12(c)(5) or as authorized by a court in accordance with 42 CFR 2.64 or 2.65. In addition, the Federal rules prohibit you from making any other use or disclosure of this record unless at least one of the following applies: (i) Further use or disclosure is expressly permitted by the written consent of the individual whose information is being disclosed in this record or as otherwise permitted by 42 CFR part 2. (ii) You are a covered entity or business associate and have received the record for treatment, payment, or health care operations, or (iii) You have received the record from a covered entity or business associate as permitted by 45 CFR part 164, subparts A and E. A general authorization for the release of medical or other information is NOT sufficient to meet the required elements of written consent to further use or redisclose the record (see 42 CFR 2.31).

Consent accompanying this disclosure — 42 CFR §2.32(b)

Required by 42 CFR §2.32(b): this disclosure is made under the patient’s written consent, signed and held by the program. The scope of that consent is set out in full below.

Audit chain verified through entry 148 (148 entries).

"Facility-wide" entries are disclosures of the whole facility record, such as a backup, that included this resident. They do not mean this record was opened on its own.

When	Disclosure	Scope	By	Record	Details
Mon, Aug 24, 2026, 10:10 AM	Full-record read	Facility-wide	Avery Admin	Full facility record
Tue, Sep 1, 2026, 10:05 AM	Consent captured (record management — not a disclosure)	This resident	Avery Admin	Consent
Fri, Sep 18, 2026, 11:30 AM	Record update	Facility-wide	Avery Admin	Facility record changes
Fri, Oct 2, 2026, 10:10 AM	Report generated for disclosure	This resident	Avery Admin	Printed report	Report: Weekly accountability report. Period: 2026-W40. Released to: Example County Probation. Purpose: Court-ordered progress reporting
Mon, Oct 5, 2026, 9:00 AM	Internal print recorded (not a disclosure)	This resident	Avery Admin	Printed report	Report: Medication administration record. Period: 2026-10. Internal use, not released outside the program
Thu, Oct 8, 2026, 8:30 AM	Report generated for disclosure	This resident	Avery Admin	Printed report	Report: Resident summary report. Period: 2026-08-24..2026-10-08. Released to: not recorded. Purpose: not recorded

Today

Medications today

Pending meetings

Refills

Supplies not issued

Out / Back

Rent

Transportation

Weekly accountability report

Tracking requirements

Recovery

Outpatient groups

Legal

Issues and concerns

Medication narrative

Weekly schedule

Goals

Transitional plan

Employment verification

School verification

Volunteer verification

Scheduled work hours

Medication administration record

Adherence — October 2026

Scheduled medications

As-needed (PRN) medications

Physical pill counts

Resident summary report

Resident

Weekly compliance, admission to date

Current tracking requirements

Requirement history

Medication history

Goal progression

Supplies held

Facility roster

Active roster

Accounting of Disclosures (45 CFR §164.528)