Diagnosis: Mood dysregulation
Treatment: Residential treatment admission
The residential treatment admission was not medically necessary.

This patient's ongoing acting out behaviors were consistent with severe parent-child relational problems as well as her initial diagnosis of borderline personality disorder. The usual and acceptable standard of care for such conditions involves ongoing outpatient treatment, with possible partial hospitalization in the patient's community, and brief acute admissions only for situations of imminent danger.

The patient's chronic acting out behaviors as described in progress notes did not represent an acute danger to self or others, did not require 24-hour daily observation and treatment, and were unlikely to improve with such treatment.

It is apparent from the progress notes that this patient was unable to derive any benefit whatsoever from this residential stay. Furthermore, there was no evidence of appropriate psychiatric involvement throughout the stay.