UCAOA Policy & Procedure Manual 2017 Edition. Table of Contents

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1 UCAOA Policy & Procedure Manual 2017 Edition 100.XXX Administration Table of Contents XXX- Advanced Beneficiary Notice (ABN) English Version 2020 Large Print XXX- Advanced Beneficiary Notice (ABN) English Version XXX- ABN Spanish Version 2020 Large Print XXX- Absent Medical Provider XXX- Abuse Neglect Overview or Reporting Responsibilities XXX- Abuse Neglect Violence State Reporting XXX- Abuse Reporting- Child/ Elderly Abuse Reporting XXX- Abuse Child Report or Neglect XXX- Advanced Beneficiary Notice (ABN) Form Instructions XXX- Advanced Beneficiary Notice XXX- Advance Directives Page XXX- Advance Directives Page XXX- Animal Bite Control Form- Oakland County (sample state or county specific) XXX- Animal Bite Reporting XXX- Animal Bite Reporting Guidelines Form- Louisiana (sample state or county specific) XXX- Animal Bites Reporting- Louisiana (sample state or county specific) XXX- Care Coordination Follow-Up PCP or Referring Physician XXX- Care Coordination Follow-Up Doc XXX- Care Coordination Referral Letter XXX- Care Coordination Sample Cover Letter PCP XXX- Collection Log Front Desk XXX- Consent In Office Procedure Form XXX- Disruption of Information Process XXX- Established Patient Intake Form XXX- Flag System Form XXX- Flag System- Managing Patient Flow XXX- Front Desk- Influenza Vaccine Consent XXX- Front Desk- Occ Med Acknowledgment of Responsibility for Charges for Workers Comp XXX- Front Desk- Auto Accident Claim Processing- UC XXX- Front Desk- Auto Acknowledgement of Responsibility for Charges XXX- Front Desk -Billing- Global Periods XXX- Front Desk- Billing- Recheck Policy XXX- Front Desk- Cash Pay Flu Shot- Patient Information Sheet XXX- Front Desk- Cash Drawer Log XXX- Front Desk-Chief Complaint /Consent for Treatment- Louisiana XXX- Front Desk- Consent for Treatment & Use of Disclosure of Protected Health Info Form XXX- Consent to Release of Information XXX- Front Desk- Customer Service Encounter

2 XXX- Front Desk- Established Patient Information Short Form XXX- Front Desk- Established Patient Update Form XXX- Front Desk- External Referrals or Service Options XXX- Front Desk Form- for Consent and Chief Complaints XXX- Front Desk Form - Employee Discount Request Form XXX- Front Desk Form- for Notice of Receipt of Privacy XXX- Front Desk Form- Patient Registration XXX- Front Desk Form- Payment Policies XXX- Front Desk Form- Practice to Release Private Health Information to Third Parties XXX- Front Desk Form- Supplemental Claims Information XXX- Front Desk- Forms Request- Completion of Forms XXX- Front Desk- Influenza Vaccine Cash Pay Form XXX- Front Desk- Log Collections XXX- Front Desk- Log Patient Registration XXX- Front Desk- Medical Treatment Discount XXX- Front Desk- Medical Treatment Discount- Discounted Services XXX- Front Desk- Missing Router XXX- Front Desk- Occ Med Employer Authorization Form XXX- Front Desk- Occ Med Medical Record Form XXX- Front Desk- Occ Med Patient Form XXX- Front Desk- Occ Med Patient Registration Form XXX- Front Desk- Occ Med Work Status Form XXX- Front Desk- Occ Med Worker Intake Form XXX- Front Desk- Patient Call Back Forms XXX- Front Desk- Patient Check Out XXX- Front Desk- Patient Identifiers XXX- Front Desk- Patient Information Sample Form XXX- Front Desk- Patient Payments XXX- Front Desk- Patient Presentation of Serious Illness or Injury XXX- Front Desk- Patient Registration XXX- Front Desk- Patient Information Consent Form XXX- Front Desk-Patient Identification XXX- Front Desk- Receipt of Privacy Documents Acknowledgement XXX- Front Desk- Time of Service Collections V XXX- Front Desk- Time of Service Collections XXX- Front Desk- Visit Policy XXX- Front Desk- Workers Compensation Claims Policy XXX- Front Desk- Workers Compensation Claims Processing XXX- Governance- Social Media XXX- Governance- Clinical Work Flow XXX- Governance- Corporate Spending Expense Report Sample XXX- Governance- Corporate Spending XXX- Governance- Employee Recognition Committee XXX- Governance- Finance Capitalization

3 XXX- Governance- Management Leadership Competencies XXX- Governance- Mission Statement XXX- Governance- Mission and Core Values Statement XXX- Governance- Operations Committee Policy XXX- Governance- Organizational Chart- Leadership Sample XXX- Governance- Organizational Hierarchy and Clinical Staffing Model XXX- Governance Organization Meetings XXX- Governance- Organization Chart XXX- Governance- Purpose, Governance Policy XXX- Governance- Scope of Service and Population Served XXX- Governance- Scope of Services Policy XXX- Governance- Social Media Policy XXX- Identity Theft and Red Flag Rules XXX- Influenza Immunization Consent Form XXX- Informed Consent for Procedure Form XXX- Informed Consent for Procedure Information XXX- Interpretive Services and Communication Barriers XXX- Interpretive Services- Louisiana and Texas XXX- Minors Treatment- State Specific XXX- Non- Retaliation Policy XXX- Occ Med Audiometer Calibrations XXX- Occ Med Direct Billing Protocol Policy XXX- Occ Med End of Day Staff Activities XXX- Occ Med Pulmonary Function Testing Machine Calibrations XXX- Occ Med Respiratory Fit Test Machine Calibrations XXX- Opening and Closing Procedures with Checklist XXX- Patient Call Follow Up Contact XXX- Patient Intake Form XXX- Patient Rights and Ethical Care XXX- Patient Rights and Responsibilities Policy XXX- Patient Rights Specific Request Form XXX- Policy/ Procedure/ Forms Management XXX- Policy and Procedure Process XXX- Policy and Procedure Request XXX- Policy and Procedure Template XXX- Prescription Secure Handling XXX- Privacy Practices Acknowledgement Form XXX- Radiology Only Process XXX- Radiology Only Log XXX- Router Form XXX- Signature and Initial Sample Log XXX- Telephone Encounter XXX- Terminating a Patient from the Practice XXX- Unable to Reach Patient About Test Results

4 200.XXX- Human Resources, Orientation, Competencies, Credentialing XXX- Behavior of Employee XXX- Incident Reporting Employee Policy XXX- Peer Review- Medical Provider XXX- Absenteeism and Tardiness XXX- Absenteeism and Sick Leave XXX- ACLS Requirement and Training XXX- ACLS BLS PALS Training XXX- Annual Training and Review Checklist XXX- Annual Training XXX- Appointment Approval Sample Letter XXX- Appointment- Authorization to Release information XXX- Appointment- Authorization Release Form XXX- Appointment- Authorization Consent to Release of Information XXX- Appointment- Provider Checklist XXX- Appointment- Reappointment Application XXX- Background Checks XXX- Background Check Release Organization XXX- Background Checks XXX- Behavior- Discrimination/ Harassment XXX- Behavior- Patient Non- Discrimination XXX- BLS Requirement and Training XXX- BLS Requirement and Training XXX- Breaks and Meals XXX- Breaks XXX- Catheterization Straight Female XXX- Code of Conduct XXX- Competencies Annual Checklist XXX- Competencies XXX- Competency- Checklist New Hire XXX- Competency- Clean Catch XXX- Competency- Digital X-Ray Images XXX- Ear irrigation XXX- Competency- Injectable Medication XXX- Competency- Injection IM XXX- Competency- Injection Subcutaneous XXX- Competency- Specimen Labeling and Handling XXX- Competency- TB Mantoux Skin Test XXX- Competency- Tuberculin Skin Test Mantoux XXX- Competency- Vital Signs XXX- Complaint Form Employee XXX- Conflict of Interest Form Attachment 1

5 XXX- Conflict of Interest Attachment XXX- Conflict of Interest Policy XXX- Conflict of Interest XXX-Credentialing Appeals Process XXX- Credentialing Disclosure Claims Information Form XXX- Credentialing of Providers XXX- Credentialing- Appointment/Reappointment XXX- Credentialing- Initial Verification Form XXX- Credentialing- License Insurance Verification XXX- Credentialing- Practitioner Profile for Appointment Cover Sheet XXX- Credentialing- Provider XXX- Credentialing- Release and Immunity- Initial Application XXX- Criminal Background Checks XXX- Cultural Diversity XXX- Cultural Awareness and Sensitivity Training XXX- Cultural Sensitivity XXX- Dress and Appearance XXX- Drug/Alcohol Free Environment XXX- Electronic Devices, Use of XXX- Employee Change Form XXX- Employee File Contents XXX- FMLA Disability Forms XXX- Hepatitis Vaccine for Employees XXX- Incident Employee Form XXX- Influenza Vaccination Program for Employees XXX- Job Description Template XXX- Job Description Policy XXX- License Verification-Non-Provider for Louisiana XXX- Medical Staff Appointment-Reappointment Application XXX- Medical Staff Approval of Appointment- Generic Letter XXX- Medical Staff Delineation of Privileges XXX- Non-Discrimination XXX- Onboarding Form- HIPAA Acknowledgement XXX- Onboarding Form- Hepatitis B Vaccination Election XXX- Onboarding I9 Form- Employment Eligibility Verification XXX- Onboarding Provider Checklist XXX- Orientation- and Training- New Hire XXX- Orientation- Checklist Pre-Patient Care XXX- Orientation- Billing Checklist XXX- Orientation- Clinical XXX- Orientation- Employee XXX- Orientation- Physician Checklist XXX- Orientation- Proficiency Requirements XXX- Orientation- Reception Checklist

6 XXX- Peer Review Medical Provider Form XXX- Performance Appraisal Template XXX- Physician Insurance Check List XXX- Privacy Employee XXX- Privileges Delineation XXX- Proficiencies XXX- Reappointment- Release and Immunity XXX- Re-credentialing Verification Form XXX- Reimbursement-CME XXX- Roles and Responsibilities- Medical Director XXX- Scheduling Change Requests XXX- Scheduling Time Off- Holidays XXX- Scheduling Time Off- Provider XXX- Student Letter Sample XXX- Student Rotation or Shadowing Policy XXX- Student Shadowing Form XXX- Student Application XXX- Student Checklist XXX- Substance Use- Prohibited XXX- Supervision- Advanced Practice Clinicians XXX- Termination from Employment Form XXX- Termination Involuntary Form XXX- Time and Attendance XXX- Training- Annual Training Checklist XXX- Training Required XXX- Tuberculosis Annual Questionnaire XXX- Tuberculosis Testing- Employee XXX- Tuberculosis TST Questionnaire XXX- Vacation, Sick, Holiday Pay Eligibility XXX- Vehicle Use- Release of Driving Record Form XXX- Vehicle Use-Safety XXX- Video and Audio Recording XXX- Warning Form 300.XXX- Clinical, General, Occ Med XXX- Abuse and Assault Treatment XXX- Chaperones XXX- Consent- Informed XXX- Consent- Informed Form XXX- Consent- Informed XXX- Discharge Guidelines XXX- Discharge Instructions Policy

7 XXX- Discharge Instructions Form Template XXX- Ear Irrigation XXX- Education- Patient and Family XXX- EKG Operation XXX- Emergency Situations XXX- Emergency Transfers XXX- Emergency Transfers Log XXX- Emergency Transfers Tracking Policy XXX- Emergency Transfers XXX- Emergency Staff Responsibility During Cardiac Arrest XXX- Eye Irrigation XXX- Fast Track Patient Assessment XXX- Fecal Specimen Collection XXX- Fecal Specimen XXX- Gait Training/Crutch Fitting XXX- Hard of Hearing Patient XXX- Hepatitis B Acknowledgement Form XXX- Identifiers- Patient XXX- Identifiers- Patient XXX- Nasal Specimen XXX- Occ Med- Breath Alcohol Testing XXX- Occ Med- Employers Authorization for Examination or Treatment XXX- Occ Med- Pre-Employment/Return to Work Clearance Form XXX- Occ Med- Pre-Placement Examination-Pre-Employment Return to Work Combo XXX- Occ Med- Return to Work Examination XXX- Occ Med- Audiometric Testing and Screening XXX- Occ Med- Breath Alcohol Test Checklist XXX- Occ Med- Breath Alcohol Testing XXX- Occ Med- DOT Physical Exam XXX- Occ Med- DOT Physical Exam XXX- Occ Med- Grip Strength Testing XXX- Occ Med- Physical- Return to Work XXX- Occ Med- Pre-Employment Return to Work Clearance Form XXX- Occ Med- Pre-Placement Exam and Physical Exam Form- Two Forms XXX- Occ Med- Pre-Placement Physical Policy XXX- Occ Med- Pre-Placement Physical XXX- Occ Med- Pre-Placement Physical XXX- Occ Med- Pulmonary Function Testing XXX- Occ Med- Respirator Fit Tests XXX- Occ Med- Vision Screening-Titmus Ishihara XXX- Orders- Standing XXX- Orders XXX- Oxygen Administration XXX- PCP Follow Up Letter- Rochester (sample)

8 XXX- Pediatric Bulb Suctioning XXX- Pediatric Fever Control XXX- Pediatric IV Therapy XXX- Pelvic Exam XXX- Physical Examinations XXX- Physical- Return to Work XXX- Physical- Sports XXX- Physician Inquiries- Walk-in Established Patients XXX- Referral Letter XXX- Refusal of Care Against Medical Advice-Left Exam Room XXX- Refusal of Care AMA Acknowledgement XXX- Refusal of Care Form XXX- Refusal of Care- Left Without Being Seen XXX- Refusal of Care XXX- Refusal of Treatment- Attachment XXX- Return to Work- School Note XXX- Sports Physical Form from Michigan High School Athletic Association XXX- Suture/Staple Removal XXX- Td or Tdap Consent XXX- Telephone Advice XXX- Throat Specimen XXX- Triage Process- Check In XXX- Tuberculosis Skin Test Consent and Results XXX- Tuberculosis Test Consent and Results XXX- Tuberculosis Test Log XXX- Tuberculosis Positive Exempt Surveillance Questionnaire XXX- Tuberculosis Screening Mantoux XXX- Urine Collection- Female Catheter XXX- Urine Collection- Male Catheter XXX- Vaccine Influenza XXX- Vital Signs 2 Attachment XXX- Vital Signs XXX- Vital Signs- Pediatric XXX- Vital Signs 400.XXX- Medication XXX- Adverse Reactions Management XXX- Adverse Reactions Management XXX- Dispensed Medication Log XXX- Dispensing Practitioner- Point of Care Dispensing Indiana XXX- Expired Medication or Hazard Disposal Log XXX- Formulary- Annual Review

9 XXX- Formulary- Approved XXX- Immunization Reporting State- Louisiana XXX- Influenza Control Log XXX- Influenza Immunization Sign in Sheet XXX- Influenza Immunization- CDC Patient Information XXX- Influenza Vaccine Immunization Administration XXX- IV- Adding Medication XXX- IV- Bolus XXX- IV- Discharging XXX- IV- Monitoring the Site XXX- IV- Push XXX- IV- Starting XXX- L.E.T. Application XXX- Medical Recall Log XXX- Medication Refrigerator- Temperature Check Graph XXX- Medication- Administration XXX- Medication- Administration Error XXX- Medication- Administration XXX- Medication- Disposal Log XXX- Medication- Expiration Date Audit XXX- Medication- Management Inspection Checklist XXX- Medication- Samples Log XXX- Medication- Tracking Form XXX- Medication- Alerts/Warnings XXX- Medication- Disposal Log XXX- Medication- Disposal XXX- Medication- Expired Log XXX- Medication- Injection Log XXX- Medication- Refrigerator Temperature XXX- Medication- Sample Receipt Log XXX- Medication- Samples Management XXX- Medication- Samples Management XXX- Medication- Samples Dispensed Log XXX- Medication- Samples Log XXX- Medication- Security Storage Disposal XXX- Medications and Dated Patient Items Review Log XXX- Narcotic Monitoring Daily Log XXX- Narcotic Controlled Substance Inventory Log XXX- Narcotic Controlled Substance Control XXX- Pharma Rep- Confidentiality Form XXX- Recall- Medication, Product, or Equipment XXX- Recall- Medication XXX- Request for New Medication or Service Policy XXX- Td or Tdap Consent

10 XXX- Td or Tdap XXX- Td or Tdap CDC Informational Sheet XXX- Vaccine Encounter XXX- Vaccine Refrigerator/Freezer Temperature Log XXX- Vaccine Reporting Form 500.XXX- Laboratory XXX- Stool Collection Policy XXX- CLIA Waived Testing XXX- Competency- Fecal Occult Blood XXX- Competency- Glucometer XXX- Competency- hcg Urine Cassette Pregnancy Test XXX- Competency- Influenza A & B Test XXX- Competency- Mono Test XXX- Competency- Strep A Test XXX- Competency- Urinalysis XXX- Competency- Critical Test Results- After Hours XXX- Encounter Lab Only XXX- Glucometer XXX- Glucose Level Testing XXX- H. Pylori Testing XXX- Hemoccult XXX- HIV Testing XXX- Influenza Testing XXX- Influenza Molecular Testing XXX- Lab Courier Form XXX- Lab Environment Criteria XXX- Lab Ordering and Tracking Results XXX- Log- Glucometer XXX- Log- Glucometer XXX- Log- hcg XXX- Log- hcg XXX- Log- Hemoccult XXX- Log- Hemoccult XXX- Log- H. Pylori Control XXX- Log- Influenza AB XXX- Log- Influenza AB XXX- Log- Bab Daily Quality Controls XXX- Log- Mono Test XXX- Log- Mono Test XXX- Log- Room Temperature and Humidity XXX- Log- RSV

11 XXX- Specimen Transport XXX- Log- Strep XXX- Log- Strep XXX- Log- Urine Analyzer Daily Maintenance XXX- Log- Urine Dipstick XXX- Manufacturer Package Inserts and Instructions XXX- Mono Test XXX- Non DOT Urine Drug Screen Collection XXX- Occ Med Drug Screen, DOT and Non- DOT Collection XXX- Patient Preparation XXX- Point of Care Testing and Results Reporting XXX- Pregnancy hcg XXX- Quality Controls XXX- Reagents- Lab XXX- Records Retention- Lab XXX- Refrigerator- Lab Specimen- Temperature Check Graph XXX- Room Temperature and Humidity XXX- RSV XXX- Safety Overview Lab XXX- Send Out Reference Lab Procedure XXX- Send Out Unable to Complete Test Procedures XXX- Specimen- Blood XXX- Specimen- Fasting XXX- Specimen- Identification XXX- Specimen- Preparation and Transport XXX- Specimen- Urine Clean Catch XXX- Specimen- Wound or Viral XXX- Specimen- Unacceptable XXX- Strep Testing XXX- Training- CLIA Waived Documentation XXX- Urinalysis Results Form XXX- Urinalysis Dipstick XXX- Urinalysis Dipstick XXX- Urine Drug Screen Affidavit of Correction (Memorandum for Record) XXX- Waived Testing Overview 600.XXX- Radiology XXX- Outside X-Ray Protocol XXX- Over-reads Process XXX- Over-reads XXX- Patient Log XXX- Pregnancy Consent Form

12 XXX- Radiation Protection XXX- Radiation Discrepancy Policy XXX- Radiation Protection XXX- Radiology Read Discrepancy Log XXX- Radiology Safety XXX- Radiology Summary- Monthly XXX- Radiology Tracking Log XXX- Radiology Tracking XXX- Request for X-Ray 700.XXX- Infection Control XXX- Autoclave- Maintenance Monthly Log XXX- Autoclave- Maintenance XXX- Autoclave- Bio Monitoring Policy XXX- Autoclave- Bio Monitoring XXX- Autoclave- Bio Log XXX- Autoclave- Instruments XXX- Autoclave- Log XXX- Autoclave- Procedures XXX- Autoclave- Spore Checks XXX- Cleaning Responsibilities XXX- Communicable Disease Report Form XXX- Communicable Disease Reporting- Louisiana XXX- Communicable Disease Reporting- State Specific XXX- Daily Surface Disinfectant Log XXX- Exposure- Consent Form XXX- Exposure- Control Plan XXX- Exposure- Employee (Biological) XXX- Exposure- Follow Up Protocol XXX- Exposure- Incident Report XXX- Glove Use Audit XXX- Gloving Procedures- WHO Guidelines XXX- Hand Hygiene Policy XXX- Hand Hygiene- CDC XXX- HIV- Healthcare Workers- CDC XXX- Infection Control and Cleanliness Overview XXX- Infection Control- Annual Program Evaluation XXX- Infection Control- Sample Audit XXX- Infection Prevention and Control XXX- Infection Control- Annual- Infection Prevention and Control Surveillance Audit XXX- Infectious Disease- Emergency Response XXX- Infectious Disease Reporting Form

13 XXX- Instruments- Reusable XXX- Personal Protective Equipment- OSHA- Fact Sheet XXX- Personal Protective Equipment- OSHA- Cuts Risk XXX- Reportable Conditions Example- State Specific Policy XXX- Sharps Bloodborne Fact Sheet- OSHA XXX- Sterile Field Preparation XXX- Tuberculosis Annual Screening Questionnaire XXX- Tuberculosis Annual Test Questionnaire XXX- Tuberculosis- Risk Reduction Plan- Louisiana XXX- Universal Precautions- CDC XXX- Universal Precautions Policy 800.XXX- Quality & Safety XXX- Quality and Performance Improvement Plan Form XXX- AED Machine Log XXX- Body Mechanics and Ergonomics XXX- Closure of Center (Unforeseen) XXX- Complaint and Grievance Resolution Policy XXX- Complaint and Grievance- Civil Rights XXX- Complaint- Completing Form and Process XXX- Complaint Form XXX- Complaint Letter- Requesting Emp. Response XXX- Complaint Letter to Complainant XXX- Complaints Tracking Spreadsheet XXX- Crash Cart- Set-Up XXX- Crash Cart- Inventory XXX- Crash Cart-Log (Seals) XXX- Crash Cart- Maintenance XXX- Drill- Behavior Disruption XXX- Drill- EMR Outage XXX- Drill- Internal Event XXX- Drill- Medical Emergency Form XXX- Drill- Missing Person XXX- Drill- Participant Roster XXX- Security Threat XXX- Drill- Severe Weather XXX- Drills- Annual Schedule XXX- Drills- Mock Code XXX- Emergency Preparedness Notification Call Tree XXX- Emergency Evacuation- Fire Explosion XXX- Emergency Evacuation- Sample Center Map XXX- Emergency Management

14 XXX- Emergency Preparedness- Refrigerated Med Test Kits XXX- Emergency Response- Inventory Log XXX- Emergency Response- Inventory Tags XXX- Emergency Response Kit- Inventory XXX- Environment of Care- Annual Assessment XXX- Equipment- AED Daily Log XXX- Equipment- AED Monitoring XXX- Equipment- Annual Evaluation Form XXX- Equipment- Biomedical Inspections XXX- Equipment- Management XXX- Equipment- Management and Maintenance XXX- Equipment- Medical Device Reporting XXX- Equipment- Refrigerator and Freezer Temperature Log XXX-Equipment- Refrigerator Log- Cleaning XXX- Equipment- Refrigerator Log- Temperature with Ranges XXX- Equipment-Refrigerator- Monitoring and Maintenance XXX- Equipment- Refrigerator Temperature Monitoring XXX- Equipment- Refrigerator- Vaccine Storage XXX- Equipment- Safety Evaluation Form XXX- Equipment- Vaccine Refrigerator- Temperature Log XXX- External Events XXX- Fire Drill Record XXX- Fire Safety Inspection Checklist XXX- Fire Safety Version XXX- Fire Safety XXX- Fire Audit XXX- Hazardous Materials and Waste Inspection Checklist XXX- Hazardous Mat- Communication XXX- Hazardous Mat- Disposal XXX- Hazardous Mat- List Sample XXX- Hazardous Mat- List XXX- Hazardous Mat- Materials and Waste XXX- Hazardous Mat- Soiled Instrument and Item Transport XXX- Incident and Occurrence- Patient or Visitor Policy XXX- Incident and Occurrences-Corrective Action Documentation XXX- Incident or Occurrence Report- Building XXX- Incident or Occurrence Report- Employee Only XXX- Incident Report- Accident Form XXX- Incident Report- Patient or Visitor Form XXX- Incident Report Policy XXX- Incident Corrective Action XXX- Incident- Root Cause Analysis XXX- Incident- Sentinel Event XXX- Incident- Significant Investigative Report Form

15 XXX- Incident- Significant Policy XXX- Medical Equipment Inspection Checklist XXX- Medical Equipment Safety Evaluation Form XXX- Near Miss Report XXX- Patient Satisfaction- Measuring Outcomes XXX- Patient Satisfaction- Phone Survey Spreadsheet XXX- Patient Satisfaction- Survey Policy XXX- Patient Throughput- Time Measuring XXX- Physical Environment- Non-Smoking XXX- PPE- OSHA Facts XXX- Quality and Performance Improvement Plan XXX- Quality and Performance Improvement Plan XXX- Quality and Performance Improvement- PDCA Form XXX- Quality Management- Sample Overarching Plan XXX- Safety and Health Overview XXX- Safety Inspection- Environment of Care- Annual Evaluation XXX- Safety- Accessing and Securing the Center XXX- Safety- Annual Assessment Form XXX-Safety- Annual Device Evaluations- OSHA XXX- Safety- Device Evaluation Form XXX- Safety- Electrical and Hazardous Energy XXX- Safety- Electrical Heater and Purifiers Prohibition XXX- Safety- Environmental Annual Assessment XXX- Safety- Environmental XXX- Safety- Facility Hazard Assessment XXX- Safety- Fire Control XXX- Safety- Fire Control XXX- Safety- Inspection Checklist XXX- Safety- Monthly Center Evaluation Form XXX- Safety- Monthly Center Evaluation Policy XXX- Safety- Panic Button and Security System XXX- Safety- Panic Button XXX- Safety- Pediatric XXX- Safety- Security Annual Review XXX- Safety- Security XXX- Safety- Weapons Prohibition XXX- Safety Survey- Annual XXX- Security Inspection Checklist XXX- Service Animals Access XXX- Sharps- OSHA Facts Sheet XXX- Utilities- Annual Review XXX- Utilities- Annual Review XXX- Utilities- Inspection Checklist XXX- Utilities- Outages

16 900.XXX- Medical Records XXX- Abbreviations- Do Not Use XXX- Abbreviations- Do Not Use List XXX- Abbreviations- Do Not Use XXX- Chart Audit Review- Tool XXX- Chart System XXX- Completion of Forms XXX- Documentation Guidelines XXX- Documentations Guidelines XXX- Medical Record Audit XXX- Medical Record Retention XXX- Missing Router XXX- Outages or Disruption XXX- Outages- Disruption in Patient Information Processes XXX- Patient Chart- Computer Down Policy XXX- Patient Chart- Discharge Instructions XXX- Patient Chart- Paper Nurses Note XXX- Patient Chart- Paper Progress Note XXX- Patient Chart- Paper XXX- Patient Medical Record- Processing XXX- Progress Notes XXX- Release of Medical Records Policy XXX- Release of Medical Records Form XXX- Release of Medical Records XXX- Release PHI- Patient Authority XXX- Release- Patient Authorization- PHI to Third Parties XXX- Request for Medical Records Letter Sample XXX- Retention and Management of Medical Records XXX- Router Form XXX- Router XXX- Superbill Sample

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