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Patient Property Inventory Form |
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Manual: Ambulatory Services Environment of Care Manual (Ver 3) External Reference: (TJC EC.2.10)
As the health care industry’s most comprehensive library of customizable policy and procedure templates, MCN Healthcare’s Ambulatory Services Environment of Care Manual includes this customizable template, Patient Property Inventory Form. MCN’s policy library helps you meet compliance with Joint Commission and federal regulations including CMS, CDC, OSHA, OIG, HIPAA and more. MCN provides more than 80 health care specific policy and procedure manuals for Acute Care Hospitals, Ambulatory Care, Behavioral Health, Home Health, Physician Practice, and Long Term Care. MCN’s policy and procedure manuals focus on the latest healthcare "hot topic" issues related to patient safety and prevention of medical healthcare errors. Here is some sample content from Patient Property Inventory Form:
| | PATIENT PROPERTY INVENTORY
Patient's Name:
Patient's Signature:
Persons authorized to withdraw property other than patient:
Relationship to Patient:
Officer:
Indicate all patient property received by Security personnel:
Quantity
Item
Quantity
Item
Cash $
Clothing
Checks
Eyeglasses
Traveler's Checks
Purse
Money Orders
Wallet
Bracelet
Keys
Earrings
Knife
Necklace
Other List
Watch
Rings
Pins
Disposition:
Patient Property Released to:
List Property Released:
q Property Released in Entirety
Releasing Officer:
q Property Impounded
Comments:
Reference #2013 Ambulatory Care EOC... |
| Second excerpt: |
| | ...$
Clothing
Checks
Eyeglasses
Traveler's Checks
Purse
Money Orders
Wallet
Bracelet
Keys
Earrings
Knife
Necklace
Other List
Watch
Rings
Pins
Disposition:
Patient Property Released to:
List Property Released:
q Property Released in Entirety
Releasing Officer:
q Property Impounded
Comments:
Reference #2013 Ambulatory Care EOC... |
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