Patient Care Facility Accreditation Guide

The online Resource Pack is the go-to source for sample forms, templates, checklists and articles available to review, use and modify to fit a practice’s needs. It is accessible through the facility’s MY ABC account.

Resource Pack Includes:

Administrative

• Annual Facility Review Checklist
• OIG Exclusion Checklist (AD.5.1)
• Patient Acknowledgement Form

Human Resources

• Employee Verification (HR.2, 4.1 and 4.2)
• Instructions for Establishing Privileging Criteria (HR.6 and 6.1)
• Individual Privileging Record Template (HR.6 and 6.1)
• Employee Performance Evaluation Form (HR.7)
• Assessment of Employee Continued Competency (HR.7)

Product Safety

• Equipment Maintenance Log (PS.3.1 and PS.12)

Performance Management

• Free Sample Patient Satisfaction Survey (PM.2)
• How to Write and Analyze Customer Satisfaction Surveys (PM.2.1)
• Guide to Patient Satisfaction Trends
• Billing and Coding Error Report (PM.6)

Facility Safety

• Safety Management Checklist (FS.1.1)
• Fire Emergency Drill Documentation (FS.3.2.1 and 3.2.2)
• Disaster Preparedness Resources (FS.3.3)

Claims and Billing

• Billing Education Documentation (CB.3)
• Patient Chart Audit Form (CB.4 and 4.1)

Patient Care

• Patient Care Communication Log

Miscellaneous

• Medicare Patient Phone Surveys
• Medicare Complaint Form
• CAP FAQ Flyer
• Sample Referral Thank You Card
• Sample Accreditation Press Release