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Regional Memorial Hospital Inpatient Report Checklist
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Patient First Name
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Patient Last Name
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Patient MRN #
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Patient Date of Birth
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H&P Report Enter or Attach
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H&P Report Completed
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Anesthesia Report Enter or Attach
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Anesthesia Report Completed
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Discharge Summary Enter or Attach
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Discharge Summary Report Completed
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Consultation Report Enter or Attach
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New Yes / No
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Physician's Order Report Enter or Attach
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New Yes / No
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Progress notes Enter or Attach
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New Yes / No
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Diagnostic & Lab Report Enter or Attach
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New Yes / No
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Inpatient Certification Enter or Attach
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New Yes / No
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Admission Order Enter or Attach
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New Yes / No
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Surgical Procedure Report Enter or Attach
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New Yes / No
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Medication Administration Enter or Attach
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New Yes / No
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Nurse's Notes Enter or Attach
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New Yes / No
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Ambulance Run Sheet Enter or
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New Yes / No
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Signed ABN/HINN
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New Yes / No
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Submit to Billing
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