Patient Administration - Army Publishing Directorate - U.S. Army

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clothing or equipment become lost through no fault of the patient, the patient will be compensated. When such a loss occurs, the patient administrator will prepare a memorandum which will serve to— (1) Relieve the Soldier of liability for Government-issued clothing or equipment. (2) Serve as evidence to claim reimbursement from the servicing claims office for lost personal clothing, effects, or personally purchased Government-issued items. 4–6. Patient accountability and admission processes a. Approved automated systems (for example, Composite Health Care System (CHCS)) are used in support of admission processes when available. (See automation system manual specific to the system.) DA Form 2985 (Admission and Coding Information) and DA Form 3648 (Coding Transcript-Individual Patient Data System) will be used during the admission and disposition process when automated systems are not available. b. The AAD office performs admission processing when a privileged provider desires to admit, discharge, or carded for record only (CRO). Patients requiring immediate emergency care are admitted directly to the treatment setting or service and admission processing is performed secondary to treatment. Deaths in the emergency room and deaths classified as dead on arrival (DOA) are not recorded as admissions. Procedures are locally developed for the admission of prisoners, patients with contagious diseases (for example, tuberculosis), psychiatric conditions, and victims of disasters. c. Admitting officers use DA Form 2985 to authorize an admission. The admitting officer will enter on either of these forms the patient’s name, ward, time, date of admission, admission diagnosis, and signature. All remaining entries are completed by AAD personnel. DA Form 4029 (Patient’s Clearance Record) is used as a means of ensuring that a patient clears all necessary hospital activities before discharge (for example, PTF, AAD). DA Form 2985 and DA Form 4029 are available on the APD Web site (www.apd.army.mil). d. Admission processes include but are not limited to— (1) Verifying eligibility for care. (2) Collecting other information required for preparing medical records and reports. (3) Initiating the inpatient treatment record (ITR). (4) Furnishing information to patients concerning advanced directives, living wills, and organ donations. (5) Obtaining insurance information. (6) Identifying patients on admission (ID bands). (See para 4-2.) (7) Inventorying personal effects and clothing. (See para 4-5.) (8) Receiving PTFs. (9) Coordinating air evacuations and transfers of patients. (10) Providing standard and ad hoc reports for information management and accountability of patients which may include but are not limited to the following: admissions by diagnosis; admission, discharge, and transfer notifications to units; alpha rosters of patients; patient diagnosis and procedures; projected admissions; inpatient histories; remaining over night rosters; ward rosters; absent sick patient rosters; casualty and command interest rosters; long-term patient rosters; WTU rosters; status out rosters; admission injury rosters; air evacuation bed capability status; and recapitulation table of inpatients. (11) Advising patient of financial responsibility for care to be received. e. The MTF commander will report an Army general officer’s admission, change in status, or release as soon as possible. The report, as described in (1) through (10) below, will be sent electronically at https://medcompad1@amedd. army.mil or faxed to: USAMEDCOM, Patient Administration Division, DSN 221-6630 during duty hours (0730-1630), Central Standard Time. After duty hours, notify the USAMEDCOM staff duty officer, DSN 471-8445, commercial (210) 221–8445. (1) Last name, first name, and middle initial. (2) Last four digits of the social security number. (3) Grade. (4) Position. (5) MTF and ward admitted. (6) Date of admission. (7) Brief medical diagnosis. (8) Prognosis and expected length of hospitalization. (9) Attending physician. (10) Name and telephone number of person reporting and date/time of reporting. The USAMEDCOM, Patient Administration Division will notify the OTSG, who in turn will notify HQDA, ATTN: DACS-GOM, Washington, DC. 4–7. NATO STANAG 2132 and ABCA QSTAG 470 International Agreement requirements NATO countries are defined in paragraph 3-18a. ABCA countries include Australia, Canada, New Zealand, United 36 AR 40–400 27 January 2010
Kingdom, and the United States The following requirements apply when military personnel of NATO or ABCA countries are patients in an Army hospital. a. Any medical unit that admits, treats, transfers, and discharges nationals of the other NATO/ABCA countries has the responsibility to notify-either direct or through the reporting nation’s staff channels-the national authority about casualties of that nation. b. Patients considered by the appropriate medical authority to be “Very Seriously Ill” (VSI) and/or “Seriously Ill” (SI) will be reported in special lists. Every variation of these special lists, as well as deaths in medical installations, will be reported immediately to allied authorities and to the casualty area command (CAC) responsible in the area in which the casualty was hospitalized. (Also see para 6-2e.) The loss of a hand, foot, limb, or eye will also be included. c. The minimum information to be reported to parent nations is as follows: (1) Designation and nationality of medical unit issuing list. (2) Serial number and date of issue of list. (3) Personal ID number. (4) Rank/grade. (5) Surname and initials of forenames. (6) Unit/regiment. (7) Nationality of the casualty’s unit/regiment. (8) Diagnosis. (Also showing whether VSI or SI and indicating if loss of a hand, foot, limb, or eye has occurred). (9) Category— (a) Hostile casualty. (b) Non-hostile accident/injury. (c) Sick/disease. (10) Date of admission, transfer out, or discharge. (11) Unit to which transferred or discharged (show nationality of unit). (12) If died, to be shown as “Died” giving date. d. When a member of NATO/ABCA forces dies and is examined by a medical officer, the medical officer should determine the cause of death and forward a completed death certificate to the deceased’s parent nation. Chapter 5 Dispositioning Patients 5–1. General policies a. Before military outpatients or inpatients are returned to their units, they will be evaluated for duty restrictions. Each member will also be evaluated under such special standards as may be applicable (for example, aviation, diving, airborne, or special forces). The long-range effect, if any, on the health and well-being of the patient after return to regularly assigned duties will be considered in the disposition to a duty status. A person who is unable to meet special standards but is otherwise fit for duty will not be continued in a disabled status. b. Military patients will be available for treatment at all times. Leave will not be granted when it will delay a patient’s disposition, except for emergencies. c. Army military patients who are administratively unsuitable for retention will be processed as prescribed in AR 600-8-24 and AR 635-200. d. Patients discharged from an MTF on weekends or holidays should be administratively processed on the preceding workday. e. Convalescent leave may be granted according to AR 600-8-10. All administrative actions should be expedited. However, no patient will be retained in an MTF solely to complete administrative actions. Military patients will not be kept in an MTF longer than is necessary to receive optimum hospital benefit. f. When efforts to disposition a patient are not successful, the case will be brought to the attention of the proper major Army medical command. 5–2. Responsibility for dispositions a. Army MTF commanders. MTF commanders will disposition patients under their jurisdiction and will evaluate medical fitness of military patients. b. Attending medical officers. Medical officers are responsible to the MTF commander for the timely care of assigned patients and their continual evaluation for early dispositions. c. MEB. The MEB assists the MTF commander in determining the medical fitness, mental competence, and disposition of patients. (See chap 6.) d. The Secretary of the Army. The responsibilities of the Secretary of the Army in administering the Physical AR 40–400 27 January 2010 37
Page 1 and 2: Army Regulation 40-400 Medical Serv
Page 3 and 4: Headquarters Department of the Army
Page 5 and 6: Contents—Continued Department of
Page 7 and 8: Contents—Continued Autopsy author
Page 9 and 10: Contents—Continued Chapter 13 Inj
Page 11 and 12: Chapter 1 Introduction 1-1. Purpose
Page 13 and 14: nonemergent specialty care. The Pri
Page 15 and 16: (1) If not prohibited under the law
Page 17 and 18: Table 2-3 Supplemental care payment
Page 19 and 20: a. Treatment during and after duty.
Page 21 and 22: the camp commander or the MTF comma
Page 23 and 24: e provided an employee paid from ap
Page 25 and 26: (2) The Health Insurance Portabilit
Page 27 and 28: (n) Section 13. Signature of the MT
Page 29 and 30: discharged or transferred. When an
Page 31 and 32: encompasses the geographic area whe
Page 33 and 34: (3) Peace Corps applicants. (a) Exc
Page 35 and 36: the emergency. The patient or respo
Page 37 and 38: physicians, dentists, nurses (pract
Page 39 and 40: . Each Uniformed Service secretary
Page 41 and 42: 3-61. Treatment of former military
Page 43 and 44: Figure 3-2. Sample format memorandu
Page 45: 4-3. Comfort items for patients a.
Page 49 and 50: f. The MTF commander who starts act
Page 51 and 52: (1) Attempt to arrange transfer to
Page 53 and 54: (3) Patients who are being or have
Page 55 and 56: personal decisions will be assisted
Page 57 and 58: authorities, to the sponsor or NOK.
Page 59 and 60: (2) Enabling care (EC). AD patients
Page 61 and 62: patients in absent sick status, cha
Page 63 and 64: date the packet is mailed to the PE
Page 65 and 66: (4) A complete, current report of m
Page 67 and 68: Table 7-1 Distribution of medical b
Page 69 and 70: d. Instructions for the preparation
Page 71 and 72: . After approval by the Service rev
Page 73 and 74: . Soldiers who are in initial entry
Page 75 and 76: a. The following information will b
Page 77 and 78: c. Civilians interned by the Army.
Page 79 and 80: a. Members of the Army, RC, and app
Page 81 and 82: medical documents by submitting DD
Page 83 and 84: 11-10. Audit and review The MSA is
Page 85 and 86: lost. The MSA must have the interna
Page 87 and 88: Figure 11-2. Sample memorandum form
Page 89 and 90: Chapter 12 Patients’ Trust Fund 1
Page 91 and 92: (2) Deposits and requests for check
Page 93 and 94: whom administrative responsibility
Page 95 and 96: 13-7. Concurrent medical affirmativ
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(4) Establish a process whereby all
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(1) Receive and open mail including
Page 101 and 102:
d. Patient administrators of deploy
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AR 215-1 (not cited) Military Moral
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AR 36-2 Audit Services in the Depar
Page 107 and 108:
VASRD Veteran’s Administration Sc
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DA Form 5009 Medical Record-Release
Page 111 and 112:
Appendix B Persons authorized care
Page 113 and 114:
Table B-1 Persons authorized care a
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Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
(3) Is there a procedure in place t
Page 129 and 130:
Glossary Section I Abbreviations AA
Page 131 and 132:
EIN employee identification number
Page 133 and 134:
MPRJ military personnel records jac
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REP 63 Reserve Enlistment Program o
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VA Veterans Affairs VARO Veterans A
Page 139 and 140:
Disability separation Temporary or
Page 141 and 142:
Maximum hospital benefit That point
Page 143 and 144:
standard CHAMPUS cost shares apply.
Page 145 and 146:
Convalescent leave, 5-1 Cosmetic su
Page 147 and 148:
Civilian participants in Army-spons
Page 149 and 150:
For assignment to WTU, 8-3 Outside
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Special consideration of USFHP bene
Page 153 and 154:
Social Security, table 2-1, 3-21, 3
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