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Business Essentials > 00 Owner and Administrator Forms (371 docs) > 03 Record Reviews (76 docs)

03 Record Reviews (76 docs)

Free Forms, caregiving, nursing forms, policies, Licensing, Training, Case Management, Home Care, Assisted Living, DD, MI, HCBS

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Documents in 03 Record Reviews (76 docs) (76)

This free document is a required posting (OSHA regulations) and explains the employees' rights to review their medical records, exposure records and material safety and data sheets on chemicals and materials used in their work area. Access to Medical and Exposure Records - for California
AZ Community Based Care Home Visit Report AZ Community Based Care Home Visit Report
This form is designed to help administrators of residential care and assisted living facilities track the various fall in their facilities, which can help them see if there are any patterns or trends, or other information that can help them reduce residents falls. Care Facility Administrator's Fall Tracking Record - Community and Residential Care
A great form for helping to ensure your care facility business is employing people following the letter of the law.  This two page form contains the basic record standards for a care facility to comply with for care home employees. 

Is there a current copy of his/her First Aid Training card on file? (see First Aid)

If CPR Training is required is there a current copy of his/her card on file?

Are Licenses and/or Training Certificates on file (i.e. Certified Nurses Aide) for the positions held by the employee? Care Facility Staff Records Review Form
Form used to document the care and services needed for a resident. For all type of community care homes and businesses. Care Service Plan Record
Laws usually are created because of a particular circumstance.  This law was created because a need was found for a system to account for the resident's money to prevent theft.  This article addresses the use of a form called the Cash Resource Record. Cash Resource Record
When a resident's medicine is received from a pharmacy, the duplicate label is placed on this form in order to track the label information. Centrally Stored Medication Label Record
This document contains information about why community-based care homes should use a Centrally Stored Medication Record which serves as a record of incoming medications for each resident. This type of form is usually required by state licensing.  The care facility must know what medications the resident takes - it is part of the assumed care service. Centrally Stored Medication Record
This form is used by a care facility to list a resident's centrally stored medications and contains information such as:  resident's name, physician's name, name of medicaiton, date prescription was filled, directions, strength and amount, pharmacy name and phone number, RX number, expiration date and number of refills. Centrally Stored Medication Record (Form)
A form used in a Care Facility to audit a resident's blood sugar results over a period of time. Diabetic Audit Record Form for Home Care and Community Based Care Facilities Diabetic Audit Record for Home Care and Community Based Care Facilities
Form used to log information disclosed to a state or federal agency due to a court order for an employee. Disclosure Accounting Record - Employee
Form used to log information disclosed to a state or federal agency due to a court order for a resident. Disclosure Accounting Record - Resident
Form used to document, the release of PCBI and RMCI information, including the method of release, reason, date, and person of authority information was released to. Disclosure PCBI and Risk Management Record
Information on the disposition of a resident's medication in a Care Facility.  

The word Disposition Record Information
This is a check list of items that need to be returned (such as uniforms, keys, cell phones, etc.) when an employee working in a care facility or care business terminates employment. Employee Checkout Record Form
This document outlines how the Safety Manager will make sure the Medical Records of all employees who have occupational exposure are maintained in accordance with the record access requirements of 29 CFR 1910.20. Employee Medical Records
Facility policy on employee access to their personal employment records. Employee Personnel Records
This complete and detailed form is used for keeping a record on start/termination dates, wages, training received and other necessary information that should be maintained in the employee's record at a care facility. Employee Record
An employee wishing to inspect his or her personnel records maintained by the care facility, or to authorize another person to inspect the employee's file needs to submit this form for approval. Employee Records Access Release Form
Brief statement concerning the importance of care facility personnel not interpreting medical reports. Extra Medical Records
Resident, Personnel, and Administrative Records that are required to be kept by a facility. General Required Records
The general rules of the Confidentiality of Information Act prohibit the dissemination of records to unauthorized persons.  This great article covers obtaining permission to access the resident's medical records by using a Release of Records Form. 

This clause gives you some authorization to get information, however, most health care providers will require a written authorization form. These types of forms are getting much more... Getting Access to Resident Records Including HIV
Form to keep track of attendance at group activities. Group Activities Attendance Record
Form used to keep track of group volunteer's activity assignments. Group Volunteer Assignment Record
Form used for recording information about the volunteer group. Group Volunteer Record Form
Section Narrative about group volunteer records.

Each group that is providing activities in the facility needs to have a file.  The file needs to contain the forms listed below.  These form are self-explanatory. ... Group Volunteer Records
This form is used by staff to assess hazardous situations and document any corrective action taken. Hazard Assessment and Correction Record
This form is used to document an employees training on safety policies and procedures. IIPP Employee Training Record
Section narrative for individual volunteer records.

A file must be created for each volunteer that is providing activities in the facility needs to have a file.  The file needs to contain the forms listed below.  These form are self-explanatory. Individual Volunteer Records
All medical information is protected by federal law.  The care facility personnel must always make sure they are safeguarding the resident's medical records. 

Federal law protects all medical information.  The facility personnel must always make sure they are safeguarding the resident's medical records.  The resident's record needs to be kept in a locked or inaccessible area.  Only those persons who are providing care should have access.  HIV and AIDS, Substance Abuse, and some Mental Health Information should be kept with extreme security secure.  See Confidentiality Handbook

Before giving access to other persons, make sure..... Medical Information Resident Record
This document stresses residents' right to privacy and lists personnel including staff, doctors and agency representatives that normally have access to the Medication Book.  

The Medication Book, affectionately called the Medication Book and Resident Record Access
A form used by Residential Care Facilities or Adult Assisted Living Facilities to document how and when medications were destroyed in compliance with state and federal laws. Medication Destruction Record - Long
Two copies on one page of a form used by Residential Care Facilities or Adult Assisted Living Facilities to document how and when medications were destroyed in compliance with state and federal laws. Medication Destruction Record - Short
Every care facility needs to have a system of keeping track of destroyed medications for each resident.  The ProvidersWeb.com has developed a choice to two forms for this purpose; the Medication Destruction Record - Long and the Medication Destruction Record - Short. Medication Destruction Record Information
The word Medication Disposition Record
A form used by a Care Facility to show the disposition of a resident's medications. Medication Disposition Record (Form)
Policy and procedure for documenting a resident's medication in a Residential Care Home or Adult Assisted Living Facility.  Common procedure for home and community based services.

Special Note: if required by State Licensing the funding agency, or the Resident, Responsible Party, Resident's Doctor, or other Appropriately Skilled Medical Professional, we document each dose taken by the resident, on the... Medication Documentation Policy
A form used to document and record an individual resident's medication dosage in a Residential Care Facility, Adult Day Care, Homes for the Developmentally Disabled or Mentally Ill and Assisted Living Facilities. Medication Dosage Record
A form used by an Assisted Living Community, Residential Care Facility or Board and Care type home to record the staff members that are trained in medications:  name, signature, and initials. Medication Staff Initials Record
Form to document resident's monthly bowel movements. Monthly Bowel Record
This form should be completed for all new employees of a care facility for the business office records, which will allow them to complete all required documentation for state and federal regulations, payroll, etc. New Employee Record Form - for Care Businesses
This is a free listing of OSHA requirements for record keeping for care businesses. OSHA Record Keeping Requirements helpful for Care Businesses
A free definition and list of OSHA regulations for training records. OSHA Training Records
This free document contains information stating that the employer shall comply with the requirements involving transfer of records set forth in 29 CFR 1910.1020(h). OSHA Transfer of Records
What items should not be kept in an employee's file. Personnel Record Exceptions - the What's Not
The best of ProvidersWeb's Record Review Forms in an eBook.  ISBN 1-889226-27-0 ProvidersWeb's "Record Review" Forms eBook - ISBN 1-889226-27-0
Table of contents of ProvidersWeb's ProvidersWeb's "Record Review" Forms TOC
Form for the Administrator to complete to track facility infections among the residents. Residential Care Homes, Assisted Living Facilities tracking record of infections. RCF ALF Administrator's Facility Infection Record
This great document explains employers requirements to have procedures in place to protect the employee's confidentiality and prevent release of medical information, personal, and certain employment information (such as Social Security Number, HIV status, etc.). 

Under the Privacy Act the release of certain personal employment information, especially medical information, without authorized permission is generally prohibited. Employers are required to have procedures to protect the employee's confidentiality and prevent release of medical information, personal information (such as SS#) and certain employment information.  Employers also have the right to.... Releasing Employee Records, Information and HIV
A resident wishing to inspect his/her personal records that are maintained by the care facility or who wants to authorize another person to inspect the resident's file, need to complete some type of Resident Records Release Form.  This document explains the basics. Releasing Resident Record Information
Form used in assessing residents level of activity. Resident Activity Record Form
Section Narrative for resident activity records.

Activity Assessments are used to learn about the resident's likes, dislikes, and special interests.  Depending on the state law and the facility's requirement, some or all of these forms may be required.  A good place to start is the Resident Activity Records
Document cover types of records that must be retained by a facility. Resident and Employee Confidential Records
Form to document bathing and showering procedures for individual residents. Resident Bathing and Showering Record
This great ProvidersWeb form is used by caregivers to document details of a resident's fall and how often the falls occur. Resident Fall Tracking Record
A record of resident food substitution. Resident Food Substitution Record
This document provides a general list of persons who have access to a resident's personal records in a care facility.

Resident Activity Record
~Activity Director
~Facility Manager
~State Licensing
~Resident's Physician 
~Resident's Home Health Nurses and Therapists
~Resident's Responsible Party as specified on the Admission Agreement Resident Records Access
This form is used to authorize access to a resident's confidential records kept by the Community Based Care Facility and must be signed by the resident or their responsible party. Resident Records Access and Release Form
Sample of a House Policy for a care community to use regarding the protection of a resident's confidential records in a facility.  

The Community should inform the resident that his/her information shall be accessible or given to the pharmacy, podiatrist and others providing services to the resident or Community. Resident Records Sample House Policy
A record of residents' self-stored medications must be maintained by the facility.  The Medication Manager updates this form monthly to comply with regulations. Used in all types of community based care homes. Resident Stored Medication Record
Form for documenting a resident's vital signs in a care facility or for documenting in home based care. Staff form for documenting vital signs by lay person or nurse. Resident Vital Signs Record
Form to document visitor, date, time and purpose of visit. Resident's Dietary Visitation Records
Form used to record an individual resident's visitation. Resident's Individual Visitation Record
This great form document contains an example of the order that the resident's records can be kept.  It is a great way to organize the resident's record and can be used as a check-off list to make sure the resident's record contains everything it should.  This is an excellent tool for board and care facilities, assisted living facilities, and even nursing homes. Resident's Record Order Form
A form used to document a resident's cash form in the care facility's possession. Used in all types of community based care homes. Resident's Safeguarded Cash Record Form
Most Licensing Agencies allow the facility to use their own style of forms. However, the forms must contain all the required information. This document covers all the information needed. Setting Up the Resident's Record
This form insures the resident know of their rights to medical record privacy.

The federal law protects the Right to Privacy.  The Medical Records Confidentiality Act of 1995 ensures that all 50 states adopt a uniform policy for protecting the confidentiality of medical records. State's Authority to Review the Resident's Record
This form is used to document discharge/resignation of an employee of the company. Termination of Employment Record
This great document provides links to the Federal Medical Records Confidentiality Act of 1995. The Medical Records Confidentiality Act of 1995
Records that are disclosed to third parties shall remain privileged.  Any person receiving records that the care facility considers confidential shall not disclose the records or related information without the written authorization of the resident or responsible party.... Third Party Access to Records Policy
This form is used to document universal precautions training of care facility staff, with instructor summary. Universal Precautions In-Service Training Record for Care Facilities
Form for visitors to sign in and out of the facility. Visitor Sign In and Out Record
Upon admission to a residential care or assisted living facility a resident's vital signs should be taken and documented and monitored at least monthly.  

Note: Any licensed nurse can teach a layperson how to take a blood pressure, and most caregivers learn how to take a pulse, count respirations and take a temperature when they learn first aid. Vital Signs Record
Form used to record individual volunteers assignments. Volunteer Assignment Record Form
Form used to record information about an individual volunteer. Volunteer Record Form
Form for recording an employees attendance in a care facility during a one year period. Yearly Attendance Record
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