CGHS Empanelment Documentation Checklist

• CGHS Empanelment Documentation

• Hospital Registration Certificate

• NABH Accreditation Certificate

• Hospital PAN Card

• GST License

• Type of ownership Deed Copy

• Hospital Map ( Blue print)

• Hospital Sanction bed Certificate

• Bed details, Emergency, Daycare, dialysis, Recover room beds, labor room beds, ICU, Private, General ward bed, Semi private bed, Private, deluxe

• Total Number nurse ( Manpower Details)

• Paramedical Staff (Manpower Details)

•  Number of In house Doctor

• Number of Consultant

• Number of Visiting Doctor

•  Bed Occupancy Rate (General ward, Semi Private/private, ICU, HDU)

• Average daily OPD attendance ( Last 6 month)

• Mortality Rate

• Post-Operative Mortality Rate.

• C- Section Rate

• Alternative power Source

• Generator Capacity (Kwh)

• Drinking Water Source

• Water Tank Capacity storage in litres (Total no of Tank)

• Ambulance transport services (MoU)

• Hospital Laundry services (MoU)

• Hospital Canteen Services (MoU)

• Hospital Kitchen (Dietary Services

• Physiotherapy insource or outsource

• Blood Bank MoU

• Pharmacy Licenses or MoU

• Housekeeping outcourse and insource

• Housekeeping cleaning schedule daily

• Housekeeping staff details

• CSSD department ( 3 zone Clean, semi-sterile, sterile

• Autocalve Photo, ETO, Boiler

• CSSD Chemical indicators

• CSSD Biological Indicator

• CSSD Temperature and humidity Charts records

• Bowie Dick test

• OPD,IPD, ER Registration form and Policy

• Doctor Initial assessment

• Hospital Signages display list with photo

• Scope of services displayed at prominent location

• Infection control SOP, Manual

• Blood & Blood component Policy

• Policy for Adverse events during transfusion

• Patient Right and responsibility display

• Induction Training for staff job assigned

• Maintained Medical Records Department Photo of department

• Policy for Keep records in Safe environment and ensure there confidentiality

• Staff personal File Scan copy

• Hand washing facility  display and photo

• Clean Wash room facility.

• Tariff list available

• Satutory Complaince

• Pollution Control Board Licenses

• MoU BMW

• Fire NOC Form

• PC PNDT

• MTP Registration

• Blood Bank license (if available)

• Blood Storage Centre License

• Pharmacy License

• Nacrotic druge

• X-ray License

• Hospital all MoU

• Scope of Services

• Specialty services provided ( Avg. OPD, Avg Admission, list of 5 most frequent surgical procedure, list of 5 most frequent clinical diagnosis.

• Pathology Services and  number of sample per day.

• Radiology and workload per day

• Equipment List ( Name of service, Name of equipment, make/Model, Name of manufactuere, Date of installation, Calibration status, AMC (Yes/No)

• Professional Services

• Emergency Services

• No of bed available

• Per month admission

• Bed Occupancy Rate

• Equipment List

• Monitor

• Defibrillators

• Nebulizer

• Infusion Pump

• Pulse Dosimeter

• Suction Apparatus

• Ventilator

• Crash cart

• Laryngoscope

• ABG Machine

• OT air conditonring  photo

• Pathology Services

• Radiology Services

• TAT OPD and IPD (Pathology)