Manual of Organization and Management of the Administrative and Finance Service for Hospitals

In this document:

•a Table 4.2 Standard Staffing Pattern for Level 2 Hospitals
•G 200 300 400 500 Position Title beds | beds beds beds GENERAL SERVICES UI Administrative Assistant III 5S | 5 | 4 | 6 | 9 | 3 | 0 | Administrative Aide II] Laundry Worker II i8_ [| o [ o | | a To | Hospital Housekeeper/ it | | 6 | 6 | 8 | o | o | 15 | Securit ty Offer I lo | Security Guard IT] Security Guard II Security Guard I Manual of Organization and Management of the Administrative and Finance Service for Hospitals 21 4| nN i) _ Il 2 w2 :
•OFFICE OF THE CHIEF OF THE ADMINISTRATIVE AND FINANCE SERVICE Under the general supervision and control of the Chief of the Hospital, the Chief, AFS equally plays a vital role in providing line and staff functions in the overall operations of policies: Public officials and employees shall at all times be accountable to the people and shall discharge their duties with utmost responsibility, integrity, competence and loyalty, act with patriotism and justice, lead modest lives, and uphold public interest over personal interest. ¢ Employees shall be afforded Opportunity to be heard in any administrative disciplinary action. e Dissemination of important issues and concerns shall be done at all levels. ¢ Good manners and professional conduct shall be observed in dealing with fellow workers, patients, clients, general public and other stakeholders, e Equal Opportunity shall be given to employees in case of promotion and/or staff development and training. ¢ A business like and client friendly work environment shall be maintained. Function Headed by : Chief of the AFS Assisted by
•Provides services/inputs to Internal Clients

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Document Info

Office of the Medical Center Chief/ Chief of Hospital Office of the Chief of the Administrative and Finance Service I . eae See i 1 Administrative f f i Service i i 1 ' 1 Do i a SE wrens. UJ ee as as os ennrea I [ee eeiee eerie | Se | Se omen ae a i i i SSS | re erste Srila 7 ; Internal i 4 ; 1 s ° if . ° ° ! | Administrative | | Patient Support ‘ Financial I } Management | ! Services ; 3 Management; he proencneneecoe a es ae Pon Human _ Resource + Admitting and + Accounting Management Information [Procurement | Medical Records a Budget Procurement Fy Medical Social Service

Cash Management Central 8 7 Information [—)} Nutrition and Management Dietetics | Engineering Pharmacy L_ General Services Figure 3.4 Organizational Structure Sor Level 4 Hospital (Teaching and Training, Non C orporate Hospital) Hospital Business Operation Billing and Claims Manual of Organization and Management of the Administrative and F inance Service for Hospitals 17

Figure 3.4 illustrates the organizational set-up in a Level 4 hospital either as a teaching and training hospital or as a medical center. The departments/sections are grouped into two major services, namely: Administrative Service and Finance Service. These are further subdivided into different sub-units based on its nature, functions and relationship within the hospital set-up and operation, such as: For the Administrative Service: © Administrative Support group refers to the departments/sections performing internal administrative management functions and providing logistics and resources for a continuous and uninterrupted delivery of services such as human resource management, procurement, property and supply management, central information management, material management, engineering and general services; and e Patient Support group refers to the departments/sections performing direct patient support services such as admitting and information, , maintenance and keeping of patients’ medical records, nutrition and dietetics, uninterrupted and continuous supplies of drugs and medicines and other pharmaceuticals, and social services; For the Finance Service: © Financial Management group refers to the departments/sections handling all the financial transactions of the hospital such as accounting, budget and cash management, e Hospital Business Operation group refers to the departments/sections performing the functions of planning and marketing including billing and claims and accounts receivable management. Another illustration of Administrative and Finance Service is included in the Appendices for Level 4 hospital in a corporate structure in consonance with the Department of Health Rationalization Plan. This features the separation of the Administrative and Finance Service into two major divisions in the hospital system, both directly under the Chief of the Hospital. Leveling of hospitals is defined based on their service capabilities. Table 3.1, presents the different service capabilities of each level as provided in the guidelines issued by the Department of Health. 18 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |:

Table 3.1 Service Capabilities of Hospitals According to Level Service Capabilities Level 1 Level 2 Level 3 Level 4 Emergency Hospital Non-departmentalized | Tertiary, Non-teaching Teaching and Training Hospital Hospital Primary care on prevalent discases in the locality Clinical care on prevalent diseases in the locality Clinical care on prevalent diseases in the locality, as well as particular form of treatment, surgical procedure and intensive care With at least one Accredited Residency Training Program, specialized and sub-specialize forms of treatment, surgical procedure and intensive care Clinical services (Gen. Medicine, Pediatrics, Obstetrics & Gynecology, Non- surgical and minor surgery) Clinical services (Gen. Medicine, Pediatrics, Obstetrics & Gynecology, Surgery and Anesthesia) Clinical services (Gen. Medicine, Pediatrics, Obstetrics & Gynecology, Surgery and Anesthesia and specialty clinical care Clinical services (Gen. Medicine, , Pediatrics, Obstetrics & Gynecology, Surgery , Anesthesia and specialty clinical care and sub-subspecialty care) Ancillary services (Primary clinical lab and first level radiology and pharmacy) Ancillary services (Secondary clinical lab and first level radiology and pharmacy) Ancillary services (Tertiary clinical lab and second level radiology and pharmacy) Ancillary services (Tertiary clinical lab and third level radiology and pharmacy) Nursing care for patients who require 24 hours or longer Nursing care for patients who require 24 hours or longer as well as intermediate, moderate and partial category of supervised care Nursing care for patients who require 24 hours or longer as well as intermediate, moderate and partial category of supervised care; total and intensive skilled care Nursing care for patients who require 24 hours or longer as well as intermediate, moderate and partial category of supervised care; total and intensive skilled care, continuous and highly specialized critical care General administrative services Appropriate administrative services Appropriate administrative services Appropriate administrative services Source: Administrative Order No. 147 dated April 28, 0029 dated December 12, 2005 2004 as amended by Administrative Order No. 2005- Manual of Organization and Management of the Administrative and Finance Service for Hospitals 19

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4 STAFFING REQUIREMENTS The staffing requirement depends on the category of the hospital. The DOH in coordination with DBM and CSC has set the minimum staffing requirement for every level based on the authorized bed capacity as follows: Table 4.1 Standard Staffing Pattern for Level 1 Hospitals 7 Position Title SG 25 beds | 50 beds | 75 fet | OFFICE OF THE ADMINISTRATIVE OFFICER Administrative Officer V 18 0 0 1 Administrative Officer [V 15 0 l 0 Administrative Officer II 1] 1 0 1 Administrative Assistant II 8 0 l 2 Administrative Aide [V 4 l | 0 Security Guard II 4 0 0 1 Security Guard I 3 2 3 3 Total 4 6 8 FINANCE ACCOUNTING Administrative Officer IV/Accountant iS) 0 0 1 Administrative Assistant II 8 1 1 1 Administrative Aide VI 6 0 I 1 Administrative Aide [V 4 1 0 0 Total 2 Dy 3 BUDGET Administrative Officer IV ile 0 0 1 Total 0 0 1 BILLING Administrative Aide VI 6 0 1 1 Administrative Aide [V 4 0 0 2, Total 0 1 3 CASHIER Administrative Officer II 14 0 0 1 Administrative Officer I 10 1 l 0 Manual of Organization and Management of the Administrative and Finance Service for Hospitals 21

Position Title 25 beds 50 beds Administrative Assistant Il Administrative Aide VI — mi: Total PERSONNEL Administrative Officer IV ibs, Total PROPERTY Administrative Officer IV 15 Total —] GENERAL SERVICES Engineering I font Administrative Aide VI Medical Equipment Technician I Administrative Aide IV Administrative Aide III Laundry Worker II Seamstress NI WI]W[BRIDAID Total BSlHIV[ejFIS|o lo — TNS [Ay RH] 1S NH lololuajelypl]— — TOTAL MANPOWER REQUIREMENTS 18 id nN

a Table 4.2 Standard Staffing Pattern for Level 2 Hospitals

Position Title SG 100 beds 150 beds 200 beds OFFICE OF THE ADMINISTRATIVE OFFICER Supervising Administrative Officer Administrative Officer V Security Officer I Security Guard II] Administrative Assistant I Security Guard II Administrative Aide III Security Guard I Total wolUarjelealRK|olo|-|o welBR|elel—el—Hlol-|o wWlR]elRelAelol-—|o|>- HUMAN RESOURCE MANAGEMENT SECTION Administrative Officer V 18 Administrative Officer IV 15 —_— Administrative Officer II 11 0) Manual of Organization and Management of the Administrative and Finance Service for Hospitals

a 100 beds Administrative Assistant IT Administrative Assistant I Engineering [I] Engineering I] Administrative Assistant III Administrative Assistant II Administrative Assistant | | 7 | Administrative Aide VI | 6 | Medical Equipment Technician | | 6 | Administrative Aide IV | 4 | Administrative Aide MT} [Dormitory Manager 77 J Dormitory Manager I/Hospital Housekeeper Administrative Aide III 3. | -—Launey Worker Tailor | 3. | l Seamstress | 2 | a a i Accountant II Administrative Officer II Lu | Administrative Assistant III | 9 | Administrative Assistant} J tmuuncavems Administrative Assistant |. |_Administrative Aide VI + Administrative Aide [V Total Position Title SG “4 BUDGET Administrative Officer V Administrative Officer [V Administrative Officer I] — — ; ):} Manual of Organization and Management of the Administrative and Finance Service for Hospitals 23

Position Title SG 100 beds | 150 beds 200 beds Administrative Assistant II 1 Administrative Assistant I a ee Administrative Officer Vv 18 1 Administrative Aide VI PROPERTY AND SUPPLY Administrative Officer V Administrative Officer I Administrative Aide VI 5 MEDICAL RECORDS Administrative Officer V Administrative Officer IV Administrative Officer Il Administrative Assistant Il | | — & _ (= ary Mn | oo Fr —v — Administrative Assistant I minis NUTRITION AND DIETETICS Nutritionist Dietitian III 18 Nutritionist Dietitian Il Nutritionist Dietitian I Food Service Supervisor Administrative Aide VI Administrative Aide IV 4 Administrative Aide III 3 Total SOCIAL SERVICES Social Welfare Officer I Social Welfare Officer | Administrative Aide IV Administrative Aide III minis ees

24 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (:

Position Title PHARMACY Pharmacist II] Administrative Aide [V Administrative Aide II] | 3 | TOTAL MANPOWER REQUIREMENTS Table 4.3 Standard Staffing Pattern for Level 3 Hospitals SG 200 Position Title | 8 beds ‘ornice oF ue anynusreativeomnicne | Supervising Administrative Officer INTERNAL ADMINIST, RATIVE MANAGEMENT HUMAN RESOURCE MANAGEMENT Administrative Officer [V PROCUREMENT, PROPERTY AND SUPPLY Administrative Officer V 1 Administrative Officer [V I Administrative Assistant II 2 Buyer/Canvasser Administrative Aide VI e

w S os Fy ® Q n 400 500 beds l 5 a +H } 5 +H 0 1 :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 25

SG 200 300 400 500 Position Title beds | beds | beds beds om ef Administrative Aide II] P37 pt fo fo fo Total ee Oe Se

rongnatios MANAGEMENT AND RESEARCH MANAGEMENT AND RESEARCH Fo | Administrative Officer V ass po Pt Pt tt Statistician I ras to fo | 1 tt ie Operator III fee OO [Compu operat Bn a Data Controller II] ee —Raminisintive Assistant Assistant Il rst et Et een oT ACCOUNTING ee se —raministrative OficerIV Officer IV is Do | 2 | o fo —fainiststive Offer Officer I pa Pe oo Assistant III 9 ee ee —TrninmetadeeinTE Assistant IT poe tei ioe Assistant I 7 ro fo | 2 0 | nee Aide VI rs Do | 4 [4] 4 4 rast le) ae Administrative Officer IV aso Pa Pr occ Officer Il 1 To | 0 fo Administrative Assistant Assistant IT Tap Pp 2 ft ft Administrative Aide VI ite Pp 2 | 2 | 3 | 34 —————— oe Total oe as as 3 a oa oe oe ae a ee Administrative Officer IV 5-0 [1 fi [1 Administrative Officer II 1 ra | 1 | Administrative Assistant II r2 | 2 | Total Administrative Officer V —————— ns Administrative Officer II r2 {2 | 2 | ce Officer I ro | 1 | Administrative Assistant Il ; 8 | Administrative Aide V1 | 6 | 26 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

G 200 300 400 500 Position Title beds | beds beds beds GENERAL SERVICES UI Administrative Assistant III 5S | 5 | 4 | 6 | 9 | 3 | 0 | Administrative Aide II] Laundry Worker II i8_ [| o [ o | | a To | Hospital Housekeeper/ it | | 6 | 6 | 8 | o | o | 15 | Securit ty Offer I lo | Security Guard IT] Security Guard II Security Guard I Manual of Organization and Management of the Administrative and Finance Service for Hospitals 21 4| nN i) _ Il 2 w2 :

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PATIENT SUPPORT SERVICES | ADMITTING AND INFORMATION r | | Administrative Officer V 18 -; Administrative Officer III ros pt 1 | 1 fo [ 0 _| Administrative Officer II Pau fo Po ft ft Administrative Assistant | 1 Communication Operator II rel p4 p44 | 4 [4 a ee i a a Qa.2 5 an

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- ; a es Pa pau [a fi Administrative Officer MI Officer III ris | 0 | —ainistative Roe sae Administrative Aide VI | 6 | 4 | 4 a ye AideIV Lt [14 {14 | crpnmrma aS aa UTRITION AND DIETETICS P| [| o | [| 1 | HY — oO 18 nr w Nutritionist Dietitian [V ro | o | 1 | Nutritionist Dietitian II 1 ra [1 [ 9 | ras_ fo | o [| o | 2 | rap 2 | 2 fi ft 1 Nutritionist Dietitian I top 2 | 2 | 3 [3 | [ Nutstonie Distia o t ee SOCIAL SERVICES Social Welfare Officer III Social Welfare Officer Il Social Welfare Officer | Administrative Assistant Ill Administrative Aide VI Pharmacist IV Pharmacist III 28 Manual of Organization and Management of the Administrative and Finance Service for Hospitals {:

Position Title SG Pharmacist II 12 Administrative Aide VI Administrative Aide [V 200 300 400 500 beds | beds | beds beds 8 8 8 12 6 2 2 4 4 4 2 s) 4 4 16 16 23 27 Table 4.4 Standard Staffing Pattern for Level 4 Hospital (Teaching and Training) and Level 4 (Non Corporate Structure) L 250- | 400 Position Title SG 300 beds beds OFFICE OF THE ADMINISTRATIVE OFFICER Chief Administrative Officer 24 I 1 l 1 Supervising Administrative Officer 22, | O 0 l l Computer Programmer III 18 1 1 l 1 Information System Analyst II 16 l ] | 1 Administrative Officer IT 15 0 0 1 1 Administrative Officer I 10 l I 0 ] Administrative Assistant | a I 1 I 0 Administrative Aide VI 6 1 1 1 2 Total 6 6 7 8 ADMINISTRATIVE SUPPORT SERVICES CLUSTER HUMAN RESOURCE MANAGEMENT Administrative Officer V 18 1 1 l 1 Psychologist II 15 l I I 1 Administrative Officer [V 15 1 1 ] l Administrative Officer II | 1 1 2 2 Administrative Assistant II 8 2 2 4 4 Administrative Assistant I fa l I | 2 2 Administrative Aide VI 6 2 2 4 8 Total 9 9 15 19 PROCUREMENT Administrative Officer V 18 1 | I 1 Administrative Officer I] 15 1 1 1 | Administrative Officer I 10 I I 2 2 Administrative Assistant I 7 1 l 4 4 Buyer/Canvasser 6 2 4 4 4 Total 6 8 12 12 :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 29

| 250- a | 500 | >500 Position Title SG 300 beds | beds beds beds PROPERTY AND SUPPLY Administrative Officer V 18 1 | 1 l Administrative Officer IV 15 1 1 1 i Administrative Officer II 11 0 1 —_ 2 Administrative Assistant IT 8 2 3 3 3 Administrative Assistant I y | l 1 1 Buyer/Canvasser 6 0 0 1 2 Administrative Aide VI 6 0 1 | 5 Administrative Aide IV 4 0 | | 0 | Administrative Aide Il 3 | 0 0 0 Total 6 9 10 15 NUTRITION AND DIETETICS Nutritionist Dietitian IV 20 0 0 0 | Nutritionist Dietitian III 18 1 1 1 0 Food service Supervisor III 13 0 0 0 2 Nutritionist Dietitian II 15 2 2 1 l Nutritionist Dietitian I 11 2 2 3 3 Food Service Supervisor I 9 0 0 1 1 Administrative Aide VI 6 4 4 4 4 Administrative Aide IV 4 4 4 12 16 Cook I 5 2 2 2 4 Cook I 3 2 3 3 4 Total 17 18 pa 34 ENGINEERING — Engineering III 19 l 1 1 1 Engineering II 16 1 2 2 2 Medical Equipment Technician IV 13 l | i 1 Medical Equipment Technician III 11 1 2 2 2 Administrative Assistant III 9 | 1 i 1 Administrative Assistant IT 8 1 1 1 2. | Medical Equipment Technician II 8 | 2 2 2 Administrative Assistant I i 0 1 l 1 Administrative Aide VI 6 7 9 9 9 Medical Equipment Technician I 6 2 3 3 3 Administrative Aide V 5 a 7 Z 9 Administrative Aide IV 4 6 9 9 11 Total 27 39 39 44 ae | GENERAL SERVICES | Linen and Laundry Dormitory Manager IV/Administrative Officer V 18 0 i i 1 Dormitory Manager II 15 i 0 0 1 Laundry Worker III 6 2 3 3 ~ Master Tailor I 5 1 1 1 1 Administrative Aide III 3 3 3 3 3 30 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

250- 400 Position Title SG 300 beds beds ; Housekeep ing Administrative Officer V Administrative Officer II] | is | Hospital Housekeeper/Administrative Assistant IT] | 9 1 Administrative Aide VI | 6 [al Administrative Aide IV | 4 1 6 Administrative Aide II] | 3 | 107 St gp Security Officer IT] | is [0 Security Officer I] | is | 1 Security Officer I Security Guard III MATERIAL MANAGEMENT Administrative Officer V Administrative Officer I] Statistician [] Data Controller [] Administrative Assistant | Administrative Aide VI Data Controller Il Administrative Assistant I] ADMITTING AND IN FORMATION |] Administrative Officer V Data Controller II

Position Title PATIENT BUSINESS AND SUPPORT SERVICE BILLING AND CLAIMS Administrative Officer V Administrative Officer [V Administrative Officer IT Administrative Assistant I] Administrative Aide VI Administrative Aide [V Administrative Officer V Administrative Officer [V Administrative Officer IT Administrative Assistant IT Administrative Aide VI PHARMACY Pharmacist III a =es a) —> -i-i 250- 400 500

500 G beds | beds beds | i It = ‘ Hee eeE Bonus 12 NIN | in ae rrr ree ete Administrative Aide VI Administrative Aide [V i" £ SOCIAL SERVICES Social Welfare Officer [V Social Welfare Officer II] Social Welfare Officer II 15 Social Welfare Officer | 11 Administrative Assistant II] Administrative Aide VI | 6 | —_ah. sli . we nN ” |, |- HH +H sh 12 12 19 22 Manual of Organization and Management of the Administrative and Finance Service for Hospitals 33

NOTE: Standard staffing requirements vary from one hospital to another depending on its category and capability. Staffing requirement for Level 4 Hospital (Teaching and Training and/or corporate structure) based on the proposed DOH Rationalization Plan under Executive Order No. 366 is shown in Appendices. 34 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (-(° €

S EQUIPMENT REQUIREMENTS There are basic equipment requirements based on the service capability. The requirements for Administrative Service and its sub-units may vary depending on the levels of the hospital. Below are the lists of basic equipment. A. Basic Equipment for Administrative Service Departments / Sections ease ey he NNR RO i i i ed KH OUOANIDNBRWNF CO tides a3. 24. 25. 26. esp 28. Time Recording Machine (Bundy Clock, Biometric scanner or equivalent) Computer unit with UPS, printer and bundled with OS Manual typewriter Adding Machine Calculator Duplicating Machine/Plain paper copier Fax Machine Executive Table and Chair Clerical Table and Chair . Computer Table and Chair . White Board . Locator Map . Filing Cabinet (wood or steel) . Scanner . server . Typing Table and Chair . Working/Drafting Table . Push Cart . Conference Table and Chairs . Air conditioning Unit . Laptop/Notebook computer and LCD projector and monitor for multi-media presentation Video/digital camera for documentation Audio Visual System for training/public health information Paper Shredder Telephone Communication System Electric and Exhaust fan Cash Register Counting Machine/Money Counterfeit Detector :} Manual of Organization and Management of the Administrative and Finance Service for Hospitals ao

B. Basic Equipment for General Services, Engineering, Pharmacy and Dietary areas: Ambulance Vehicle with complete accessories and tools Service Vehicle with complete accessories and tools Carpentry Equipment and Tools Mechanical Equipment and Tools Electrical Equipment and Tools Generating Set Bio-medical and Tools Laundry Equipment (Washing machine, Dryer and pressing machine or flat iron) 9. Sewing Machine 10. Biological Refrigerator 11. Refrigerator (No frost) 12. Freezer (Walk-in or chest) 13. Compounding and distilling apparatus 14. Kitchen/cooking equipment and wares 15. Dispatching trolleys 16. Food Conveyors 17. Dish washing machine 18. Exhaust Fans 19. Air Conditioning Unit 20. Forklift (portable) 21. Weighing Scale Sat hee 36 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |:

PART 2 HOSPITAL ADMINISTRATIVE SYSTEM

6 FUNCTIONS, POLICIES AND PROCEDURES the hospital organizational structure composed of several units. Each unit is further subdivided into subsystems with its own set of objectives, policies, responsibilities and procedures. In each level of hospital category, there are specific administrative support service units required to respond to the basic services for effective and efficient hospital operation. The activities and operations of these units shall be directed and controlled by the head of the Administrative and Finance Service. To illustrate the relationship of the Administrative and Finance Service to other stakeholders and the hospital system, the flow of command responsibility and relationship is shown in F igure 5.1. :y_):) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 39

CHIEF OF THE HOSPITAL Ih Tf DOH / OTHER MEDICAL Gov’Tt SERVICE Te. HEAD OF THE a AGENCIES “ty ADMINISTRATIVE AND a FINANCE SERVICE ve, NURSING a *, NGO& SERVICE GENERAL Il Tf PUBLIC SECTIONS / DEPARTMENT HEADS Unit HEADS/ ADMINISTRATIVE RANK & FILES Figure 5.1 Flow of Inter- and Intra-Relationship of Administrative and Finance Service the flow of communication from top to bottom and The up and down arrows illustrate the line coordination among the different services vice versa. The dotted lines show within the hospital and with external agencies. 40 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

OFFICE OF THE CHIEF OF THE ADMINISTRATIVE AND FINANCE SERVICE Under the general supervision and control of the Chief of the Hospital, the Chief, AFS equally plays a vital role in providing line and staff functions in the overall operations of policies: Public officials and employees shall at all times be accountable to the people and shall discharge their duties with utmost responsibility, integrity, competence and loyalty, act with patriotism and justice, lead modest lives, and uphold public interest over personal interest. ¢ Employees shall be afforded Opportunity to be heard in any administrative disciplinary action. e Dissemination of important issues and concerns shall be done at all levels. ¢ Good manners and professional conduct shall be observed in dealing with fellow workers, patients, clients, general public and other stakeholders, e Equal Opportunity shall be given to employees in case of promotion and/or staff development and training. ¢ A business like and client friendly work environment shall be maintained. Function Headed by : Chief of the AFS Assisted by

Department/Section Heads Responsible to : Chief of the Hospital Expects inputs from : All hospital units :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 4]

Provides services/inputs to Internal Clients

All hospital units External Clients : Department of Health Civil Service Commission Commission of Audit House of Representatives Department of Budget and Management Other government agencies Non Government Organizations Patients Private and other clients Policies e Formulation and preparation of strategic plan for operation shall be participated by and disseminated to all concerned. e Participative decision making shall be encouraged in discussing and solving problems, issues and concerns related to administrative service functions. e Prompt and responsive provision for logistic support shall be ensured. © Confidentiality of information shall be strictly maintained consistent with existing laws, rules and regulations. e Preparation of accurate and timely submission of required reports shall be strictly observed. Responsibilities e Plans and directs the implementation of policies pertaining to administrative and financial management and operations of the hospital. e Ensures the provision of uninterrupted logistic support to effectively and efficiently deliver quality service. e Provides technical assistance to the Chief of the Hospital in the promulgation and formulation of policies, standard operating procedures and strategies to improve the hospital system and its operation. 42 Manual of Organization and Management of the Administrative and Finance Service for Hospitals “

Provides direction in the conduct of continuous manpower development programs and researches to upgrade the standard of hospital operations and management. Prepares short, medium and long term development and operational plans. Directs the evaluation and analysis of procedures and cost of operations and recommends changes to improve the work system. Recommends approval of Work and Financial Plan and the Annual Procurement Program of the hospital. Recommends approval of appointments, staff assignment, disciplinary and other personnel actions. Directs the maintenance of the physical conditions of the buildings, facilities, equipment and determines proper space utilization. Plans and directs purchase and inventory control of required resources, Directs the management and maintenance of hospital information System. Directs the preparation and submission of required reports and official communications. Reviews and signs/initials financial reports and other documents. Identifies and recommends the need for revision of policies, systems and procedures. Monitors programs/projects and activities. Maintains good working relationship. :} Manual of Organization and Management of the Administrative and Finance Service for Hospitals 43

Standard Operating Procedures e Operational Planning eee Procedures Person/s Responsible

Notifies concerned staff. CAFS staff
Drafts plan and programs CAFS
Discusses with concerned staff/units
Presents OP to Executive Committee
Finalizes plans and programs
Submits to Chief of the Hospital for approval J. Records and releases documents to the office of the CAFS staff Chief of the Hospital
Takes action on the submitted documents Chief of the Hospital
Forwards documents to CFAS
Distributes copies of approved documents to CAFS staff concerned units/staff
Records and files copy Processing of Documents en Procedures Person/s Responsible
Checks completeness and legality of documents Receiving staff
Receives and records them
Forwards to CAFS
Reviews, signs/initials and/or takes action CAFS
Forwards to releasing staff
Records and releases documents Releasing staff
Files documents, if required Manual of Organization and Management of the Administrative and Finance Service for Hospitals (:

e Conduct of Meetings Procedures Person/s Responsible |. Receives request/Releases notice of meetings CAFS staff 2. Schedules meetings CAFS 3. Notifies concerned unit/person CAFS staff Decision Making Process Procedures Person/s Responsible

Receives request CAFS staff
Assesses problems/issues CAFS
Takes action and/or recommendation
Notifies concerned unit/person CAFS staff Manual of Organization and Management of the Administrative and Finance Service for Hospitals 45

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7 INTERNAL ADMINISTRATIVE MANAGEMENT The Internal Administrative Management cluster is composed of Human Resource Management, Procurement, Property and Supply Management and Central Information Management. General Policies ¢ Human resource is considered the most important resource of an organization. e Acquisition, utilization and conservation of hospital assets shall be one of the major concerns of all personnel. e Continuing systems improvement shall be done to ensure effective and efficient hospital operations. ¢ Security policy for data integrity, confidentiality, and availability of patients and employees information shall be observed. e Accurate and updated administrative, financial and hospital statistical information shall be maintained for decision-making. :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 47

HUMAN RESOURCE MANAGEMENT Function This department/section develops and administers comprehensive Human Resource Management Plan, which includes recruitment, selection, promotion, separation, welfare and benefits, training and other personnel actions and transactions. Headed by : Department/Section Head Responsible to : Chief of the AFS Requires/Expects inputs from : All hospital personnel Provides services to Internal clients : All hospital personnel External clients : Department of Health Department of Budget and Management Civil Service Commission Government Service Insurance System Home Development Mutual Fund (PAGIBIG) National Home Mortgage Finance Corporation Applicants Former employees Other clients Policies « A Comprehensive Recruitment and Selection Plan consistent with the standard and guidelines set up by CSC and DOH shall be adopted providing equal opportunity to all qualified applicants. e The Career and Personnel Development Plan of the agency shall be consistent with the organizational plan, goal and thrust of the DOH to enhance skills, knowledge, values and interest of human resources. e An agency-wide Program on Reward and Incentive for Service Excellence (PRAISE) shall be established and administered in accordance with the provisions of the Civil Service Law and Rules. 48 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (,

Internal Adt ir The agency shall devise an acceptable mechanism for personnel movement such as demotion, transfer, re-assignment, secondment and Gender and Development (GAD) concerns. The agency shall comply with the requirements for payment of any compensation and other employee benefits. Grievance machinery shall be created to address complaints or grievances of employees in accordance with the policies promulgated by the Civil Service Commission. The agency shall recognize the right to self organization of employees subject to the guidelines set by the CSC and Magna Carta of Health Workers or RA 7305. The agency shall adhere to the Code of Conduct and Ethical Standards (RA 6713) and the Uniform Rules on Administrative Discipline. The agency shall establish an atmosphere conducive to harmonious supervisor- employee relationship and uplift employees’ welfare and morale. The agency shall provide a conducive working condition for all its employees. The department/section shall maintain the safety, security and confidentiality, including the updating of personnel records. The agency shall provide a post retirement services program for its employees. Responsibilities Prepares comprehensive manpower development program which _ includes recruitment and selection, promotion, training, welfare and benefits, manpower planning and research. Implements a Comprehensive Human Resource Management Plan consistent with DOH standards and Civil Service Law and Rules. Maintains and ensures confidentiality of personnel records. Acts on personnel actions and transactions in accordance with Civil Service Law and Rules. :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 49

© Coordinates training and research needs with the other services. e Provides counseling and/or gives advice on referred cases. e Reviews and submits required reports. e Acts as Liaison Office to other government agencies pertaining to Human Resource Management. Standard Operating Procedures ¢ Recruitment, Selection and Promotion Procedures Person/s Responsible — _ Prepares list of vacant positions for publication 2. Posts list at CSC /agency’s bulletin boards 3. Assesses applications and prepares list of qualified applicants 4. Schedules Selection and Promotion Board (SPB) deliberation 5. Notifies qualified applicants/SPB for the schedules Administrative Officer (HRMO) 6. Deliberates results of the screening process based on Selection and Promotion set criteria Board (SPB) 7. Submits the comparative evaluation results to the Chief of the Hospital 8. Chooses from the list of qualified candidates for Chief of the Hospital appointment 9. Notifies the candidate for appointment for Administrative Officer submission of requirements (HRMO) 10. Notifies applicants not chosen 11. Prepares appointment for approval 12. Reviews/Recommends the approval of appointment CAFS to the Chief of the Hospital 13. Approves/ Signs the appointment Chief of the Hospital 50 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |;

e Application for Leave Procedures Person/s Responsible — . Accomplishes prescribed application for leave Employee . Forwards to HRM Office for certification of balance of leave credits 3. Forwards to immediate supervisor for action N 4. Recommends approval/disapproval Immediate Supervisor 5. Processes application HRM Staff 6. Records action taken on personnel index 7. Forwards to AOV for signature 8. Signs leave credit certification and initials action Administrative Officer taken for approval of the Division Chief (HRMO) concerned/Chief of the Hospital 9. Approves/disapproves recommendation Division Chief concerned/ Chief of the Hospital 10. Records and forward ¢ Employee Welfare and Benefits » Request for Payment of Personnel Claims Procedures Person/s Responsible

Submits request and requirements for payment to Employee HRMO
Checks completeness of requirements HRM staff concerned
Prepares disbursement voucher and forwards to AOV
Reviews and initials voucher Administrative Officer
Forwards to Budget Office (HRMO) :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 51

» Payroll Preparation Procedures Person/s Responsible

Checks Daily Time Record (DTR) and personnel index
Prepares payroll and disbursement voucher and forwards to AOV HRM staff concerned
Reviews, signs certification and initials disbursement voucher
Forwards to Budget Office Administrative Officer (HRMO) » Request for Service Record/Certification Procedures Person/s Responsible . Submits request indicating the purpose . Pays the application fee NOR Employee
Prepares requested document and forwards to AOV HRM staff concerned
Reviews and initials document
Forwards to CAFS for signature Administrative Officer (HRMO)
Reviews and signs the document
Returns to HRM for release CAFS/Chief of the Hospital Staff concerned ay) Manual of Organization and Management of the Administrative and Finance Service for Hospitals (:

PROCUREMENT Function This department/section develops and administers a comprehensive plan of systematic management of procurement and acquisition of supplies and materials, healthcare equipments, vehicles, services, infrastructures, works and other required logistics for the effective and efficient delivery of quality services. Headed by : Department/Section Head Responsible to : Chief of the AFS Expects input from : All hospital units Hospital Inventory Committee Appraisal and Disposal Committee Bids and Awards Committee BAC Secretariat Commission on Audit Provides services/inputs to Internal clients : All hospital units External Clients : Department of Health Department of Budget and Management/ Procurement Service Government Procurement and Policy Board (GPPB) Commission on Audit Suppliers/Contractors Other clients Policies ¢ Procurement of goods, infrastructures and Services shall be in accordance with RA 9184 otherwise known as Government Procurement Reform Act and its Implementing Rules and Regulations. e Adherence to the principle of transparency, accountability, equity, efficiency and economy shall be strictly observed. Manual of Organization and Management of the Administrative and Finance Service for Hospitals 53

Procurement shall be based on the approved Agency Procurement Plan (APP) consistent with existing government rules and regulations. Transparency in the procurement process and in the implementation of procurement contracts through wide dissemination of bid opportunities and participation of pertinent non-government organizations shall be adhered. Assurance in the quality and provision of continuous supply of required logistics shall be maintained. Responsibilities Prepares a comprehensive plan for the procurement of goods, services and infrastructure requirements to effectively and efficiently provide quality health care services. Consolidates and prepares the agency’s Annual Procurement Plan (APP) in consonance with the guidelines of RA 9184. Acts as secretariat to the Bids and Awards Committee (BAC) and performs the responsibilities stated in the Implementing Rules and Regulations of RA 9184. Prepares procurement documents such as purchase orders, job orders, contracts and their attachments based on the result of Public Bidding and approved alternative mode of procurement. Creates, maintains and updates the registry of suppliers, contractors and consultants and monitors the price index of the item being procured. Provides utmost priority to BAC assignments over all other duties and responsibilities until the requirements for the procurement at hand are completed. Coordinates with Procurement Service, National Printing Office and Philippine Government Electronic Procurement System (Phil-GEPS). Prepares and submits reports of — purchases indicating the suppliers/dealers/manufacturers, terms, conditions and mode of procurement. Monitors procurement activities and ensures that it is properly documented. Manual of Organization and Management of the Administrative and Finance Service for Hospitals [;

Acts as central channel of communications between the BAC with the different end-users, internal and external clients, program managers, and the general public. Standard Operating Procedures (Refers to separate DOH Manual of Procurement and GPPB Manual of Procurement for Goods, Services and Civil Works) ):) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 55

PROPERTY AND SUPPLY Function This department/section receives, stores, issues and conducts inventory of supplies, materials and equipment and disposes unserviceable/ condemned hospital properties. Headed by : Department/Section Head Responsible to : Chief of the AFS Expects input from : All hospital units Hospital Inventory Committee Appraisal and Disposal Committee Procurement Department/Section Accounting Department/Section Budget Department/Section Internal Control Service (ICS) Commission on Audit Provides services/inputs to Internal clients : All hospital units External Clients : Department of Health Department of Budget and Management/ Procurement Service Commission on Audit Suppliers/Contractors Other clients Policies » An effective and efficient property and supply management program shall be established and maintained. e Effective planning and scheduling of requirements shall be observed to assure the continuous availability of supplies, materials and equipment for the effective and efficient delivery of quality services. e Delivered goods and services shall be accepted based on the required specifications and existing standards. 56 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

e Procured goods shall be properly stored, regularly inventoried, appropriately insured, and correctly issued. ¢ Government properties when transferred without cost to other government agencies or when disposed due to unserviceability shall be properly documented. ¢ Adequate inventory controls and accountability records (Acknowledgement Receipt Equipment (ARE) ) shall be maintained and regularly updated. ¢ Proper care for acquired assets including its preservation, preventive maintenance, handling and storage shall be assured. ¢ Newly acquired property and supply is adequately inspected to assure proper quantities, acceptable conditions and compliance with specifications and standards. * Property and supply management reports, including accountability requirements, are accurately prepared and submitted. Responsibilities ¢ Prepares a comprehensive plan for the receipt, storage, issuance and inventory of hospital supplies, materials and equipment and disposal of unserviceable hospital properties. ¢ Maintains supplies and materials stock and equipment ledger cards. e Prepares/Updates Acknowledgement Receipt of Equipment and Inventory Custodian Slip for items with amount falling in the ceiling set by COA. ¢ Facilitates required insurance of hospital properties. ¢ Prepares Purchase Request for recurring items based on the approved Agency Procurement Plan (APP) e Submits Purchase Requests to BAC for appropriate action. e Maintains sound inventory level of stocks and implements proper storage system. ¢ Observes the orderliness and cleanliness of the storage room. :} Manual of Organization and Management of the Administrative and Finance Service for Hospitals a7

e Prepares and submits reports of summary of receipts and issuance of equipment, supplies and materials. « Prepares and ensures the completeness of accountable documents required for the payment of the delivered , received and completed transactions. e Prepares and submits report of undelivered goods and services. e Verifies and issues gate pass for the exit of any property whether personal or hospital property. Standard Operating Procedures (Refer to separate DOH Property and Supply Management Manual) 58 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |:

CENTRAL INFORMATION MANAGEMENT Function This department/section develops and administers a comprehensive plan of systematic management of data and research for the improvement of acquisition, utilization of finances, assets and development of human resources, operating systems and procedures. Headed by : Department/Section Head Responsible to : Chief of AFS Expects inputs from : All hospital units All hospital committees Provides services to Internal clients

All hospital units All hospital committees External clients : DOH and other clients Local and International Research Institutions Policies ¢ The hospital management shall designate and maintain secured areas to ensure system security and to provide appropriate access to information. e Security policy for data integrity, confidentiality, and availability of patient and employee identifiable health information shall be observed. ¢ All hospital data, information and technology resources shall only be used for official business purposes. ¢ The hospital shall respect the legitimate propriety interests of intellectual property holders and observe copyright law that prohibits the unauthorized use or duplication of software. e The computer system or network design shall be regularly evaluated and monitored to ensure that appropriate security has been implemented. :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 59

e Prudent physical and environmental measure for the hardware, software and data within its purview shall be provided.

Accurate and updated administrative, financial and hospital statistical information shall be maintained for planning and decision making. e Prior clearance from hospital management shall be secured before release of any information. « Research for systems maintenance and improvement shall be encouraged for effective, efficient and productive hospital operations. » A written Disaster Recovery Plan for stored data and information shall be established. e Linkages with local and international research institutions shall be established. Responsibilities ¢ Prepares a comprehensive plan on management improvement of acquisition, utilization and development of human resources, finances, assets and operating systems and procedures. « Maintains reasonable and appropriate administrative, technical and physical security to ensure the integrity and confidentiality of patient and employee identifiable information. e Establishes measures to counteract events which may compromise data integrity such as system failure, inadvertent manipulation, unauthorized use and handling. » Conducts studies on systems improvement of human resources, finances, assets, and hospital operation. e Implements systems, programs and projects on information technology.

Ensures that all hospital personnel understand their obligations and responsibilities in protecting the system and information. * Develops the preventive maintenance program to ensure the regular checking and calibration of IT equipments and accessories. 60 Manual of Organization and Management of the Administrative and Finance Service for Hospitals {:

¢ Prepares Project Procurement Management Plan (PPMP) for supplies, materials, equipment and software for systems improvement. e Establishes and maintains data bank/files on hospital information, directives/ issuances. ¢ Collates and prepares required accomplishment reports. e Receives and records communications and documents and forwards to concerned units for appropriate action. e Coordinates with identified local and international research institutions for the improvement of the entire hospital operations. Standard Operating Procedures e Incoming and Outgoing Records Procedures Person/s Responsible

Receives and records incoming documents CIM staff concerned
Sorts and forwards to immediate supervisor
Reviews and takes corresponding action Head, CIM
Acts on instruction CIM staff concerned
Records and releases outgoing documents Network Operations » Software Troubleshooting Procedures Person/s Responsible
Submits reports to System Administrator any IT Implementers/ noted glitz on the program designated staff Manual of Organization and Management of the Administrative and Finance Service for Hospitals 61

Procedures Person/s Responsible A 2. Checks reported glitz and takes appropriate System Administrator/ action designated staff 3. Maintains the sustainability of HOMIS and other IT programs 4. Refers to DOH IMS for necessary technical assistance _5. Maintains general records/reports » Hardware Troubleshooting ? Procedures Person/s Responsible

Prepares request for troubleshooting of hardware Implementer/designated staff
Assesses request System Administrator/
Conducts troubleshooting and prepares the designated staff necessary report and requisition of materials if warranted
Refers to DOH IMS for necessary technical assistance
Maintains general records/reports Procedures Person/s Responsible
Submits report or request for data collection and All Hospital units research
Receives/ Gathers report for data bank CIM Staff concerned
Collates and types data and forwards to Head of unit

Analyzes and summarizes data CIM Head. 5. Prepares and submits final report to the Chief of the Hospital through the CAFS 62 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

Procedures Person/s Responsible

Reviews and determines need for revision, CIM Head modification or change .
Gathers needed data and drafts the proposed change/s
Types draft of proposal and gives back to Head CIM Staff
Reviews and forwards proposal to the Chief of the CIM Head Hospital through the CAFS Manual of Organization and Management of the Administrative and Finance Service for Hospitals 63

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8 FINANCIAL MANAGEMENT Financial management in a hospital setting is the process of seeking the optimal financing, allocation, and control of all resources of the health care organization. It is through the accumulation of financial data and its results, the month-end and year-end accounting and statistical reports are prepared. Financial reports and statements are useful in planning, organizing, directing and controlling the activities of any organization. The Financial Management Cluster is responsible for financial transactions of the hospital such as: accounting, budgeting, billing and claims, and cash management. General Policies e The existing government budgeting, accounting and auditing rules and regulations shall govern the financial transactions and operations of the hospital. ¢ The highest standard of honesty, objectivity and consistency shall be observed in keeping the Books of Accounts. e The existing government directives on patient’s rights, benefits and privileges, whenever applicable, shall be incorporated in the patient’s billing and claims. e Cash flow shall be properly monitored to alert management of the available money to sustain hospital operation. ¢ There shall be a proper cost-finding and rate-setting of services (and procedures) rendered primarily for purposes of cost-recovery. Benefits and Activities to Achieve Good Financial Management The benefits of high-quality government financial management are substantial. These benefits can be achieved through the application of the typical financial management activities such as: :} Manual of Organization and Management of the Administrative and Finance Service for Hospitals 65

Enhanced fund sourcing » Identification of the most effective revenue sources. » Proper management of the collection of revenues and other receipts » Management of the receipt of external resources, including loans and official development assistance, through proper procedures and controls which comply with requirements of lenders and donors. More optimal resource allocation decisions to achieve clearly articulated public policy objectives » Planning and prioritization of investments and their funding. » Systems establishment and management to identify policy priorities, cost and benefits of decision alternatives, presenting information and implementing monitoring and reporting on outcomes. Improved financial management and expenditure control through more effective processes and control mechanisms » Planning and budgeting systems for revenues and expenditure. » Establishment of systems for preparing, reviewing and consolidating medium- term financial plans and budgets. » Implementation and monitoring of policies. Financially viable management of inflows and outflows » Anticipating the liquidity needs of the hospital for deploying surpluses to achieve maximum use of liquid funds. Improved technical efficiency in managing and utilizing resources » Ensuring that expenditures and other resources are applied to the maximum advantage of government. » Directing resources to high priority through cost benefit analysis. Enhanced transparency and accountability of government, providing better historic information as a guide to the future » Recording, accounting for the financial transactions, assets and liabilities of government Good management of public funds and assets, resulting in reduction in the levels of corruption and leakages 66 Manual of Organization and Management of the Administrative and Finance Service for Hospitals {:

» Protecting and enhancing the right of government to receive maximum benefits for its money’s worth. » Carry out the necessary financial transactions of government, e.g. bills to settle, staff to pay and revenues to collect. » Ensuring better government’s financial reputation among customers, investors ete. Integrative Approach to Financial Management The government financial management is a circular process made up of several interrelated systems, as follows: Long- and medium-term planning; Recurrent and developmental budgeting and funds derived from income; Fund release and liquidity management; Accounting and monitoring; Internal and external audit; and Systems of information feedback and reporting Integration of these subsystems is important for decision making, control and monitoring. Recent developments in information technology made the integrated approach to financial management possible. The benefits from integration of, or linkages between, subsystems are substantial. The information outflows from one component are inflows to another component. All utilize a common financial valuation and measurement model. Recognition of the linkages and commonality can improve performance within each sub-component, and hence of the system as a whole. By treating the system as a whole, more effective procedures, information flows, training, and systems tools can be developed. Modern information technology makes it both more feasible, and the gains greater, to treat financial management as a single system. :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 67

ACCOUNTING Function This department/section directs and coordinates the systematic recording of all financial transactions, preparation of financial statements and relevant reports, and maintenance and safekeeping of Books of Accounts. Headed by : Department/Section Head Responsible to : Chief of the AFS Expects services/inputs from : Budget Procurement, Property and Supply Cash Operation Billing and Claims Pharmacy Cost and Revenue Centers Human Resource Management Nutrition and Dietetics Medical Social Service Linen and Laundry Special Disbursing Officers Central Supply Room Ancillary services Financial Planning and Management Committee Provides services to Internal Clients : All Hospital Units Financial Planning and Management Committee External Clients : Department of Health - Central Office/CHD Department of Budget and Management Commission on Audit Bureau of Internal Revenue Other Government Agencies Non-Government and Other Clients 68 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (:

Policies The Accounting Department/Section shal] be accountable in safeguarding government resources against loss or wastage. All financial transactions shall be supported with complete documents and shall comply with existing accounting and auditing rules and regulations Public accountability shall be strictly observed in the conduct of government activities and operations. Records of all financial transactions shall be maintained and updated in conformity with the New Government Accounting System. Responsibilities Prepares a Comprehensive Financia] Management Work Plan. Directs and implements the generally accepted accounting and auditing principles and maintains/ updates the Books of Accounts. Implements and monitors the systematic recording of financial transactions. Ensures that the implementation of accounting practices as to disbursements of funds is in accordance with COA and DBM rules and regulations. Certifies as to the availability of funds/cash and completeness of documents. Maintains/ Reconciles Equipment and Supplies ledger cards. Provides data to the Budget Department/Section the analyzed financial statements (Income and Revolving Fund) including unutilized obligation. Provides technical assistance on financial matters.

Provides financial information that is useful in making decisions involving the effective and efficient allocation and control of government resources. e Signs accountability clearance and PHIC claims of personnel Standard Operating Procedures
Recording of Allotment/Notice of Cash Allocation (NCA) / Notice of Transfer of Cash Allocation ( NTCA) Procedures Person/s Res onsible

Receives and records copy of allotment and Receiving/Releasing staff NCA/NTCA from Budget Department/Section.
Forwards to the Head, Accounting Department/ Section i
Acknowledges/notes copy of the allotment and Head, Accounting NCA/NTCA. Department/ Section
Forwards to accounting staff concerned.
Journalizes receipt of NCA/NTCA. Designated staff
Files copy of allotment
Signs the J ournal Entry Voucher (JEV) Head, Accounting 8 Returns to accountin staff concerned. Department/ Section
Records JEV in the General Journal. Designated staff
Files copy. 70 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |:

¢ Processing of Purchase Order (PO)/Job Order (JO)/Market Order (MO) Procedures Person/s Responsible

Receives/Records PO, JO and MO Receiving/Releasing staff
Forwards to accounting staff concerned
Reviews completeness and appropriateness of Designated staff supporting documents as to mode of procurement
Checks and verifies computations.
Reviews ObR , BUR number and corresponding amount allotted.
Initials and forwards documents to Head, Accounting De artment/Section. & Dep aint
Reviews and certifies as to availability of Head, Accounting funds/cash in the PO/J O/MO. Department/ Section
Forwards to releasing staff.
Forwards/Records the PO/JO/MO to the division Releasing/Receiving staff head concerned

Processing Payment/Claims » Processing of Payroll, First Salary, Terminal Leave and Other Personnel Benefitsa Procedures Person/s Responsible

Receives /Records payroll, voucher and Receiving/Releasing Obligation Request staff
Assigns voucher number and records in the logbook
Forwards to designated accounting staff
Verifies outstanding cash advance from previous Designated staff payroll
Processes/Checks summary
Reviews appropriateness of supporting documents, whether first/last payment of salaries/benefits and allowances
Reviews obligation number and amount in the voucher and payroll
Prepares Journal Entry Voucher (JEV)
Reviews and signs the JEV
Posts cash advance to the index of payment.
Initials and forwards documents to the Head, Accounting Department /Section
Certifies and signs voucher/payroll based on the Head, Accounting following: Department/ Section

Availability of cash

Completeness of the supporting documents 13. Signs JEV and initials index of payment 14, Forwards to releasing staff 15. Records and forwards voucher/payroll to the Receiving/Releasing CAFS staff 72 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

» Processing of Payments Chargeable against Maintenance and Other Operating Expenditure (MOOE) and Capital Outlay (CO) Funds Procedures Person/s Responsible

Receives and records disbursement vouchers
Assigns and indicates voucher number
Forwards to assigned accounting staff Receiving/Releasing staff
Checks/Verifies completeness of additional supporting documents according to the nature of transactions
Confirms obligation number in the voucher Designated staff
Reviews computation of Value Added Tax (VAT), Expanded Withholding Tax (E-VAT) and penalties, if there’s any
Prepares, reviews and signs the JEV and initials the voucher Designated staff
Records vouchers in the index of payment.
Forwards to Head, Accounting Department/Section Designated staff
Certifies/Signs the voucher based on the following:

Availability of cash

Completeness of the supporting documents 11. Signs JEV and initials index of payment 12. Forwards to releasing staff. Head, Accounting Department/Section. 13. Records, releases to CAFS and files copy Receiving/Releasing staff :)} Manual of Organization and Management of the Administrative and Finance Service for Hospitals 73

» Processing of Remittances (BIR, GSIS, HDMF, NHMFC and other authorized deductions) Procedures Person/s Responsible

Receives the following: Designated staff

Remittance list of mandatory deductions (Based on Payroll and Voucher)

Report of Checks Issued (RCI) 2. Prepares the report of taxes withheld (BIR) 3. Prepares, checks, totals and prints final Designated staff Remittance List (e.g. GSIS, etc.) 4. Prepares and initials the monthly remittance/ Designated staff Returns of Taxes Withheld with corresponding TRA for the following:

Compensation

Expanded Creditable Tax

Value Added Tax 5. Prepares Summary of Tax Withheld for Trust Fund 6. Prepares disbursement voucher per remittance and its corresponding JEV 7. Initials vouchers and JEVs 8 Posts the remittances in the index of payment 9. Approves/Signs remittance list/BIR form Head, Accounting reports/TRA and JEV. Department/ Section 10. Certifies/Signs voucher as to availability of cash and completeness of the supporting documents for TRA and other remittances not requiring ObR 11. Records and forwards voucher with Receiving/Releasing staff corresponding remittance list not requiring ObR to the CAFS. 12. Records and forwards voucher with corresponding remittance list to the Budget Section/Department 74 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (-( o

e Preparation of Monthly Remittances Report Procedures Person/s Responsible

Prepares and initials the following: Designated staff

BIR Form No. 2306

Certificate of VAT/Final Tax

BIR Form No 2307 Certificate of Creditable Tax Withheld for distribution to suppliers

PHIC Claim Form 1

Certificate of Remittances per request (GSIS/PHIC/HMDF). 2. Prepares/fills up/initials employer portion of Philhealth Claims Form 1 3. Signs/certifies accomplished forms mentioned above __ Head, Accounting Department/ Section 4. Distributes forms/certificates to concerned parties Designated staff e Request for Release of Notice of Cash Allocation (NCA) Procedures Person/s Responsible I. Prepares letter request for release of NCA based on Designated staff the certification issued by Bureau of Treasury (BTr) for payment of various trust liabilities 2. Prepares List of Due and Demandable Accounts Payable (LDDAP) and request for release of NCA 3. Checks and signs Corresponding portion of LDDAP Head, Accounting and initials request for NCA. Department/ Section 4. Records/Forwards LDDAP to Cash Operation Receiving/Releasing Section and NCA request to CAES. staff 5. Forwards/Instructs Liaison Officer to transmit requests to DOH/DBM. 6. Records approved LDDAP and keeps file. :} Manual of Organization and Management of the Administrative and Finance Service for Hospitals 75

e Recording in the Books of Account Procedures Person/s Responsible

Receives reports and other documents from Receiving/Releasing staff different sections/services/unit to be recorded in the Books of Accounts.
Reviews/analyzes/journalizes the following Designated staff reports/transactions: Deliveries and issuances of purchased and donated equipment, drugs and medicines, other supplies and materials. Report of Collections and Deposits (RCD) Report of Disbursements (cash advances) Report of Checks Issued and Cancelled (RCIC) Report of Bills Rendered (RBR) Transactions for adjustments
Prepares JEV and corresponding special journals
Certifies as to the correctness of entries and Head, Accounting signs JEVs and special journals Department/ Section
Posts on the General Ledger (GL) entries made Designated staff from general/special journals
Maintains subsidiary ledgers as required 76 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

Procedures Person/s Res onsible I. Prepares the required monthly and quarterly financial Designated staff reports as follows:

Trial Balance
Statement of Income and Expenses
Balance Sheet
Statement of Government Equity
Cash Flow
Report of Income ~ Bank Reconciliation Statement
List of Obligated PO/JO but not yet Due and Demandable
Statement of Taxes Withheld and Remitted
Statement of Actual Income Collection and Utilization
Statement of Accounts Receivable
Statement of Accounts Payable

Prepares the required semi-annual and annual Designated staff financial reports as follows:

Statement of Management Responsibility Notes to Financial Statements
Trial Balance (Preliminary and Final)
Statement of Income and Expenses
Balance Sheet
Statement of Government Equity
Cash Flow
BIR Alpha List (Compensation, VAT/ECT)
Ageing of Accounts Receivables ~ Ageing of Accounts Payable
Summary of Receipt of NCA/NTCA
Detailed Report of Disbursement
BIR Form No, 2316 (Annual Income Tax) Statement of Affiliation/Professional Fees Collected for distribution ~ Other Reports that may be required from time to time eee

Signs statements/reports made Head, Accounting
Certifies and signs statements/reports Department/ Section
Records/Submits to the different concerned agencies Designated staff as required

BUDGET Function This department/section directs and coordinates with the persons concerned in the consolidation and preparation of the Budget Proposal, Work and Financial/Operational Plans including its implementation and monitoring. Headed by : Department/Section Head Responsible to : Chief of the AFS Expects services/inputs from : All hospital units Provides services to Internal Clients : All hospital units External Clients : Department of Health, CHD Department of Budget and Management House of Representatives Other government agencies Other clients Policies « Government laws and regulations on expenditures of government funds shall be strictly observed. « Availability of allotment shall be certified in accordance with the General Appropriation Act. ¢ All financial transactions shall be done in accordance with the Work and Financial Plan and supported with complete documents. 78 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

Responsibilities Prepares a Comprehensive Budget Management Plan. Analyzes and consolidates budget proposal. Prepares and submits budget proposal, Work and Financial/ Operational Plans. Records, analyzes, monitors and controls allotment and fund utilization. ! Allocates available funds to hospital programs and projects based on approved’ guidelines, policies and priorities. Ensures the accuracy and correctness of the Obligation Requests/Budget Utilization Requests made and maintains Registries of Allotment. Prepares and submits the Annual Budget Execution Documents (BEDs)/Quarterly/Monthly Budget Accountability Reports (BAR). Prepares the Quarterly Financial Statement Matrix. Plans, directs and prepares request for re-alignment/reprogramming of funds corresponding to the appropriate reserves. Provides technical assistance to and coordinates with all units regarding budget related matters. Prepares various communications/request relating to the release of additional/supplemental allotments and other matters relating to the budget of the hospital including congressional initatives. Serves as the hospital’s liaison officer for budgetary matters. Manual of Organization and Management of the Administrative and Finance Service for Hospitals 79

Standard Operating Procedures e Receipt/Recording of Allotment Procedures Person/s Responsible

Receives/Records the ABM/ SARO/Sub- Receiving/Releasing staff Allotment from DBM/DOH Z. Signs/Acknowledges receipt of allotments Head, Budget Dept./ Section 3, Prepares/Posts the allotment in the Designated staff corresponding Registries
Reproduces and files the original co _ Records and furnishes concemed offices Receiving/Releasing staff _5, Records and furnishes concen e Request for Funding Procedures Person/s Responsible
Receives/Records PO/JO/DV Receiving/Releasing staff
Examines/Verifies completeness of supporting Designated staff documents
Determines/Verifies the availability of allotment Head, Budget Dept./ Section
Prepares the Obligation Request (ObR) for ABM/ Designated staff SARO/Sub-Allotment Releases) and Budget Utilization Request (BUR) for Special Account in the General Fund (SAGF)/Trust Accounts in four (4) copies Assigns appropriate serial number and expense code Types the name of the concerned division head Records ObR/BUR Reviews the correctness of the prepared ObR/BUR
Initials duplicate copy of the ObR/BUR
Forwards to the concerned division head for review and signature ale ca a 80 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

nesses Procedures Person/s Responsible ——__________Frocedures OTE 11. Receives/Records approved ObR/BUR Receiving/Releasing staff 12. Verifies that all documents are in order and properly signed 13. Reviews/analyzes the correctness of the Obligation Head, Budget Dept./ Request (ObR)/Budget Utilization Request (BUR) Section and the supporting documents 14. Affixes signature on the ObR/BUR, certifying to the availability of allotment 15. Records the ObR/BUR in the Registries of Designated staff Allotments and Obligations (RAO) for PS/MOOE/CO and Registry of Budget and Utilization (RBU) for SAGF/Trust Accounts 16. Records/ Forwards to the Accounting Department/ Receiving/Releasing staff Section e Preparation and Submission of Reports me ne eee Procedures Person/s Responsible

Prepares and submits the required Monthly* and Designated staff Quarterly/Semi- Annual/Annual** reports.
Summarizes gathered data and drafts them in the required form
Reviews and corrects the draft accomplished form Head, Budget Dept/Section
Finalizes corrected draft report and prepares letter for Designated staff the Reports
Reviews and signs the accomplished form and Head, Budget Dept/ Section initials the letter
Records/ Forwards the same to the CAFS. Receiving/Releasing staff
Receives/Records signed accomplished forms and letter
Keeps file copy and submits the report to DOH/DBM :} Manual of Organization and Management of the Administrative and Finance Service for Hospitals 81

Monthly Reports:

Statement of Allotments, Obligations and Balances (SAOB) (Appendix I-3)
Status of PDAF Utilization **Quarterly/Semi-Annual/ Annual Reports:
Work and Financial Plan
Monthly Cash Program
Estimate of Monthly Income
Physical Report of Operation
Financial Report of Operation
Monthly Status Report on the Release and Utilization of Funds
Expenditure Actual Budget Variance for the Month
Expenditure Actual Budget Variance for the Quarter
Quarterly Estimate of Income Collection and Utilization
Statement of Revenues
Report on Savings
Actual Budget Releases versus Plans
Status of PDAF Utilization
Accomplishment Report per Work and Financial Plan (WFP)
Appropriations and Obligations
Actual Obligations
Summary of Appropriations, Allotment, Obligations and Balances e Budget Preparation a Procedures Person/s Responsible

Coordinates with the CAFS for a budget meeting Head, Budget Department/ with the Chief of Hospital, different services, Section sections/unit heads
Gives instruction on the details of the budget preparation pursuant to the Budget Call and other instructions
Requests the department/section heads to submit their respective plans
Reviews the submitted plans
Discusses the plans and proposals of the respective divisions/sections to ensure conformity to the hospital targets, objectives and the mandate of the budget call. Revises, if necessary.
Consolidates the reviewed plans and proposals
Prepares/Encodes the consolidated plans into the Designated staff required forms in four (4) copies 82 Manual of Organization and Management of the Administrative and Finance Service for Hospitals i

Procedures Person/s Responsible 8. Reviews/Signs/Initials the accomplished budget forms Head, Budget Department/ Section 9. Forwards the accomplished budget forms to the CAFS for review and recommendation 10. Receives/ Records the approved budget forms Receiving /Releasing staff 11. Prepares letter of endorsement Designated staff 12. Reviews/A ffixes initial in the letter Head, Budget Department/ Section 13. Records /Releases letter to the Chief Administrative Officer for initial/approval of the Chief of the Hospital 14. Receives/Records the approved letter. 15. Keeps file copy and submits the proposed plan of the hospital to the Department of Health (DOH) Receiving/Releasing staff e Preparation of the Agency Budget Matrix (ABM) Procedures Person/s Responsible

Coordinates with the DBM Analyst on the instructions/details upon the receipt of the approved General Appropriations Act (GAA)
Prepares draft of the Agency Budget Matrix as to appropriation to support expenditures to be made for the year Head, Budget Department/ Section
Finalizes the draft and prepares the letter of endorsement Designated staff
Reviews and signs the “Prepared By” portion of the ABM and initials the letter Head, Budget Department/ Section
Records/Forwards ABM together with the letter for initial and review of the CAFS Receiving/Releasing staff :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 83

Procedures Person/s Responsible 6. Receives/Records the approved ABM and letter 7. Keeps file copy and submits the approved ABM to the Department of Budget and Management (DBM) Receiving/Releasing staff e Preparation of Communications/Requests on Budgetary Matters Procedures Person/s Responsible

Prepares draft of request for additional/supplemental allotment/re-alignment of funds
Forwards the draft to the Chief of Hospital Head, Budget Department/ Section
Receives/Records the corrected draft (if any)
Finalizes the request Designated staff
Reviews the finalized draft and affixes initial Head, Budget Department/ Section
Records/Forwards the request to the Chief of the Hospital for approval
Keeps file copy and submits the letter request to DOH/DBM Receiving/Releasing staff 84 Manual of Organization and Management of the Administrative and Finance Service for Hospitals ({ é

Preparation of the Operational Plan (OP) and Work and F inancial Plan St (WEP) Procedures Person/s Responsible

Drafts the Operational Plan (OP) and Work and Head, Budget Financial Plan (WFP) using the required forms Department/ Section
Coordinates with, and consults the different division heads for their performance targets and activities eee
Finalizes the OP/WFP draft and prepares the Designated staff letter of endorsement
Reviews and initials the finalized OP/WFP and Head, Budget letter Department/ Section te a a, ae
Records / Forwards OP/WFP together with the letter for initial and review of the Chief of the AFS
Receives/Records approved OP/WFP and letter
Keeps file Copy and submits the approved OP/WFP to the DOH aaa Receiving/Releasing staff Manual of Organization and Management of the Administrative and Finance Service for Hospitals 85

BILLING AND CLAIMS Function This department/ section implements proper charging system, by recording of all hospital procedures, services, medical supplies, drugs and medicines incurred to patients regardless of patient’s classification including claims, fees and use of facilities and other non patient services. Headed by

Department/Section Head Responsible to

Chief of the AFS Expects services/inputs from

Chief of the Hospital Chief of the AFS Cash Operation Accounting Financial and Management Review Committee Medical Records Statistical Unit Medical Social Service External Clients : Patients COA, PHIC Other clients Policies e Proper billing of patients and hospital services shall be based on applicable policies, rules and procedures. e Patient/Client shall be assured of prompt access to billing information (progress billing) for all services provided.

All hospital diagnostic and therapeutic procedures and other services rendered including drugs, medicines and supplies issued to patients and other clients shall be properly charged. 86 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

—S— * Issuance of pre-numbered charge slips to all type of patients shall be implemented. ¢ There shall be a cut-off time in forwarding charge slips from Revenue Centers to the Billing and Claims Department/Section. ° PHIC and other claims shall be filed within the Prescribed period from discharge of patient, ¢ All other non-patient services/claims shal] be billed within the prescribed period of time. Responsibilities ° Accounts and monitors patient’s hospital charges in accordance with existing policies, rules and regulations. * Consolidates and computes charges and maintains patient’s ledgers, ¢ Prepares Progress billing and informs patients accordingly, ° Reviews and Processes PHIC and other claims. * Monitors accounts receivable and follows Up outstanding and overdue accounts. * Prepares periodic analysis of receivables versus collections, ¢ Prepares and submits summary of bills rendered. * Conducts Periodic account reconciliation with Accounting and Cash Departments/Sections, Manual of Organization and Management of the Administrative and F inance Service for Hospitals 87

e Conducts account monitoring and analysis regularly. n letters on a monthly basis. « Prepares and sends appropriate collectio Standard Operating Procedures bution of Charge Slip

Control and Distri erson/s Responsible Procedures P e Slip Booklets from Property Designated staff

Receives Charg ion. and Supply Department/Sect
Checks the number series of the booklets and records in the control logbook.
Issues Charge Slip Booklets to requesting Revenue Centers. of issued charge

Prepares monthly summary slips. Person/s Responsible Procedures 1, Prepares/Reviews records of unpaid accounts Designated staff /second and final 2. Prepares initia notices/collection letters . gns collection letters Head, Billing and Claims 3, Reviews/Si Designated staff ee 4, Prepares mailing list and send via registered mail 88 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (

¢ Discharge of Patient Procedures Person/s Responsible

Receives notice of admission from the Designated staff Admitting & Information Department/Section
Prepares patient individual jacket and Ledger Card and arranges in alphabetical order
Receives and sorts charge slips accordingly and encodes daily charges of patients
Issues progress billing within 24 hrs. of confinement or every three (3) days during confinement period
Requires patient to submit document/s requirement for PHIC/other health insurance reimbursement, if an ; updates patient’s bills $e, Ut any; updates p
Receives discharge notice of patient from Nurse Designated staff Station

Retrieves patient’s Jacket/ledger card, checks charge slips used and prepares/checks billing statement 8. Issues Statement of Account to the patient or relative ¢ Preparation of Reports Procedures Person/s Res onsible

Prepares Monthly Report of Bills Rendered (RBR) Designated staff
Signs the “Prepared By” portion of RBR
Reviews/Certifies to the correctness of the report. Head, Billing and Claims
Records/Forwards to Accounting Department/ Receiving/Releasing staff Section RBR and copy of patient bills,

e Preparation of PHIC Claims Procedures Person/s Responsible

Retrieves patient’s jacket. Designated staff
Checks/Verifies supporting documents. 3, Computes the allowable PHIC benefits. _ Fills up the required data in the PHIC form. _4, Fills up the required data in the PHC Tor
Reviews/Initials the accomplished PHIC form/ Head, Billing and Claims supporting documents. _
Records/Forwards the PHIC Forms with the attached Receiving/Releasing staff supporting documents to the Chief of AFS for signature.
Records/Submits the signed PHIC forms/supporting documents to PHIC. e Preparation of Other Claims (Collections for rentals, affiliation fees, dormitories, and other fees) Procedures Person/s Responsible
Prepares statement of account/ order of payment to Designated staff various clients.
Reviews/Initials statement of account/order of Head, Billing and Claims payment together with the supporting documents.
Issues statement of account/ order of payment to Receiving/Releasing staff clients. 90 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |:

CASH MANAGEMENT Function This department/section directs controls and ensures the proper disbursement and collection transactions of the hospital. Headed by Responsible to Expects services/inputs from Provides services to Internal Clients External Clients Policies Department/Section Head Chief of the AFS Procurement, Property and Supply Human Resource Management Accounting Engineering Billing and Claims Revenue Centers All hospital employees Patients Creditors/Suppliers/Contractors All collecting/disbursing officers shall be properly bonded. All collections shall be properly receipted, safe kept and deposited intact daily in authorized government depository bank. book. Records of all monetary transactions shall be properly maintained in the cash All disbursement vouchers and supporting documents shall be‘stamped “PAID”. All remittances shall be remitted on or before the deadline to avoid penalties. :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 9]

Issuance and releases of checks to payees and or authorized representative shall be assured within the prescriptive period. Preparation and Submission of required reports shall be observed on or before deadline. Responsibilities Prepares and implements a comprehensive and systematic Cash Management Plan. Implements the prescribed disbursement systems and procedures. Monitors the receipts of collections and deposits. Directs and monitors the preparation and disbursement of payments for various expenses. Pays compensation and other monetary benefits of hospital officials and employees. Maintains records of cash collections, deposits, disbursements and other related transactions. Verifies/Certifies the accuracy of the cash collection / remittances report and regular reports of accountabilities. Designs and develops methods and procedures concerning receipts, deposit, custody, and disbursement of cash. Prepares Agency Check Issued and Cancelled/Agency Debit Advice. Acts as Special Disbursing Officer for Petty Cash management and disbursement. Coordinates with the government depository bank for the Automated Teller Machine (ATM) transactions. Manual of Organization and Management of the Administrative and Finance Service for Hospitals

Standard Operating Procedures ¢ Receipt of Notice of Cash Allocation (NCA) and Other Documents Procedures Person/s Responsible

Receives/Records copy of the NCA, LDDAP Receiving/Releasing staff and other documents
Initials copy of the NCA Head, Cash Operation
Signs the corresponding portion of LDDAP _
Records NCA in the Cash Receipts Book. Designated staff
Records/Forwards LDDAP to CAO « Receipts/Report of Collections and Deposits Procedures Person/s Responsible
Receives cash/check from payor based on the Designated staff order of payment/charge slip.
Issues official receipt to acknowledge receipt of cash/check.
Indicates OR Number in the order of payment/charge slip
Records collection in the Cash Receipt Registry Designated staff (CRR) oy . Prepares Deposit Slip (DS) in three (3) copies. Designated staff
Deposits collection with the Authorized Government Depository Bank (AGDB).
Prepares Report of Collection and Deposit (RCD) in two (2) copies and should be based on the validated DS from the AGDB and copy of the ORs on file
Initials the RCD and forwards the same together Designated staff with duplicate copy of the ORs and DS to the Manual of Organization and Management of the Administrative and Finance Service for Hospitals 93

Procedures Person/s Responsible Head of the Cash Unit for review and signature. 9. Prepares List of Deposits (Affiliation/PHIC Professional Fees) to BTr/Trust Account for confirmation of deposits Designated staff 10. Reviews and signs the RCD and BTr Confirmation Deposits Head, Cash Operation 11. Records/Forwards original RCD, duplicate copy of the ORs and DS and BTr for confirmation of the Accounting Unit Designated staff Payment of Claims » Personal Services (PS) Procedures Person/s Responsible

Receives/Records approved disbursement vouchers (DV) Receiving/Releasing staff and corresponding payroll
Prepares corresponding payroll diskette Designated staff
Verifies the completeness of the signatories and sources of funds
Determines balances of the bank account to be used Designated staff
Types the check and the corresponding Advice of Checks Designated staff Issued and Cancelled (ACIC)
Records the amount and check number in the control book
Checks the amount in the check and DV.
Signs the check Head, Cash Operation
Records/Forwards the check and ACIC with the approved voucher to the office of the CAFS
Receives/Records signed check and ACIC with the DV Receiving/Releasing staff 94 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (.(°

Procedures Person/s Responsible 11. Submits copy of ACIC with diskette/soft copy to the Designated staff AGDB for transfer to the employees’ ATM account 12. Submits duly approved and certified Monthly Alpha List of Payees with attached Monthly Remittance Return of Creditable Income Taxes Withheld along with TRA for General Fund on or before the deadline to avoid penalties 13. Submits Authority to Debit Advice (ADA) and Designated staff Summary of Tax Withheld for Trust Fund on or before the deadline to avoid penalties 14. Remits payment for monthly deductions of GSIS/PHIC/ Designated staff HDMEF and other authorized deductions on or before the deadline to avoid penalties. Designated staff 15. Distributes employee’s pay slip. » Maintenance and Other Operating Expenditure (MOOE)/ Capital Outlay (CO) Procedures Person/s Responsible . Receives/Records approved disbursement vouchers Receiving/Releasing staff (DV) Sorts/Verifies the completeness of the signatories and Designated staff sources of funds 1eS) Determines balances of the bank account to be used Designated staff Types the check and the corresponding Advice of Checks Issued and Cancelled (ACIC) . Records the amount and check number in the control book ON Checks the amount in the check and DV Head, Cash Management Signs the check . Records/Forwards the check and ACIC with the Receiving/Releasing staff approved voucher to the office of the CAFS . Reccives/Records signed check and ACIC with the DV Manual of Organization and Management of the Administrative and Finance Service for Hospitals 95

Procedures Person/s Responsible 10. Records the check in the registry in numerical and chronological sequence. 11. Submits the original copy of the ACIC to the AGDB. Designated staff e Disbursements from the Petty Cash Fund » Establishment Procedures Person/s Responsible

Receives check for the establishment of petty Petty Cash Custodian cash
Records in the Cash Disbursement Record Petty Cash Custodian (CDR) the date, reference and the amount of check in the disbursement column
Encashes check in the GSB. Keeps cash in the safety vault » Utilization Procedures Person/s Responsible
Accomplishes Box A “Requested By” portion of the Petty Cash Voucher (PCV) (Appendix K6) Requesting Personnel
Signs Box A “Approved By “portion of the PCV and returns to the requesting personnel. Immediate Supervisor
Submits to the Petty Cash Custodian for the release of fund Requesting Personnel
Receives from the requesting personnel the PCV duly approved by concerned official
Signs Box B “Paid By” portion of the PCV upon granting the petty cash advance, Petty Cash Custodian 96 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

Procedures Person/s Responsible 6. Receives petty cash and signs in Box B “Cash Requesting Personnel Received By” portion of the PCV 7. Issues duplicate copy of the PCV to requesting Petty Cash Custodian personnel 8. Records paid PCVs in the CDR \o . Files original copy of PCV awaiting liquidation » Liquidation Procedures Person/s Responsible . Receives from requesting personnel duplicate Petty Cash Custodian copy of the PCV together with supporting documents Checks/Reviews completeness of documents. . Retrieves the original copy of PCV from file and fills up Box D “Liquidation Submitted” portion of the original and duplicate copy of PCVs Checks the appropriate boxes for Petty Cash Custodian (received/refund) or reimbursement paid portion and signs Box C of the PCV. Checks and fills up the appropriate boxes for Requesting Personnel “Liquidations Submitted” and “Reimbursement Paid” upon submission of necessary supporting documents and receipt of reimbursement of cash, if any, and signs the PCV Returns duplicate copy of the PCV to the Petty Cash Custodian requesting personnel. Files the original PCV together with the supporting documents awaiting replenishment if the amount granted is equal to the amount paid as shown in the liquidated PCV ) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 97

Replenishment Procedures Person/s Responsible . Retrieves from file the original of the PCV Petty Cash Custodian together with the supporting document. . Checks the completeness of all PCVs for replenishment. . Prepares the Petty Cash Replenishment Report (PCRR) (Appendix K7) in two (2) copies based on PCVs in numerical sequence. . Signs in the “Certified Correct By” portion of the PCRR. . Prepares DV in three (3) copies, and forwards the same together with supporting documents to authorized official for review and signature. . Signs in Box A portion of the DV Head, Cash Management . Records/Forwards the DV and the supporting Receiving/Releasing staff documents to Budget Department/Section for funding Manual of Organization and Management of the Administrative and Finance Service for Hospitals (:

» Request for Confirmation of Deposits of Trust Accounts a cra Procedures Person/s Responsible I. Prepares summary of Daily Deposits of Trust Designated staff Account to the BTr oan =: cer 2. Records/Forwards to the Accounting Receiving/Releasing staff Department/ Section for reconciliation with the Book of Accounts Bi Receives/Records reconciled accounts Designated staff 4. Prepares a letter of request for confirmation of deposits to the BTr 5. Reviews/Initials letter of request Head, Cash Mana ement ee Tagen, Ee bash Management _ 6. Records/Forwards letter request to the CAFS for Receiving/Releasing staff initial 7. Receives/Records signed letter 8. Forwards Summary of Daily Deposits and Letter Request to the Bureau of Treasury 9. Receives/Records confirmed Summary of Daily Deposits from the BTr and forwards the same to the Budget Department/Section for request of NCA :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 99

» Preparation/Submission of Reports Procedures Person/s Responsible

Prepares the required monthly reports as follows: Designated staff

Cash Receipts Record
Report of Collection and Deposit _ Cash Disbursement Record
Check Disbursement Record
Report of Check Issued
Report of disbursements
Petty Cash Replenishment Report
Liquidation Report
Monthly Report of Accountability

Submits prepared reports to the Accounting Designated staff Division/Department for recording. 100 Manual of Organization and Management of the Administrative and Finance Service for Hospitals &C

9 PATIENT SUPPORT MANAGEMENT General Policies ¢ Patient’s rights shall be respected at all times. ¢ Confidential information of patients shall be maintained and secured. regulations. e Nutritious and well-balanced meals shall be served to either service/charity or pay patients. assistance. e Efficient and effective records management shall be maintained.

ADMITTING AND INFORMATION Function This office directs and controls the centralized registration and documentation of admission and discharges of patients including giving of information. Headed By

Department/Section Head Responsible to

Chief of the AFS Receives inputs from

Patient’s companion ER Nursing staff for unaccompanied patients Clinical Areas Security External and Internal Clients Provides services/inputs to Internal Clients

Patients/families Other clients Policies «The hospital shall designate a room for patient registration preferably located near the Emergency Room and accessible to the Outpatient Department (OPD) to be known as Admitting and Information Department/ Section. » The Admission and Information Department/Section shall be provided with adequate staff and facilities to effectively perform the required functions. « The hospital shall implement a centralized documentation system of admission and discharge of patients. 102 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

¢ Patient’s rights shall be Tespected at all times e. g. confidentiality of records. Responsibilities ¢ Maintains register or record book of admitted and discharged patients with their complete demographic profile and clinical data. * Coordinates with other concerned units, namely: the Medical Social Service and the Billing and Claims. ¢ Issues Cadaver Release/Clearance Slip to authorized persons. ¢ Provides relevant information to authorized persons. 103

Standard Operating Procedures e Admission of Patient Procedures Person/s Responsible

Receives notice of admission. Admitting staff on duty
Verifies patient’s record: _ fold, retrieves previous Master Patient Index (MPI) to get the hospital number. _ Tf new, assigns and/or issues patient’s hospital number/card and prepares MPI.
Prepares MPI in 3 copies for distribution to OPD, Medical Records and file copy.

Records the patient’s admission. Admitting staff on duty |
Collects and records patient’s demographics and | admitting diagnosis in the Clinical Cover Sheet.

Validates information and secures signature of patient/informant in the Clinical Cover Sheet. |
Coordinates with the ward nurses for bed | assignment/patient’s admission. | 8 Coordinates with the Medical Social Service for patient classification and the Billing and Claims for billing requirements. nn e Discharge of Patient Procedures Person/s Res onsible
Receives Discharge Clearance Slip from patient Admitting staff on duty | or guardian.
Records patient’s discharge | 104 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

NUTRITION AND DIETETICS Function This Department/Section directs, maintains and ensures the Provision of safe, high quality and nutritious food to patients and personnel. Headed By

Department/Section Head Responsible to : Chief of the AFS Expects inputs from : Nursing Service Medical Service Procurement Property and Supply Patients/Patient’s companion External and Internal Clients Bids and Awards Committee Infection Control Committee Healthcare Waste Management Committee Nutrition Clinic Provides services/inputs to Internal Clients : Medical and Nursing clinical areas Billing and Claims Budget Other hospital staff External Clients : _ Patients/watchers Other clients Policies ¢ There shall be an organized Nutrition and Dietetics Department/Section promoting optimal nutrition of patients and personnel through the efficient administration of high quality food service. 3) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 105

« Patient shall be provided with safe, nutritious and presentable meals through careful planning, wise procurement and proper preparation of balanced and satisfying meals within the budgetary limits. » The Nutrition and Dietetics Department/Section shall have adequate space, equipment, and supplies to facilitate its efficient, safe, and sanitary operation. «The administration of high quality nutritional care of patients shall be under the direction of a qualified Nutritionist Dietitian. » Nutrition and dietetics services shall be provided to patients in accordance with the written order of the attending physician. » The quality and appropriateness of nutritional care provided shall be regularly reviewed and evaluated. e In pursuit of professional and technical advancement to keep abreast with the latest nutritional trends and concerns, a development program shall be formulated by the Department/ Section. Responsibilities e Prepares and implements Comprehensive Dietetic and Nutritional Plan and Program. e Prepares the annual procurement program for required foodstuff and supplies in accordance with the acceptable standards and approved hospital policies and guidelines. e Prepares appropriate menu cycles, procures quality foodstuff and provides proper, clean and sanitary storage. » Provides safe, clean and nutritious food to patients and personnel within the budgetary limit on timely manner. « Implements diet prescription in coordination with the attending physician and nurse in charge. » Provides nutrition and diet consultation and education services to patients and personnel. 106 Manual of Organization and Management of the Administrative and Finance Service for Hospitals “(

Formulates and implements a safe, effective and effi Continuing Quality Improvement Pro Cient nutrition and dieteti gram to ensure C Service. Prepares and submits required reports. Standard Operating Procedures (Refer to the Separate DOH Manual of Procedures Sor Nutrition and Dietetics)

MEDICAL RECORDS Function This Department/Section directs and ensures an organized system of processing, analyzing, maintaining and safekeeping of all patients’ records measuring the quality of patient care through the written data in sequence of events covering the diagnosis, treatment and discharge of patient. Headed By

Department/ Section Head Responsible to

Chief of the AFS Expects inputs from

Nursing Service Medical Service Admission and Information Patients/Patient’s companion Property and Supply External and Internal Clients Provides services/inputs to Internal Clients . Billing and Claims Medical and Nursing units Budget Hospital staff External Clients : Patients/watchers Regular Court of Law Other clients Policies . The Medical Records Department/Section shall serve as a depository of all patients’ records in accordance with the principles and practices of efficient and effective medical records management. e The medical record is the property of the hospital. Therefore it shall be maintained with complete demographic and clinical data of patient for future reference for the patient, health provider and the facility as well, in accordance with legal, accrediting and regulatory requirements. 108 Manual of Organization and Management of the Administrative and Finance Service for Hospitals | a

e The confidentiality of patient’s medical records shall be strictly observed. e A regular inventory of medical records for appraisal and disposal shall be done in accordance with approved Records Disposal Schedule. Responsibilities ¢ Prepares and implements a Comprehensive Medical Records Management Plan. * Maintains all patient records in accordance with the principles of an effective and efficient medical record management. ¢ Reviews records for completeness and accuracy. e Ensures that coding of diseases is in accordance with the latest International Classification of Diseases (ICD). ¢ Maintains and safeguards the confidentiality of the medical records. e Ensures that all reports and results are promptly and accurately filed in the corresponding patient record. ¢ Provides records of patient data for use in approved research programs. authorities. Standard Operating Procedures (Refer to the separate DOH Manual of Procedures for Medical Records) :} Manual of Organization and Management of the Administrative and Finance Service for Hospitals 109

MEDICAL SOCIAL SERVICES Function This department/section directs and implements the programs, projects and activities on social services which include social case work, multisectoral networking and linkages in understanding the socio-behavioral and economic plight of patients and their families for the holistic approach in their management and treatment. Headed by Responsible to Expects inputs from Provides services/inputs to Internal Clients External Clients Policies Department/Section Head Chief of the AFS Nursing Service Medical Service Property and Supply Patient/Patient’s companion External and Internal Clients Billing & Claims Medical and Nursing Units Budget Other Hospital staff Patients/watchers Other clients * The Medical Social Service (MSS) Department/Section shall be well-organized, properly directed and staffed with qualified professionals. ¢ The MSS shall implement policies and procedures pertaining to social casework, social group work and community networking activities. ¢ Patient’s rights shall be observed and confidentiality of records shall be maintained. * The MSS shall provide services to all patients/individuals regardless of creed, gender, religion, socio-economic status and cultural differences. 110 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

The MSS shall classify patients in accordance with DOH existing policies and guidelines. ¢ The MSS shall have adequate space with privacy to interview patients, equipment, and supplies to facilitate the efficient and effective operation of all functions assigned to it. « A development program shall be formulated in pursuit of professional and technical advancement of the MSS personnel. Responsibilities ¢ Prepares and implements a Comprehensive Medical Social Service Plan and Program consistent with the hospital and DOH policies and guidelines. ¢ Evaluates and determines needs of patients for specific social services to be provided. * Provides assistance to the needs of patient adaptable to hospital situation subject to limitations, policies, rules and regulations. ¢ Promotes family solidarity during and after illness. ¢ Provides assistance to the medical team in understanding the socio-behavioral and economic situation of patients and their families for the holistic approach in their diagnosis and treatment. « Engages in multi-sectoral networking and linkages with other government agencies, NGOs, volunteer groups and other philanthropic individuals. ¢ Conducts continuous public information and health education campaign. Standard Operating Procedures (Refer to the separate DOH Manual of Procedures for Medical Social Services) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 111

PHARMACY Function This department/section directs and implements programs, projects and activities for the provision of safe, affordable and efficacious drugs and medicines consistent with the Generics Act, Philippine Nationa regulations. Headed By Responsible to Expects inputs from Provides services/inputs to Internal Clients External Clients Policies | Drug Formulary (PNDF) and DOH policies, rules and Department/Section Head Chief of the AFS Nursing Service Medical Service Property and Supply Pharmacy and Therapeutics Committee Infection Control Committee Patients/Companion External and Internal Clients Medical and Nursing units Billing and Claims Accounting Budget Procurement Property and Supply Pharmacy and Therapeutics Committee Hospital staff Patients/Watchers Other clients e There shall be a well-organized Pharmacy Service performing functions in accordance with ethical and professional practices and with updated license to operate 24 hours daily. 112 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

A Pharmacy and Therapeutic Committee shall be established and be responsible in Providing for the rational drug therapy at affordable cost. Hospital Pharmacy shall be managed by a licensed pharmacist. Continuing Quality Improvement Program shall be implemented. Adequate stocks of safe, efficacious and good quality drugs and Medicines shall be maintained. High quality of professional practice shall be observed. Responsibilities Ensures continuous supply of drugs and medicines based on the approved Hospital F ormulary and existing laws and regulations. Conducts the screening, filling and Proper dispensing of drugs in accordance with existing laws, rules and regulations. Monitors the filled and unfilled prescription in aid of planning and decision making. Maintains the Pharmaceutical Quality Assurance Program. Manages the distribution of floor stock to the different units/wards of the hospital. Ensures the availability of emergency drugs and medicines at the Emergency Room and treatment area. Prepares the annual hospital formulary in accordance with the PNDF lists, Generics Act and other pertinent laws. Manual of Organization and Management of the Administrative and Finance Service for Hospitals 113

Prepares and signs the Request for Issuance Slip (RIS) with complete specification based on the approved Price Schedule issued by the hospital BAC. Maintains records, files, and submits reports on dangerous drugs and other pharmaceuticals as required by law. Serves as Drug Information Center to all of the hospital personnel and hospital clients. Participates in the detection, reporting and monitoring of Adverse Drugs Reaction/Multiple Drug Resistance in the hospital. Ensures the proper storage and preservation of drugs and medicines. Provides continuous quality assurance for all the stocks of drugs and medicines. Standard Operating Procedures (Refer to the separate DOH Manual of Procedures for Pharmacy) 114 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

10 GENERAL SERVICES The General Services cluster is composed of the Engineering, Linen and Laundry, Housekeeping and Security. General Policies e Physical plant, health care equipment/devices, vehicles and grounds shall conform to all regulatory standards, policies and regulations. e A clean and safe environment shall be provided and maintained within the hospital in accordance with universally accepted standards. e The hospital shall maintain and sustain its safe and sanitary conditions for the maximum protection of patients, employees and general public on health and environmental hazards. e Engineering, housekeeping, linen and laundry functions shall be effectively organized, directed and staffed by adequate and qualified personnel. e Lives, properties and critical infrastructure shall be protected from all threats, harm and losses. :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 115

ENGINEERING Function This department/section prepares and implements Comprehensive Preventive/ Corrective/ Rehabilitative Maintenance Program of biomedical, electronic and communication equipment, electrical, mechanical, structural, civil works, physical plant, motor vehicles and other healthcare equipment/devices. Headed by : Department/Section Head Responsible to : Chief of the AFS Expects inputs from : All hospital units Bid and Awards Committee Regulatory Bodies Provides services/outputs to Internal Clients : All hospital units External Clients : Patients Department of Health Other government and non-government agencies Policies e The provision of safe and functional facilities, healthcare equipment/devices, motor vehicles and continuous supply/service of utilities shall be assured for delivery of quality patient care. e Compliance to the local, national and international codes, standards and regulations on the construction, operation and maintenance of facilities, utilities, healthcare equipment/devices and motor vehicles shall be strictly observed. ¢ Implementation of the comprehensive manual of policies and procedures based on DOH standards shall be followed. 116 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (

Technical Support and assistance Shall be provided in the implementation of Healthcare Waste Management, Energy Conservation, Sanitation and Environmental Programs and Disaster Preparedness Plan. Networking Shall be established with other healthcare facilities and agencies for further linkages, Responsibilities Prepares, implements and monitors approved Comprehensive Plan on Preventive/Rehabilitative Maintenance for electrical, mechanical, biomedical, electronic, communication equipment and other healthcare equipment/devices physical plant and motor vehicles. Conducts regular inspection of physical plant, healthcare equipment/devices, Vehicles and grounds. Prepares and recommends plans, specifications, Scope of work and cost estimates of projects, Dispatches Vehicles to convey/transport patients, hospital officials, personnel, supplies and equipment to and from destination, Prepares/Submits required reports,

Standard Operating Procedures

Preventive Maintenance Program Procedures Person/s Responsible 1, Prepares and submits preventive maintenance Unit heads in charge program.

Evaluates the program. Head, Engineering 3, Signs and certifies the necessity and Department/ Section prioritization of the program.
Forwards the plan to the CAFS.
Reviews, evaluates and recommends for the CAFS approval of the Chief of the hospital.
Approves the plan. Chief of the Hospital e Corrective Maintenance eneee Procedures Person/s Responsible
Accomplishes the Job Order Request. Requesting unit head
Forwards to Engineering Department/ Section concerned for evaluation. oa
Determines nature of work required and signs Head, Engineering the Job Order Request. Department/ Section
Forwards the Job Order Request to concerned unit
Estimates and determines the required resources. Engineering unit head
Prepares request for required supplies and concerned materials.
Forwards to stockroom in charge
Checks the availability of supplies and Designated staff materials. concerned eee ee 118 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

Procedures Person/s Responsible

If available, issues the Supplies and materials to Engineering unit concerned, then proceed to procedure No. 9.

Ifnot available, returns the RIS with the notation of non availability, then proceed to procedure Nos. 10 to 15 before doing rocedure No, 9 9. Prepares the schedule of work and assigns the Staff to do the work. 10. Prepares the PR for non available supplies and materials needed. Il. Forwards the PR to Chief Engineering De artment/Section for initial 12. Reviews and determines whether the items will be procured through petty cash or regular purchase. _13. Forwards the PR to the CAFS for action. 14. Reviews and signs the RIS and initials the PR for approval of the Chief of the Hospital. Engineering unit head concerned Engineering unit head concerned Head, Engineering Department/Section CAFS 15. Signs/approves PR and forwards to Chief of the Hospital Procurement Unit. 119

. Rehabilitative Maintenance Program Procedures Person/s Responsible

Prepares and forwards requests for Requesting unit head rehabilitation work to the CAFS concerned.
Reviews and evaluates request and forwards it CAFS to the Chief of the Hos ital 3, Approves request for rehabilitative work Chief of the Hospital
Forwards to Chief, En ineering Dept./ Section
Facilitates the preparation of plans, Head, Engineering specification, estimates and scope of work. Department/ Section
Forwards to CAFS.
Reviews and recommends a roval CAFS g. Approves and forwards to BAC for mode of Chief of the Hospital rocurement . Ambulance Dispatching Procedures Person/s Responsible ee
Checks request for completeness/ availability of Motorpool Dispatcher or ambulance. designated personnel
Notifies duty Driver and gives trip ticket. 3, Gets key of ambulance and conducts patient per Driver approved trip ticket.
Surrenders key to Information Staff on duty and completes data on tri ticket. 120 Manual of Organization and Management of the Administrative and Finance Service for Hospitals | ac

Use of Hospital Vehicle All trips must be covered by an approved trip ticket prior to the date and time of travel. oan ee Procedures Person/s Res onsible re Sa ASESPOMSIDIC I. Accomplishes the request for use of vehicle. Requesting unit 2. Forwards to motor pool dispatcher for concerned availability of vehicle 3. Verifies availability of driver and vehicle Dispatcher 4. Indicates availability of vehicle and designated driver. 5. Prepares the Trip Ticket. 6. Forwards to CAFS. Ne icine 7. Evaluates and approves request for use of CAFS vehicle and trip ticket, 8. Releases the approved trip ticket. Dispatcher 9. Designates the driver concerned and furnishes the driver a copy of the approved trip ticket. 10. Checks the vehicle as to readiness and Duty Driver availability of tool kit. 11. Indicates in the trip ticket the beginning mileage. 12. Furnishes the security guard on duty a copy of the trip ticket, 13. Checks trip ticket and vehicle before allowing Security Guard on duty at its exit. the gate. 14. Upon return, have the trip ticket signed by Duty Driver passenger, completes data on the trip ticket and reports to motor pool dispatcher

Submission of Reports Procedures Person/s Responsible

Prepares the corresponding Monthly Report of Dispatcher Trips per auditing/accounting regulation and submits to the Head, Engineering Department/Section

. Reviews and certifies the correctness of the Head, Engineering report. Department/ Section

Forwards to the CAFS for approval.
Furnishes Accounting and COA of the approved reports. 122 Manual of Organization and Management of the Administrative and Finance Service for Hospitals EU

HOUSEKEEPING Function Headed by Responsible to Expects services/inputs from Provides services/Outputs to Internal Clients External Clients Policies Provision and maintenance areas shall be assured for qu Department/Section Head Chief of the AFS All hospital units Infection Control Committee Healthcare Waste Management Committee Conservation and Environmental Committee Patients All hospital units Hospital personne] Healthcare Waste Management Committee Infection Contro] Committee Conservation and Environmental Committee DOH Other government agencies Other clients of safe, pleasant, clean and green environment in all ality healthcare delivery. ) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 123

e Proper cleaning methods, infection control standards and supplies/equipment/tools management shall be strictly followed. e Appropriate personnel protective equipment (PPE) shall be provided. e Regular program for the prevention and eradication of rodents, pests, vectors and other vermin shall be implemented. . Provision of adequate and relevant training program on proper waste management, infection control practices and quality standards to Housekeeping Department/ Section staff shall be assured. e Safe and proper handling of equipment, materials, and chemicals used for cleaning and disinfecting shall be continuously emphasized. e Proper storage of housekeeping carts/tools shall be observed. Responsibilities e Participates in the preparation and implementation of Healthcare Waste Management and Infection Control Programs for a clean, safe, and sanitary buildings, facilities and environment. » Maintains cleanliness and sanitation of buildings and facilities. e Reports immediately noted deficiencies and violations of set policies and procedures. . Coordinates the repair of furniture, fixtures and other hospital facilities. e Coordinates the implementation of infection control and healthcare waste management programs. . Maintains an adequate and acceptable inventory of housekeeping supplies and equipments. 124 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

Standard Operating Procedures e Maintenance of Cleanliness and Sanitation Procedures Person/s Responsible i, 2. 3. 4. Cleans, sanitizes and disinfects comfort rooms, Service Janitors/staff lavatories and all assigned areas. designated/ contracted Keeps housekeeping tools in proper places after use. Collects and places garbage at designated area for pick-up. Cleans waste cans. ¢ Collection/Transport of Hospital Waste Procedures Person/s Responsible 6 2. Conducts regular inspection of waste storage Designated staff and maintains its cleanliness and sanitation. Monitors garbage collection. 3. Records collection done by contracted service providers. 4. a 7. 8. Sweeps, collects garbage from the different Service janitors/staff hospital units strictly observing the policies on designated/ contracted. waste segregation. Transports garbage to transient storage area. Stores waste at appropriate storage in color- coded trash bags. Cleans/Disinfects garbage bins, storage area and surroundings. Submits monthly report to Head of Housekeeping De artment/Section ping Dep eee Manual of Organization and Management of the Administrative and Finance Service for Hospitals 125

HOUSEKEEPING PROCEDURES There are basic guidelines on proper housekeeping methods which includes the following: Basic techniques in cleaning: e Dusting is removing dirt from surfaces: equipment, furniture, ledges, and window sills; through the use of a dry, damp or treated cloth. Low dusting is used for casily reached surfaces and objects. High dusting is done through a handles tool or ladder. e Moping is wiping or rubbing a surface clean of dirt/soil through the use of a wet collection of coarse yarn on a handle. Mopping may involve four steps. Damp mopping is applied in slightly soiled area using a yarn or mop head that is wrung out after immersion in a cleaning solution. Flood mopping is good for special areas where the cleaning solution must penetrate deep into the floor and remain for a required period of time. The mop head is immersed in cleaning solution and carried to the floor without wringing out. The standing cleaning solution is removed with a warm vacuum with an approved filter system. This is best for Emergency Room, Delivery Room and Operating Room. Washing is simply mopping surfaces above the floor with a wet cloth. Wet mopping is applied to grossly soiled areas with a mop heal partially wrung out after immersion in a cleaning solution. Rinsing is not necessary. e Stripping is the removal of wax from surfaces through the use of a stripper. e Sweeping is removing soil or dirt from surfaces with a broom, brush, or vacuum cleaner. It is always a preliminary step in housekeeping. Scrubbing is a form of sweeping where water and a coarse brush is used. e Waxing is the application of wax and polishing materials on surfaces for protection and clean beautiful shine. Area cleaning techniques Three areas in the hospital require regular cleaning: wards, corridors, and compound. Since area cleaning requires team approach, a weekly cleaning schedule for these areas is essential. By and large, the steps and techniques of area cleaning and sanitizing presented conform to standards and may be applied in special areas with a little variation to comply with infection control requirements. Manual of Organization and Management of the Administrative and Finance Service for Hospitals [:

Ward cleaning and sanitizing surface. Start at the upper most left corner of the door, gradually working down in circular motion, ending at the lowermost right corner, Damp mop using the same direction, Dust windows, windowsills and jambs. Follow with damp mop. High dust bathroom ceiling and walls as in Scrub walls, sink, toilet bowl and floor, in that order, with a cleaning solution. Let stand to dry. Dust cabinets, tables and other ward fixtures. Wax & buff. Empty wastebaskets. Sweep floor from the innermost going out. Strip and wet mop. Let stand to dry. Wax then buff. Inspect the whole ward for quality control. Corridor and Lobby Cleaning and Sanitizing High dust ceilings and walls. Follow with damp mop and let dry. Dust and wash windows, if any. Dust and polish furniture and fixtures. Polish and shine. Empty trash cans. Sweep floor, Strip then wet mop. Allow to dry. Wax and Inspect the whole area for quality control. Compound Cleaning High dust facade and outside walls in the same direction. Follow with damp mop. Dust and scrub screens. Sweep and remove debris from gutters. Weed plants of dirt and trash. Sweep ground Starting from building/structures going towards gate. ¢ Inspect whole Compound for quality control

LINEN AND LAUNDRY Function This department/se Headed by Responsible to Expects services/ inputs from Provides services to Policies ction provides laundry services and ensures adequate supply of clean linens for patients and other hospital units. Department/Section Head Chief of the AFS Property and Supply Engineering Infection Control Committee Housekeeping All clinical areas Patients All Hospital Units

Universally accepted infection control, occupational health and safety standards for hospital laundry service shall be strictly observed and implemented. emergency needs of the hospital. shall be enforced. provided. safety and protection of the staff. Adequate staff, facilities, properly e Availability of clean linens shall be assured at all times to meet the daily and e Perpetual inventory of serviceable and condemned linen, supplies and materials ventilated and safe working area shall be e Appropriate Personnel Protective Equipment (PPE) shall be enforced for the Clean linen shall be properly handled and stored to minimize contamination from surface contact or airborne deposits. . Sate and secured storage area for clean linen shall be provided. 128 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

Soiled linens shall be segregated and kept from clean linens at all times. The laundry areas shall be planned, equipped, and ventilated to prevent the spread of contaminants. Adequate and relevant training program on infection control practices and continuing quality improvement shall be provided. Responsibilities Prepares Comprehensive Plan for laundry and linen services. Ensures the efficient collection of sviled linen and timely issuance of clean linen to different units of the hospital. Monitors the implementation and observation of the universally accepted infection control, occupational health and safety standards among the linen and laundry staff. Conducts periodic inventory and maintains stock and supplies/equipment ledger card for finished/purchased linen. Prepares annual procurement plan for linen supplies, materials and equipment. Ensures a regular maintenance program of linen and laundry equipment and facilities. Makes raw materials into desired linen and repairs and/or recycles damaged linen. Undertakes disinfection of soiled linen. Checks quality and quantity of linen delivered by the laundry service contractor. Monitors the proper use of linen. Prepares and submits periodic report of usable and condemned stock of linen. :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 129

Standard Operating Procedures e Issuance of Clean Linen Procedures Person/s Responsible

Submits request slip for required linen. Nursing Attendant concerned
Checks availability of linen and issues requested linen.
Records issuance. Linen staff concerned e Collection and Laundry of Soiled Linen Procedures Person/s Responsible
Sorts, accounts, lists and returns soiled linen. Nursing Attendant concerned
Verifies and records the returned soiled linen Linen and Laundry from the wards/other units.
Informs nursing attendant unaccounted / missing linen.
Forwards to laundry area. receiving staff
In-house:

Disinfects and washes soiled linen.
Sorts, records and stores clean linen. Contractual:
Accounts and records the soiled linen and releases to the contracting agency
Sorts, accounts and records returned clean linen. Laundry staff concerned 130 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (-{

¢ Inventory of Linens (in the Linen and Laundry Stock room) Re SR Procedures Person/s Responsible

Records and updates stock cards. Linen and Laundry
Conducts physical inventory of linens and Head/designated staff supplies and materials on stock.
Prepares and submits reports of inventory
Identifies and reports linen for condemn or recycling. e Inventory of Linen (in Clinical Areas) aati Procedures Person/s Res onsible —____________ Procedures <r son/s Responsible _ . Conducts monthly inventory of linen. Nursing staff concerned/
Reconciles records of linen receipt and returned. Linen and laundry Head
Prepares summary reports and issues updated inventory custodian slip.
Acknowledges inventory custodian slip. Reports missing or unaccounted linen to immediate head.
Validates the report and submits report to CAFS Immediate head concerned
Recommends appropriate action to the Chief of CAFS the Hospital, — a :) Manual of Organization and Management of the Administrative and Finance Service for Hospitals 131

Production of Linen Oe Procedures Person/s Responsible

Determines the linen requirements. Linen and Laundry Head Prepares purchase request for raw materials and supplics.
Inspects and accepts deliveries of raw materials and supplies.
Instructs linen staff for the desired finished product.
Cuts and sews linen as per desired finished Tailor/seamstress/ roducts. linen staff concerned
Checks the sewed linen for conformity to Linen and Laundry Head specifications
Returns to staff for coding/marking.
Inspects coded/marked linen.
Inspects sewed linen in conformity with specification.
Keeps inventory logbook of “all” hospital linen with corresponding costs. e Disposal of Condemned Linen Procedures Person/s Responsible
Sorts and inspects torn and worn-out linens. Linen and Laundry
Separates torn/worn out linens for recycling or Head/designated staff condemn.
Prepares itemized list. of linen for condemn and forwards to Property and Supply
Prepares report of condemned linen and Administrative forwards to CAFS Officer/designated Head, Property and Supply
Signs/Initials and forwards to Chief of the CAFS Hospital for approval. 132 Manual of Organization and Management of the Administrative and Finance Service for Hospitals |

SECURITY SERVICES Function Headed by : Department/Section Head Responsible to * Chief of the AFS Expects Services/inputs from § All Hospital units Provides Services to Internal Clients : Hospital personnel External Clients : Patients Visitors/ Guests Patient’s Watchers General Public Policies ° Preparation, implementation and monitoring of approved Comprehensive Security Plan shall be done. ° A Key Management System shall be adopted by the hospital and enforced by the Security Department/Section. :) Manual of Organization and Management of the Administrative and F inance Service for Hospitals 133

Responsibilities e Prepares Comprehensive Plan for the protection of lives and properties from threats, harm and losses, security and safety of critical infrastructure and maintenance of peace and order within the hospital premises. » Enforces strictly the security and hospital policies, rules and regulations. « Inspects bags and luggage of incoming and outgoing patients, personnel and general public. e Implements and records a systematic patrol and security inspection of all vital facilities and installations within the hospital. » Coordinates and establishes linkages with appropriate concerned law enforcement agencies including local government units. . Controls and regulates the movement of personnel, patients, clients and vehicles within the hospital premises.

Investigates and promptly submits incident reports 0 the Chief of the Administrative and Finance Service/Chief of the Hospital. Standard Operating Procedures e Deployment of Security Guardsee ee ae Procedures Person/s Responsible

Prepares schedule of duty. Head, Security Department
Checks posted uards /Section
Inspects entry/exit points of employees, patients and Posted Security Guard public including bags/luggage-
Inspects/Records incoming and outgoing vehicles.
Records and submits unusual/ incident reports.
Conducts rounds and inspects buildings, facilities Roving Security Guard and premises to ensure safety of patients and hospital personnel.
Records observations and prepares reports if warranted. 134 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

P Procedures erson/s Responsible 8. Reviews report/s, takes appropriate action and Head, Security Department/ forwards report to the CAFS. Section ¢ Conduct of I nvestigation Procedures Person/s Responsible

Receives and reviews incident report Head, Security
Conducts preliminary investigation of report of Department/Section incidents.
Submits report to the CAFS

(This page is intentionally left blank.) 136 Manual of Organization and Management of the Administrative and Finance Service for Hospitals

PART 3 ILLUSTRATIONS AND SAMPLE F LOWCHARTS

F LOWCHART It is being used when there is a need to describe activities, identify problems, identify the causes of problems, detect "bottlenecks," and define indicators. How to use it: P icons Different symbols are used in a Flowchart ( Starting to indicate the different types of actions in on the process: * acircle for the beginning or end of the process * rectangle for a step in the process (activities) * adiamond for the decision points Steps in the Ocess E " ”) Decision How to create a Flowchart: Manual of Organization and Management of the Administrative and Finance Service for Hospitals 139

A. Internal Administrative Management: Human Resource Management Ae Personnel Action on Recruitment Applicant Submits application letter Human Resource Management . Checks and initially evaluate the applicant as to minimum requirements . Verifies vacancies Prepares the line-up of applicants If Qualified YES Informed applicant Scheduling for interview with the Selection and Promotion Board Informed applicant YES For processing of appointment 140 Manual of Organization and Management of the Administrative and Finance Service for Hospitals (

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C. Patient Support Management: C.A.: Admitting and Information TING PHILHEALTH MEMBER/DEPENDENT FLOWCHART ON ADMIT PHILHEALTH CLERK Asks the guardian/patient to present the Philhealth Form 10 issued at the Admitting Section. Screens the member/patient if he/she is qualified to avail the PHIC Benefits. YES NO Qualified? x Requires them to accomplish the PHIC Form N Stamp Form 10 “Not Qualified” with initial of assigned Philhealth clerk and returns the form to the patient/guardian to be forwarded to Admitting Unit. 4 and 2 and stamp = Qualified” on the Form 10 with initial of assigned Philhealth Clerk. N Provides the checklist of other requirements ( e.g. for member's dependent: marriage contract, birth certificate, etc. ) to the guardian/patient. N Advises guardian/patient to proceed to Admitting Unit. ce for Hospitals t of the Administrative and Finance Servi 144 Manual of Organization and Managemen

D. General Services: Engineering D.1.: Preventive Maintenance FLOWCHART ON PREVENTIVE MAINTENANCE PROGRAM PREVENTIVE MAINTENANCE PROGRAM COMMITTEE Inspects hospital compound & facilities Collates & evaluates findings Prepares Preventive Maintenance Program Submits program to Chief Engineer for evaluation Considers preferred revisions by the chief Engineer, CAO & MCC II . : CHIEF ENGINEER Evaluates & revises program

Se is rae revision? > “a CHIEF ADMINISTRATIVE OFFICER Reviews program & recommends for approval by MCC II MEDICAL CENTER CHIEF II NO Approves Preventive Maintenance Program ae m,* YES "Siig CHIEF ENGINEER e Conducts Program briefing to Engineering Section & Janitorial Service provider e Forwards Program documents to PMPC for implementation T | ( PMP COMMITTEE \ Implements Program / Manual of Organization and Management of the Administrative and Finance Service for Hospitals 145

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146

PART 4 APPENDICES

Appendix A Administrative Order No. 44-A AD N the Records Section on__ Republic of the Philippines N ence COMPOUND Department of Health mane rps STA. CRUZ OFFICE OF THE SECRETARY TEL NOS eCPINES October 18, 1999 NISTRATIVE ORDER 0. Os s. 1999 SUBJECT: Guidelines for the implementation of the INTEGRATED HOSPITAL OPERATIONS AND MANAGEMENT PROGRAM CHOMP) within the Philippine Hospital System INTRODUCTION The Integrated Hospital Operations and Management Program (IHOMP) formerly Hospital Epidemiology Program (HEP) serves as a hospital based information system designed to provide relevant and timely information for decision making. The program was re-conceptualized in 1995 and expanded in 1997, in response to present information needs and evolving requirements among hospitals. This set of guidelines is hereby prescribed to improve hospital performance through sound and efficient clinical care and management Systems with the end- view of providi ng quality health services. PROGRAM GOALS AND STRATEGIES A. Goals Enhance the Preventive and promotive role of hospitals (both government and private) through the improvement of management systems and procedures within the hospital. B. Objectives B.1. General Objective To institutionalize the Integrated Hospital Operations and Management Program (II IOMP) within the hospitals, Signed 4 D} oll 149 pes

B.2. Specific Objectives

To implement the IHOMP preferably within 2 computer-based environment.
To build on and integrate existing hospital information systems.
To standardize the flow of information within and among hospitals.
To fully utilize hospital data/information for evidence-based decision making. 5 To develop computer software for the program based on the Department of Health standards and the International Classification of Diseases. C. Strategies

Program Planning This shall cover the development of policy guidelines and implementing mechanisms such as : organizing working commnittees. 2. Logistic Support This concems the development of software, distribution of IEC materials for hospital. 3. Capability Building This shall cover the upgrading of the human resource skills and capabilities and provision of technical assistance. 4. Social Mobilization This shall cover the orientation of the program linkages of the different hospital service components and networking. 5. Monitoring and Evaluation This shall refer to the initial assessment Of existing hospital operation and management systems and also monitoring of the compliance to the requirements of IHOMP. D. Key Activities qn support to the strategies, the following activities shall be undertaken :

Development of a national quality management program ©.8- quality assurance program.
Accreditation of all hospitals by the DOH and Philippine Health Insurance Program. 150

Providing name for technology updates.

Conduct of annual consultative workshop. 7. Holding of Integrated Hospital Operations and Management Program (IHOMP)- Activities Updates. 8. Networking at all levels of the hospital system. 9. Sharing of technical information and expertise. E, KEY RESULT AREAS TY. The following are the key result areas to be able to sustain/maintain the IHOMP: Availability of adequate hardware and appropriate software, Timely analysis of data. Well timed availability of information. Appropriate; valid and reliable information are produced by the program. Qualified and trained staff with a plantilla position assigned to implement the wm ie 6. Trained, competent and readily available system administrator or equivalent. 7. Adequate space and facilities are available for program operations. 8. Compliance to IHOMP guidelines and procedure. 9. Utilization of information by hospital Management and clinical staff as reflected in their plans and programs. 10. Monitoring and evaluation results are used to continuously improve the quality of information generation. IMPLEMENTING GUIDELINES 1. The IHOMP shall be implemented by phases; phase I shall include the identified forty four (44) pilot hospitals (Annex A); phase II shall cover the government and private tertiary hospitals; phase II shall include all secondary and primary hospitals. 2. IHOMP implementation shall be fully supported by various committees, working groups and several services and units in the Department of Health per attached organizational structure and their function under Annex B. 3. Specific Activities as listed in Annex C shall be undertaken for the THOMP implementation on the basis of set guidelines. 151

IV. ¥ 152 FUNDING The expenses for Software Development shall be charged against the funds of the Hospital Management Information System (HMIS) component of the Integrated Community Health Service Project (CHSP). The expenses for the Human Resource Development shall be charged against the Hospital Operations and Management Service (HOMS), DOH and the Hospital Regulation and Management System component (HRMS) of ICHSP. EFFECTIVITY This Order shall take effect immediately. ALBERTO. RO ALDEZ,JIR.,M.D. Secretary of Health

ee Appendix B Executive Order No. 366 Malacafiang Manila BY THE PRESIDENT OF THE PHILIPPINES EXECUTIVE ORDER No. 366 DIRECTING A STRATEGIC REVIEW OF THE OPERATIONS AND ORGANIZATIONS OF THE EXECUTIVE BRANCH AND PROVIDING OPTIONS AND INCENTIVES FOR GOVERNMENT EMPLOYEES WHO MAY BE AFFECTED BY THE RATIONALIZATION OF THE FUNCTIONS AND AGENCIES OF THE EXECUTIVE BRANCH WHEREAS, in the midst of challenges facing the public sector such as globalization, increasing demographic pressures and scarce resources, the government has to define its proper role in society, focus its efforts on its core governance functions and improve its performance on the same; WHEREAS, to attain improved government performance, there is a need to institute reforms that would transform the bureaucracy into an efficient and results-oriented structure; WHEREAS, as an initial effort, the rationalization of agencies in the Office of the President has been effected; WHEREAS, Sections 77 and 78 of the General Provisions of Republic Act No. 9206 (General Appropriations Act of 2003), as re-enacted, authorize the President of the Philippines to direct changes In the organizational units or key positions in any department or agency, and require all departments/agencies of the Executive Branch to conduct a comprehensive review of their respective mandates, missions, objectives, functions, programs, projects, activities and systems and procedures, identify areas for improvement and implement structural, functional and operational adjustments to improve government’s service delivery and productivity, respectively; WHEREAS, the Administrative Code of 1987 has vested the President with residual powers to reorganize the Executive Branch; and WHEREAS, the Supreme Court had, in numerous cases, upheld the authority of the President to reorganize the Executive Branch; NOW, THEREFORE, I, GLORIA MACAPAGAL - ARROYO, President of the Republic of the Philippines, by virtue of the powers vested in me by law, do hereby order the strategic review of the operations and organizations of the Executive Branch to improve public service delivery, in accordance with the following provisions: SECTION 1. Coverage, This Executive Order shall cover all Departments of the Executive Branch and their component units/bureaus, including all corporations, boards, task forces, councils, commissions and all other agencies attached to or under the administrative supervision of a Department. 153

f

= = The Constitutional Offices, Legislature, Judiciary, and State Universities and Colleges (SUCs) may, on a voluntary basis, apply the parameters contained herein if they opt to review their respective operations and organization. SEC. 2. Strategic Review of Agency Operations and Organizations. All Department Secretaries are hereby directed to take the lead in the conduct of a 'strategic review of the operations and organization of all component units, including agencies attached to or under the administrative supervision, of their respective Departments for purposes of: Pp Focusing government efforts and resources on its vital/core services; and b. Improving the quality and efficiency of government services delivery by climinating/minimizing overlaps and duplication, and improving agency performance through the rationalization of service delivery and support systems, and organization structure and staffing. SEC. 3. Rationalization and Service Delivery Improvement Framework, The conduct of the strategic review by the Department Secretaries of their respective operations and organization shall be guided by the following framework: a. Focus government efforts on the exercise of its fundamental functions of establishing and providing the appropriate social, political and economic environment within which development can prosper; b. Transform the bureaucracy into an effective and efficient institution for the delivery of core public services; and c. Ensure the long term sustainability of core government services through resource mobilization and cost-effective public expenditure management. SEC. 4. Preparation of a Rationalization Plan. The Department Secretary shall prepare a Rationalization Plan for the whole Department, including the agencies and government-owned and/or controlled corporations (GOCCs) attached to or under its administrative supervision. The Plan shall be prepared in accordance with the strategic plan of the Department and shall contain the disposition of its functions, programs, projects, activities. organizations units, agencies, staffing and personnel. Such Plan shall indicate the following information: Pp The core functions, programs, activities and services of the Department and its units/agencies; b. The specific shift in policy directions, functions, programs, projects, activities and strategies, indicating the phasing of the intended shifts; c. The functions, programs and projects which would be scaled down, phased out or abolished such as: © Those that duplicate or unnecessarily overlap with other programs, activities, and projects within the Department and its attached agencies and with other government entities; ¢ Those that are not producing the desired outcomes, no longer achieving the objectives and purposes for which they were originally designed and implemented, and/or nor cost efficient and do not generate the level of physical and economic returns vis-a-vis the resource inputs, © Those are redundant/outdated or no longer relevant to the accomplishment of the major final outputs of the department/agency; © Those that directly compete with those of the private sector that can be done more efficiently and effectively by said sector; and © Those which have been devolved to local government units. 154

d. The functions, programs and projects where more resources would be channeled such as: « Those that directly support core/frontline services; ¢ Those that are directly involved in the social, economic and political empowerment of the people, or those that promote private sector initiative; ¢ Those that contribute to the creation of livelihood or employment opportunities, and an environment conducive to investment and entrepreneurship, and productivity; and * Those that directly contribute to the ultimate socictal outcome objectives of the National Government and/or the intermediate/sector/sub-sector/organizational outcome objectives of the agency. e. The resulting structural and organizational shift, stating the specific changes in the units/agencies of the Department; f. The staffing unit, highlighting the changes to be made in the staffing pattern and personnel of the Department and its agencies, as well as the organizational strengthening strategics that need to be implemented. g. The resource allocation shift, specifying the effects of the streamlined setup on the budgetary allocations of the Department and its agencies; and h. The internal and external communication plan, indicating the specific methods and strategies employed/being undertaken in conveying the rationalization process to the personnel who may be affected and to other stakeholders. SEC. 5. Submission of the Rationalization Plan, The Rationalization Plan shall be submitted to the Department of Budget and Management (DBM) for review, to ensure its consistency with the objectives of this effort, and subsequent submission to the President for approval. In case non-submission of a Rationalization Plan by the Department Secretaries, the DBM shall submit to the President the areas for rationalization and improvement in the department/agencies concerned. SEC. 6. Timetable for the implementation of the Rationalization Program. The DBM, together with the Civil Service Commission (CSC), shall coordinate the implementation of the Program. They are authorized to prepare a timetable for its implementation, including the phasing of activities and availment of the incentive package as provided under Section 10 of this Order. SEC. 7. Prohibition on Hiring/Rehiring of Personnel During Plan Preparation. Except for newly created agencies, the hiring of additional personnel (permanent, temporary, contractual or casual), and the renewal of contracts/appointments of all employees hired on contractual, casual or temporary basis is hereby prohibited during the preparation of the Rationalization Plan. SEC. 8. Options for Personnel Who May Be Affected by the Rationalization of the Functions and Agencies of the Executive Branch, Personnel who may be affected by the rationalization of the functions and agencies of the Executive Branch shall have the option to: 8.1. Remain in government service, if with permanent appointment attested by the CSC. Those with temporary appointment attested by the CSC; may opt to remain but are guaranteed tenure up to the expiration of their appointment only; or 8.2. Avail of the retirement/separation benefits as herein provided. 155

SEC. 9. Personnel Who Would Opt to Remain in Government Service. Affected personnel with permanent or temporary appointment who would opt to remain in government service shall be placed in other agencies by the CSC where additional personnel are required. However, the position of the transferred personnel in the recipient agency shall be co-terminus with the incumbent. Such affected personnel shall not suffer any diminution in pay, except certain allowances that used to be given corresponding to the performance of specific functions which would no longer form part of their new functions. Personnel who would choose to remain in government service but would later object to his/her new job assignment shall be deemed separated/retired and shall be paid retirement, separation or unemployment benefit, whichever is applicable under existing retirement/separation laws, without the incentives provided herein. SEC. 10. Personnel Who Would Opt to Retire or Be Separated from the Service. Affected personnel, with appointments attested by the CSC, whether hired on a permanent or temporary basis, who would opt to retire or be separated from the service, and those hired on a casual or contractual basis, if qualified, shall be given the option to avail themselves of any of the following, whichever is beneficial to them: 10.1 Retirement gratuity provided under RA 1616 (An Act Further Amending Section Twelve of Commonwealth Act Numbered One Hundred Eighty-Six, as Amended, Prescribing Two Other Modes of Retirement and for Other Purposes), as amended, payable by the last employer of the Affected personnel, plus the refund of retirement premiums payable by the Government Service Insurance System (GSIS), without the incentive herein provided. 10.2 Retirement benefit under RA 660 (An Act to Amend Commonwealth Act Numbered One Hundred and Eighty-Six entitled "An Act to Create and Establish a Government Service Insurance System, to Provide for its Administration, and to Appropriate the Necessary Funds Therefor," and to Provide Retirement Insurance and for Other Purposes) or applicable retirement, separation or unemployment benefit provided under RA 8291 (An Act Amending Presidential Decree No. 1146, as Amended, Expanding and Increasing the Coverage and Benefits of the Government Service Insurance System, Instituting Reforms Therein and for other Purposes), if qualified, plus the following applicable incentives: 10.2.1 % month of the present basic salary for every year of government service and a fraction thereof, for those who have rendered 20 years of service and below; 10.2.2 % month of the present basic salary for every year of government service and a fraction thereof, computed starting from the 1" year, for those who have rendered 21-30 years of service; and 10.2.3 1 month of the present basic salary for every year of government service and fraction thereof, computed starting from the 1* year, for those who have rendered 31 years of service and above. PROVIDED: That the GSIS shall pay, on the day of separation, the retirement/separation/unemployment benefits to which are affected employee maybe entitled to under RA 660 or RA 8291 and whenever there is an option, the one which the affected employee has chosen as the most beneficial to him/her. PROVIDED FURTHER: That for the purpose of complying with the required number of years of service under RA 8291, the portability scheme under RA 7699 (An Act Instituting Limited Portability Scheme in the Social Security Insurance Systems by Totalizing the Workers’ Creditable Services or Contributions in Each of the Systems) may be applied, subject to existing policies and guidelines. 156

10.3 Those with that three (3) years of government service may opt avail of the separation gratuity under RA 6656 (An Act to Protect the Security of Tenure of Civil Service Officers and Employees in the Implementation of Government Reorganization), plus the appropriate incentive provided under Section 10.2. No affected employees who opted for retirement/separation shall receive less than an aggregate of Fifty Thousand pesos (P50,000.00) as his retirement/separation gratuity benefits from both the National Government and the GSIS. In case of employees belonging to agencies and GOCCs exempted from or not following the Salary Standardization Law, the total amount of incentives to be received shall not exceed One Million Five Hundred Thousand Pesos (P1,500,000.00). SEC. 11. Return by the GSIS of the National Government’s Share in the Retirement Premiums of Personnel Who Cannot Avail of RA 660 or RA 8291. The GSIS shall return to the National Government the corresponding share of the government to the retirement premiums, with interest, of employees who are not yet entitled to avail either RA 660 or RA 8291, SEC. 12. Fast-Tracking of Date Reconciliation. The GSIS is hereby directed to fast-track the reconciliation of the records of all GSIS members with the Departments/Agencies of the Executive Branch to ensure the release of the retirement/separation benefits of personnel concerned on the day of retirement/separation. SEC. 13. Other Benefits of Retired/Separated Personnel. The affected personnel who opted the retire or be separated shall, in addition to the applicable benefits above, be entitled to the following” 13.1 Refund of Pag-IBIG Contributions. All affected personnel who are members of the Pag-IBIG shall be entitled to the refund of their contributions (both personal and government), pursuant to existing rules and regulations of the Home and Development Mutual Fund; 13. 2 Commutation of Unused Vacation and Sick Leave Credits. All affected personnel shall be entitled to the commutation of unused vacation and sick leave credits in accordance with existing rules and regulations. SEC. 14. Abolition of Positions. For every employees who would opt for voluntary retirement/separation, a funded position shall be offered for abolition by the Department/agencies concerned. Unless otherwise approved by the DBM, there shall be no instance that the number of the positions to be offered for abolition shall be less than the number of the personnel who availed themselves of the voluntary retirement/separation benefits. SEC. 15. Prohibition on Rehiring of Personnel Retired/Separated from the Service. Government Personnel who would opt to retire or be separated as a result of the rationalization efforts shall not be appointed or hired in any agency of the Executive Branch, including in GOCCs/ Government Financial Institutions (GFIs), except in educational institutions and hospitals, within a period of five (5) years. The Constitutional Offices, and the Judicial and Legislative Branches may adopt the same hiring policy. The assistance of the CSC and the Commission on Audit (COA) is hereby sought to implement this directive. SEC. 16. Funding Source of Incentives of Affective Personnel. Funds necessary to pay the incentives of affected employees in all regular government agencies shall be provided by the National Government. 157

Incentives of affected personnel of GOCCs/GFIs shall be sourced from their respective corporate funds. In case of funding deficiency of GOCCs not exempted from the Salary Standardization Law, The National Government may provide assistance in the payment of incentive benefits. SEC. 17. Period of Availability of the Benefits Package. The availment of the retirement/separation package provided herein shall be based on the implementation timetable of the Program to be prepared by the DBM and CSC. SEC. 18. Other impact Mitigation Strategies. Department Secretaries are hereby authorized to seek the assistance of agencies involved in the delivery of skills/livelihood/entrepreneurial/investments/development/enhancement programs, business management training and counseling programs to better prepare affected employees in deciding on the option most beneficial to them. For unction which are to be privatized, Secretaries shall assist affected personnel in formations of cooperatives/business enterprises. SEC. 19. Appeals Mechanism. Any appeal shall be resolved following the pertinent provisions of RA 6656. SEC. 20. Implementation Rules and Regulations. The DBM shall issue the guidelines for the effective implementation of this EO, including the mechanism for the agency utilization of savings, provided that the savings shall not be used for the creation of new positions and hiring of additional personnel, either on contractual, casual, consultancy or job order basis. SEC. 21. Repealing Clause. All executive orders, rules, regulations and other issuances or parts thereof, which are inconsistent with the provisions of the Executive Order, are hereby revoked or modified accordingly. SEC. 22. Effectivity. This Executive Order shall take effect upon its publication in a newspaper of gencral circulation. Done in the City of Manila, this 4" day of October, in the year of our Lord, two thousand and four. By the President: (Sgd.) GLORIA MACAPAGAL-ARROYO (Sgd) EDUARDO R. ERMITA Executive Secretary 158 —— a

Appendix C DOH Department Personnel Order No. 2007-0249 Republic of the Philippines Department of Health OFFICE OF THE SECRETARY Building 1, San Lazaro Compound, Rizal Avenue Sta. Cruz, Manita, Philippines Tel. Nos (632) 71 1-9502, 711-9503 and 781-4362: Telefax No. (632) 743-182: January 25, 2007 DEPARTMENT PERSONNEL ORDER No. 2007-0249 _ SUBJECT: Creation of the DOH Technical Working Group (TWG) for the Review_and Revision of the Manual of Organization and Procedures for Administrative Service specifically on Financial Management. Health Financing is one of the areas of health reforms undertaken by the Department of Health (DOH) under FOURmula ONE for Health. The objective of hospitals. Further, a Technical Working Group (TWG) composed of Hospital Finance Officers/Administrative Officers is being created to review and revise the Manual of Organization and Procedures for Administrative Service Specifically on Financial Management for DOH Hospitals. The following are hereby designated as members of the Technical Working Group (TWG), tasked to undertake the review and revision of the said manual. Chairpersons: Dr. Melecio N. Dy — Medical Officer Vil, National Center for Health Facility Development (NCHFD) Dr. Victoria H. Mandai — Medical Specialist IV, NCHFD Vice-Chair: Ms. Maria Ella T. Guerrero — Development Management Officer IV, NCHFD Members: Name Designation/ Office 1. Mr. Laureano Cruz/Ms. Agnes Marfori — OIC, Budget Division/ Budget Officer I 2. Ms. Imelda M. Lim - Development Management Officer II, NCHED 159

160 Fa ozs 8. 9. Ms. Ma. Teresa Felipe — Administrative Officer V, Tondo Medica! Center Ms. Johannabelle Orzales- Administrative Officer V, National Children’s Hospital Mr. Joselito Asis/Ms. Edwina Tarca — Division Chief, Budget and Accounting Division, Philippine Children’s Medical Center/ Budget Officer Ml Ms. Violeta Elibado/ Ms. Emma Dungca — Administrative Officer IV, Dr. Jose R. Reyes Memorial Medical Center Ms. Normita Palisoc — Administrative Officer V, San Lazaro Hospital Ms. Angeline Rojas — Division Chief, Budget and Accounting Division, Lung Center of the Philippines Ms. Marietta Cruz — Administrative Officer V, East Avenue Medical Center Functions of TWG: As Oo OP Conducts TWG meeting to review and revise the current Manual of Organization and Procedures for Administrative Service specifically on Financial Management. Collate updated data pertaining to Hospital Financial Management Invite Experts/Resource Speakers on the subject Conducts Writeshop for the drafting and finalization of drafts of Manual Organize meetings for critiquing and editing of Manual Recommends the printing and distribution of the Revised Manuals for implementation in the DOH Hospitals. Under this Order, transportation expenses incurred by the members shall be charged against their respective agencies. Expenses for meetings such as Office supplies, meals and other incidental expenses shall be charged against the funds of the National Center for Health Facility Development, subject to the usual accounting and auditing rules and regulations. By Authority of the Secretary of Health: Ta 1 es, 5 ET P. NIETO, MD, MPH,MHA, CESO III Undersecretary of Health Head, Policy and Standards Development Team for Service Delivery

Appendix D DOH Department Personnel Order No. 2007-0250 Republic of the Philippines Department of Health OFFICE OF THE SECRETARY Building 1, San Lazaro Compound, Rizal Avenue Sta. Cruz, Manila, Philippines Tel. Nos. (632) 711-9502, 711-9503 and 781-4362: Telefax No. (632) 743-182: January 22, 2007 DEPARTMENT PERSONNEL ORDER NO. 2007 - 0 SUBJECT: Creation of Technical Workin Group for the Review, Revision and Updating of the Manual of Organization and nn ative Service for DOH Hospitals. In line with the thrust of the DOH FOURmula ONE (F1) particularly on Health Service Delivery and Good Governance, it is deemed necessary to review, revise and update the Manual of Organization and Procedures for Administrative Service in DOH Hospitals for continuous development of health care facilities. The review, revision and updating of such Manual is also aimed to harmonize the flow of hospital information to generate immediate and accurate reports in aid for planning and decision making. The National Center for Health Facility Development (NCHFD) as the lead office of the Department of Health (DOH) for the review, revision, updating and printing of such Manual is hereby authorized to create a Technical Working Group (TWG) composed of NCHFD Technical Staff/Adviser and Administrative Officers of selected DOH Hospitals. Chairpersons: 1. Melecio N. Dy, M.D., MPH Medical Officer VII Chief, Technical Operations Division NCHFD to Victoria H. Mandai, MD, MM Medical Specialist [V Acting Chief, Management System Development Division, NCHFD Vice-Chairperson: Prudencia L. Casquejo, MGM Development Management Officer II] NCHFD 161

162 Members:

Clarita A. Aguilar, MPA. National Center for Mental Health Mandaluyong City Chief Administrative Officer
Virginia T. Benavidez, MPA Jose R. Reyes Memorial Medical Center Rizal Ave., Sta. Cruz, Manila -Chief Administrative Officer
Victor S. Clavel. MPA. Philippine Orthopedic Center Banaue St., Quezon City -Chief Administrative Officer 4, Bernadette G. Ipac. MHA Mariano Marcos Memorial Hospital & Medical Center, Batac, Ilocos Norte -Chief Administrative Officer
Evelyn O.Oracion, Lib. Gov. Celestino Gallares Memorial Hospital Tagbilaran City Chief Administrative Officer 6, Carlito U, Pillerin, CPA Davao Regional Hospital Tagum City -Chief Administrative Officer
Bleonorita Reyes -Chief Administrative Officer San Lazaro Hospital Quiricada St., Sta, Cruz, Manila
Eliza Roque Chief Administrative Officer Tondo Medical Center Balut, Tondo, Manila
Floserpina R. Yanguas, CPA, MPA Quirino Memorial Medical Center Proj. 4, Quezon City -Chief Administrative Officer
Engr. Pedro Bag-ao ~Administrative Officer V Gov. Celestino Gallares Memorial Hospital Tagbilaran City
Amador Esleta, Jr, MM -Development Management Officer III NCHED

Ella Tejada-Guerrero, CPA, MBA -Development Management Officer NCHFD TV (Finance Adviser) Functions of TWG: 1 PeN Conducts/attends TWG Meeting to review, revise and update the 1994 Edition (currently used) Manual of Organization and Procedures for Administrative Service. . Conducts Workshop/writeshop for the drafting and critiquing of the Draft . Finalization and printing of the Revised Manual |. Invites experts on standards, systems, policies/guidelines of hospital Administrative Service Under this Order, honoraria of Resource Speakers, meals, venue and other incidental expenses such as office supplies and materials incurred during the TWG activities and the printing of the said Manual shall be charged against the funds of the National Center for Health Facility Development (NCHFD) subject to the availability of funds and the usual accounting and auditing rules and regulations, Likewise, in cases of the conduct of Workshop/Writeshop outside DOH Central Office, transport services, meals and accommodation of TWG members to the selected place of the venue and back to DOH Central Office shall be charged against the funds of NCHFD. Further, traveling expenses, such as per diems of one (1) day before and after the activities, plane tickets, taxi, boat and bus fares of non-Metro Manila TWG members in attending such TWG related activities from and to their official stations and shal} be charged against the funds of the sending agency. By authority of the Secretary of Health:

lt 9 ET P, NIETO, M.D., MPH, MHA, CESO III Undersecretary of Health 163

Appendix E DOH Department Memorandum No. 183 s. 2000 Republic of the Philippines (Trunkina) 743-8301 (Seoretary) 1128; Asaiotent) 4425; 1134; (Head, Executve Departrnent of Health 4490: Erm. Asnt. Room) 1132; (Reoalvng OFFICE OF THE SECRETARY —e Sin Lazaro Compound, Rizal Avenue, Sta. Cruz, E-mal quaelQdoh gov. ph; oveotdoh.gov-ph Manila, Philippines October 5, 2000 DEPARTMENT MEMORANDUM No. #3 s. 2000 TO

All Centers for Health Development Directors, Chiefs of DOH Retained Hospitals, Bureau and Service Directors, ali Budget and Finance Officers concerned, and Program Managers SUBJECT: Implementation of the Policy Guidelines and Standard Operating Procedures on Finance Management Reforms Pursuant to Administrative Order no. 52 series 1999 creating the Finance Management Reform Program (FMRP), the Department of Health Central Office (DOH-CO), Centers for Health Development (CHDs), Regional Medical Centers, Regional Hospitals, Special Hospitals and other retained hospitals are mandated to implement the Finance Management Reform Policy Guidelines and Standard Operating Procedures (SOPs) developed and approved by this Department. CHDs and DOH retained hospitals staff who were given orientation on finance management reforms and fumished with manuals on policy guidelines and SOPs are instructed to implement the said reforms. Signed monographs will follow once these are ready for distribution. It is very essential that the Finance Planning and Monitoring Committee (FPMC) be immediately organized by all concerned, and make it functional as a responsibility center for finance management in their respective areas. It is also understood that all other reforms applicable in each level be applied as stated in the guidelines and SOPs. With regards to the organizational set up of the CHD, the separated Administrative Section and Finance Section must be under the Management Support Division. At the hospital level, Administrative Division/Section and Finance Division/ Section must be separated. An Officer- In- Charge for Finance shall be assigned until an organizational structure that conforms to the separation of Administrative and Finance has been approved by the Department of Budget and Management as part of the on-going reengineering of the Department of Heaith. Monitoring and evaluation shall be implemented on regular basis to follow up reforms applied on finance management. For immediate and strict compliance. LO 7 ALBERTO. ROM DEZ, JR, MD in oT Secretary of Health 164

Appendix F Philippine Government Chart of Accounts COA Circular No.2008-001 dated January 29, 2008 (For use of all Government Agencies) ASSETS Cash 101 Cash in Treasury 102 Cash — Collecting Officers 103 Working Fund 104 Petty Cash Fund 105 Payroll Fund 106 Cash — National Treasury, Modified Disbursement System 107 Cash in Bank — Local Currency 108 Cash in Bank — F oreign Currency Receivable Accounts 111 Accounts Receivable 112 Notes Receivable 113 Real Property Tax Receivable 114 Special Education Tax Receivable 115 Internal Revenue Receivable 116 Loans Receivable 117 Interests Receivable 118 Receivership and Liquidation Receivable 119 Subrogated Claims Receivable 121] Installment Sales Receivable Inter - Agency Receivables 122 Due from National Treasury 123 Due from National Government Agencies 124 Due from Government-Owned and/or Controlled Corporations 125 Due from Local Government Units Intra - Agency Receivables 126 Due from Central/Home Office 127 Due from Parent Corporation 128 Due from Bureaus/Offices 129 Due from Regional/Branch Offices 131 Due from Subsidiaries and Affiliates 132 Due from Operating/Field Units 133 Due from Other Funds/Books 165

Other Receivables 134 Advances to Officers and Employees 135 Due from Officers and Employees 136 Receivable — Disallowances/Charges 137 Subscriptions Receivable 138 Assigned Receivable 139 Dividend Receivable 141 Rent/Lease Receivable 142 Joint Ventures Receivable 143 Insurance/Reinsurance Claims Receivable 144 Due from Non-Governmental Organizations/People's Organizations 149 Other Receivables Inventories Supplies Inventory 151 Office Supplies Inventory 152 Medical, Dental and Laboratory Supplies Inventory Lo Military, Police and Traffic Supplies Inventory 154 School Supplies Inventory 155 Hospital Supplies Inventory 156 Agricultural and Marine Supplies Inventory 157 Fuel, Oil and Lubricants Inventory 158 Chemical and Filtering Supplies Inventory 159 Maintenance Supplies Inventory Trading/Manufacturing Inventory 161 Merchandise Inventory 162 Raw Materials Inventory 163 Work in Process Inventory 164 Finished Goods Inventory 165 Real Estate Inventory Other Inventories 166 Garnished/Foreclosed/Reclaimed/Confiscated/Abandoned/ Seized Real and Other Tangible Properties 167 Spare Parts Inventory 168 Construction Materials Inventory 169 Other Inventories Prepayments, Deposits and Deferred Charges 171 Prepaid Rent 172 Prepaid Insurance 173 Prepaid Interest 174 Prepaid Income Tax lib Deposit on Letters of Credit 166

176 177 178 179 181 189 Investments 19] 192 193 194 195 196 199 Advances to Contractors Guaranty Deposits Other Prepayments and Deposits Deferred Tax Asset Input Tax Other Deferred Charges Treasury Bills Stocks and Bonds Investments in Subsidiaries and Affiliates Investments in Joint Venture Investments in Economic Enterprises Investments in Acquired Companies Other Investments Property, Plant and Equipment Land and Other Improvements 201 202 Land Land Improvements Plant, Buildings and Other Structures 203 204 Plant Buildings and Other Structures Leasehold Improvements 205 206 Leasehold Improvements — Land Leasehold Improvements — Plant, Buildings and Other Structures Equipment and Machinery 207 208 209 211 212 213 214 215 216 217 218 225 Office Equipment Medical, Dental and Laboratory Equipment Military, Police and Traffic Equipment School Equipment Hospital Equipment Agricultural and Marine Equipment Land Transport Equipment Aircraft Watercraft Construction/Port Equipment Technical and Scientific Machinery and Equipment Other Machinery and Equipment Furniture, Fixtures and Books 226 227 Furniture and Fixtures Books 167

Public Infrastructures and Reforestations 231 Dad Public Infrastructures Reforestations Construction in Progress 241 242 243 244 245 246 247 249 Other Assets 261 262 263 264 265 266 267 268 269 271 219 Construction in Progress — Public Infrastructures Construction in Progress — Land Improvements Construction in Progress — Plant Construction in Progress — Buildings and Other Structures Construction in Progress — Leasehold Improvements — Land Construction in Progress — Leasehold Improvements — Plant, Buildings and Other Structures Construction in Progress — Real Estate Reforestations in Progress Intangible Assets Natural Resource Deposits Sinking Fund Premium Reserve Fund Restricted Fund Other Reserve Funds Arts, Archaeological Specimens and Other Exhibits Work/Breeding/Other Animals Agricultural Plants and Trees Aquaculture Other Assets Asset Contra Accounts 168 301 302 303 304 305 306 307 308 309 311 412 313 314 Allowance for Doubtful Accounts Accumulated Depreciation — Land Improvements Accumulated Depreciation — Plant Accumulated Depreciation — Buildings and Other Structures Accumulated Depreciation — Leasehold Improvements — Land Accumulated Depreciation — Leasehold Improvements — Plant, Buildings and Other Structures Accumulated Depreciation — Office Equipment Accumulated Depreciation — Medical, Dental and Laboratory Equipment Accumulated Depreciation — Military, Police and Traffic Equipment Accumulated Depreciation — School Equipment Accumulated Depreciation — Hospital Equipment Accumulated Depreciation — Agricultural and Marine Equipment Accumulated Depreciation — Land Transport Equipment

315 316 317 318 325 326 361 362 Payable Accounts 401 402 403 404 405 406 407 408 409 Accumulated Depreciation — Aircraft Accumulated Depreciation — Watercraft Accumulated Depreciation — Construction/Port Equipment Accumulated Depreciation — Technica] and Scientific Machinery and Equipment Accumulated Depreciation — Other Machinery and Equipment Accumulated Depreciation — Furniture and Fixtures Accumulated Amortization — Intangible Assets Accumulated Depletion — Natural Resource Deposits LIABILITIES AND EQUITY Accounts Payable Notes Payable Due to Members Dividends Payable Insurance/Reinsurance Premium Payable Interest Payable Pension and Retirement Benefits Payable Tax Refunds Payable Informers' Rewards Payable Inter-Agency Payables 411 412 413 414 Due to National Treasury Due to National Government Agencies Due to Government Owned and/or Controlled Corporations Due to Local Government Units Intra-Agency Payables 415 416 417 418 419 421 422 Other Payables 423 424 425 429 Due to Central/Home Office Due to Parent Corporations Due to Bureaus/Offices Due to Regional/Branch Offices Due to Subsidiaries and Affiliates Due to Operating/Field Units Due to Other F unds/Books Due to Officers and Employees Contractors’ Security Deposits Bail Bonds Payable Other Payables 169

Mortgage/Bonds/Loans/Lease Payable 431 Mortgage Payable 432 Bonds Payable 433 Loans Payable 439 Lease Payable Deferred Credits 441 Deferred Real Property Tax Income 442 Deferred Special Education Tax Income 443 Deferred Interest Income 444 Deferred Income from Installment Sales 445 Deferred Income from Leased Properties 446 Deferred Tax Liability 447 Deferred Internal Revenue Income 448 Unearned Premiums 449 Deposit for Future Sales/Subscriptions 451 Customers’ Deposits 452 Output Tax 459 Other Deferred Credits Liability Contra Accounts 461 Discounts on Bonds Payable 462 Premiums on Bonds Payable Equity 47\ Government Equity 472 Members' Equity 473 Capital Stock 474 Premium on Capital Stock 475 Subscribed Capital Stock 476 Treasury Stock 477 Capital/Equity Reserve 478 Revaluation Capital 479 Donated Capital 481 Retained Earnings INCOME Tax Revenue 501 Income Tax 502 Import Duties 503 Value Added Tax 504 Expanded Value Added Tax 505 Final Tax 506 Excise Tax 170

507 508 509 511 212 J13 514 515 516 517 518 a9 521 522 S23 524 325 526 327 528 529 53] 532 538 539 Business Tax Documentary Stamp Tax Amusement Tax Capital Gains Tax Franchise Tax Estate Tax Donors Tax Immigration Tax Professional Tax Property Transfer Tax Stock Transfer Tax Common Carrier Tax Travel Tax Motor Vehicles Users Tax Real Property Tax Special Education Tax Special Levy on Idle Lands Special Levy on Lands Benefited by Public Works Projects Printing and Publication Tax Tax on Sand, Gravel and Other Quarry Products Tax on Delivery Vans and Trucks Community Tax Percentage Tax Other Taxes Fines and Penalties — Tax Revenue Internal Revenue Allotment 541 Internal Revenue Allotment Fees, Permits and License Income 551 352 553 554 555 556 SOT 558 568 569 License Fees Registration Fees Inspection Fees Processing Fees Clearance and Certification Fees Permit Fees Fees on Weights and Measures Occupation Fees Other Fees Fines and Penalties — F ces, Permits and License Income Business and Service Income 571 aie Sales Revenue Commission Income 171

Gains 172 573 574 575 576 577 578 x19 581 582 583 584 585 586 587 588 589 591 592 593 594 595 596 307 598 601 602 603 604 605 606 607 608 609 611 612 613 614 618 619 621 622 623 Concession Income Rent/Lease Income Guarantee Income Generation, Transmission and Distribution Income Winnings Unclaimed Prizes Insurance/Reinsurance Premiums School Fees Seminar/Training Fees Examination Fees Athletic and Cultural Fees Fabrication Fees Financing Fees Irrigation Fees Landing and Aeronautical Fees Parking/Terminal Fees Toll Fees Transportation Fees Port Duties and Fees Wharfage Fees Lodging Fees Hospital Fees Medical, Dental and Laboratory Fees Market and Slaughterhouse Fees Garbage Fees Management Supervision/Trusteeship Fees Consultancy Fees Audit Fees Consular Service Fees Legal Fees Litigation Fees Participation Fees Postal and Telemoney Order Fees Income from Economic Enterprises Interest Income Dividend Income Membership Fees Other Business and Service Income Fines and Penalties — Business and Service Income Gain on Foreign Exchange Gain on Securitization Gain on Sale of Assets

624 629 Subsidy Income 631 632 633 634 635 636 637 638 639 Other Income 641 642 643 644 645 646 647 648 649 659 Gain on Investments Other Gains Subsidy from National Government Subsidy from Central Office Subsidy from Bureaus/Offices Subsidy from Regional Offices Subsidy from Operating/Field Units Subsidy from Local Government Units Subsidy from Government — Owned and/or Controlled Corporations Subsidy from Other Funds Other Subsidy Income Share from Income of Joint Venture Operations Share from Income of Economic Zones and Zone Locators Share from Expanded Value Added Tax Share from National Wealth Share from Receipts of PAGCOR and PCSO Share from Tobacco Excise Tax Share from Arrastre and Stevedoring Income Share from Income of Other GOCCs Grants and Donations Other Income Income Contra Accounts 661 662 663 664 665 666 667 Personal Services Cost of Sales Discounts Tax Refunds Premium Refunds Sales Returns Hospital Free Services Rebates EXPENSES Salaries and Wages 701 702 703 706 Salaries and Wages — Regular Salaries and Wages — Military/Police Salaries and Wages — Faculty Salaries and Wages — Others Other Compensations 707 Personnel Economic Relief Allowance (PERA) 173

708 Additional Compensation (ADCOM) 710 Representation Allowance 711 Transportation Allowance 712 Clothing and Uniform Allowance 713 Honoraria 714 Year-end Bonus 719 Other Bonuses and Allowances Personnel Benefit Contributions 721 Life and Retirement Insurance Contributions 722 PAG-IBIG Contributions 723 PHILHEALTH Contributions 724 ECC Contributions 725 Provident Fund Contributions 729 Other Personnel Benefit Contributions Other Personnel Benefits 731 Pension Benefits — Regular 732 Pension Benefits — Military/Police 733 Pension Benefits — Faculty 734 Retirement Benefits — Regular 735 Retirement Benefits — Military/Police 736 Retirement Benefits — Faculty 737 Vacation and Sick Leave Benefits 749 Other Personnel Benefits Maintenance and Other Operating Expenses Supplies Expenses 751 Office Supplies Expenses 752 Medical, Dental and Laboratory Supplies Expenses 753 Military, Police and Traffic Supplies Expenses 754 School Supplies Expenses T35 Hospital Supplies Expenses 756 Agricultural and Marine Supplies Expenses 757 Fuel, Oil and Lubricants Expenses 758 Chemical and Filtering Supplies Expenses 759 Maintenance Supplies Expenses 765 Other Supplies Expenses Travel and Educational Expenses 766 Travel Expenses 767 Training and Scholarship Expenses Utility Expenses 768 Water 769 Electricity 77\ Fuel 174

Communication Expenses 772 Postage and Deliveries 773 Telephone Expenses — Landline 774 Telephone Expenses — Mobile hie, Internet Expenses 776 Cable, Satellite, Telegraph and Radio Expenses Printing and Advertising Expenses 777 Printing Expenses 778 Advertising, Promotional and Marketing Expenses Taxes, Duties and Premiums 779 Taxes, Duties and Licenses 781 Insurance/Reinsurance Premiums Representation Expenses 782 Representation Expenses Awards, Prizes and Other Claims 783 Awards and Rewards 784 Prizes 785 Indemnities and Other Claims Rent/Lease Expenses 786 Rent/Lease Expenses Survey and Research Expenses 787 Survey Expenses 788 Research, Exploration and Development Expenses Demolition and Dredging Expenses 789 Demolition and Relocation Expenses 791 Desilting and Dredging Expenses Generation and Distribution Expenses 792 Generation, Transmission and Distribution Expenses Members' Benefits 793 Members' Benefits Confidential, Intelligence, Extraordinary and Miscellaneous Expenses 794 Confidential and Intelligence Expenses 795 Extraordinary and Miscellaneous Expenses Membership Dues and Contribution Expenses 796 Membership Dues and Contributions to Organizations Cultural and Athletic Expenses 797 Cultural and Athletic Expenses Food and Laundry Expenses 798 Food Expenses 799 Laundry Expenses 175

176 Repairs and Maintenance 801 802 803 804 805 806 807 808 809 811 812 813 814 815 816 817 818 825 826 827 829 Subsidies 831 832 833 834 835 836 837 838 839 Donations 841 Repairs and Maintenance — Public Infrastructures Repairs and Maintenance — Land Improvements Repairs and Maintenance — Plant Repairs and Maintenance — Buildings and Other Structures Repairs and Maintenance — Leasehold Improvements — Land Repairs and Maintenance — Leasehold Improvements — Plant, Buildings and Other Structures Repairs and Maintenance — Office Equipment Repairs and Maintenance — Medical, Dental and Laboratory Equipment Repairs and Maintenance — Military, Police and Traffic Equipment Repairs and Maintenance — School Equipment Repairs and Maintenance — Hospital Equipment Repairs and Maintenance — Agricultural and Marine Equipment Repairs and Maintenance — Land Transport Equipment Repairs and Maintenance — Aircraft Repairs and Maintenance — Watercraft Repairs and Maintenance — Construction/Port Equipment Repairs and Maintenance — Technical and Scientific Machinery and Equipment Repairs and Maintenance — Other Machinery and Equipment Repairs and Maintenance — Furniture and Fixtures Restorations and Maintenance — Books Maintenance — Reforestations Subsidy to National Government Agencies Subsidy to Central Office Subsidy to Bureaus/Offices Subsidy to Regional Offices Subsidy to Operating/Field Units Subsidy to Local Government Units Subsidy to Government-Owned and/or Controlled Corporations Subsidy to Other Funds Other Subsidies Donations Professional Services 842 843 844 845 Legal Services Auditing Services Consultancy Services General/Janitorial Services

846 847 848 849 Security Services Brokers Services Computer Data Processing Services Other Professional Services Doubtful Accounts, Depreciation, Amortization and Depletion 901 902 903 904 905 906 907 908 909 911 912 913 914 915 916 917 918 925 926 931 932 Losses 981 982 983 984 985 986 987 Doubtful Accounts Expenses Depreciation — Land Improvements Depreciation — Plant Depreciation — Buildings and Other Structures Depreciation — Leasehold Improvements — Land Depreciation — Leasehold Improvements — Plant, Buildings and Other Structures Depreciation — Office Equipment Depreciation — Medical, Dental and Laboratory Equipment Depreciation — Military, Police and Traffic Equipment Depreciation — School Equipment Depreciation — Hospital Equipment Depreciation — Agricultural and Marine Equipment Depreciation — Land Transport Equipment Depreciation — Aircraft Depreciation — Watercraft Depreciation — Construction/Port Equipment Depreciation — Technical and Scientific Machinery and Equipment Depreciation — Other Machinery and Equipment Depreciation — Furniture and Fixtures Amortization — Intangible Assets Depletion — Natural Resource Deposits Loss on Foreign Exchange Loss on Securitization Loss on Sale of Assets Loss on Investments Loss of Assets Impairment Loss Other Losses Other Maintenance and Operating Expenses 989 Other Maintenance and Operating Expenses Financial Expenses 99] O92 993 994 995 Bank Charges Commitment Fees Guarantee Fees Loss on Guaranty Documentary Stamp Expenses 177

178 996 O97 998 999 Interest Expenses Other Financial Charges INTERMEDIATE ACCOUNTS Provision for Income Tax Income and Expense Summary

Appendix G Sample Formula for Costing LUNG CENTER OF THE PHILIPPINES PATHOLOGY AND LABORATORY DEPARTMENT COSTING TEST FOR LEPTOSPIROSIS IL OVERHEAD Area

39.5 sq. m. Overhead/Day

175,891,054.45

8,688.80 sq. m. 20,243.42 sq. m. 12 mos.

724.06 24.13/day 30 days

24.13/day x 25 sq. m.

603.25/day 24 hrs.

25.14/hr

0.41/min. 60 mins. FORMULA: Overhead= Total MOOE of the previous year Total sq. m. of LCP

.41/ min. x 45 mins. Overhead= 18.45 Il. DIRECT MATERIALS Cost per kit of 30 test

Pp Others: Syringe with needles 8.00 Cotton 1.00 Alcohol 1.00 Micropore Tape 1.50 /360 days x Total hours to finish the procedure 293.33 11.50 179

FORMULA: Direct materials Total cost of direct and indirect materials Total Direct Materials

P__304.83 Il. DIRECT LABOR Med. Tech II

P 32,590.05

32,590.05

1,481.37/day 22 days 8 hrs.

185.1 7/hr

3.09/min. 60 mins.

3,09/min x 45 mins. FORMULA: Direct Labor

Gross salary of employee 22 days /8 hrs. of work x Total hours to finish procedure Cost of Direct Labor

123.30 SUMMARY: Direct Materials 411.50 Direct Labor 123.30 Overhead 18.45 Total Cost P 553.25 Add: 30% Mark-up 165.98 COST OF TEST FOR LEPTOSPIROSIS P 719.23 or 750.00 Prepared by: Noted by: ROSENELL L. INGALIA ANGELINE A. ROJAS Clerk III Chief, Budget & Accounting Division 10.16.09 Recommending Approval: Approved by: NELIA S. TAN, M.D. JUANITO A. RUBIO, M.D., MHA, CESO i Manager, Pathology & Laboratory Dept. Executive Director, LCP 180

Appendix H New Government Accounting System (NGAS) Forms Used H.1: Journal Entry Voucher (JEV) JOURNAL ENTRY VOUCHER No. Date Agency Name — ACCOUNTING ENTRIES Bengal any Accounts and Explanation | Account P Amount — Code Debit Credit TOTAL Prepared by: Certified Correct: Accounting Personnel Head, Accounting Unit For Accounting Unit Use 181

H.2: General Journal GENERAL JOURNAL AGENCY NAME Sheet No.:___ DATE JEV NO PARTICULARS ACCOUNT CODE AMOUNT DEBIT CREDIT 182

2002 Jaquiaydag pasinay TIVNYNOF LdIAOAN HSVO 9OL junowy = apor cay ypauyy 148g 10349 AMONNS d 8pod ‘ON JBIINO ‘ON | “ON aleq 99 199q | Bujoayjo9 fOOWEN |QON] As L830 Aupung [Ped LSOd30 NOWIINIOI ‘ON J89YS YjUo/
Aouaby jousnor jdiazay ysva :¢°H 3 co i

20/4/50 qunowy d apo} I3y JEDIHO jUNOWy dj 8poD 997 Buisunqsig] ‘ON GON | “ON ASL} Fed Jo WEN ANONNS Aipuns AYONTS }pad ‘ON J88US “ON }88US yJuo|| Kouaby TVNUNOL LNANSUIASIG HSVO jousnor Juamasangsig YSv) *"¢-H 184

JUNOWY) d apo) doy AUONNS junOWy d apo) day G0/41/5 0 Aipuns LIAI0 ———— 1iday9 Ol WOU ON A/D J “ON AI J2ai4f) Gusungsig. 40 awey SY99Y9 JO ‘ON JeLWaS aeq ON Je0ys TVNYNOF INAWSYNESIG MOaHD yjuoyy Aouaby /DUANOL SJuamasangsiq YIOYD ¢“H Va) oe)

: General Ledger He Genrer GENERAL LEDGER 7 Agency Name Account Code: Account Title: a Amount Dat i F ate Particulars Ref Debit Credit Balance 1/31/02 186

H.7: Subsidiary Ledgers SUBSIDIARY LEDGER Agency Name Account Code Account of GL a eeeeeeSsesesSsSC‘ Office/Address SL eee Contact Person/Number a Date Particulars 1/31/02 Ref. Amount Debit Credit Balance 187

H.8 Obligation Request Republic of the Philippines Department of Health Name of Hospital Address OBLIGATION REQUEST NO. Payee: Office: Address: Responsibility Account Center PARTICULARS P.P.A.| Code Amount TOTAL

A. Certified: B. Certified: Charges to appropriation/allotment necessary, CE] Allotment available and obligated for the purpose lawful and under my direct supervision. as indicated above. Ci) Supporting documents valid, proper & legal. Signature: Signature Printed Name: Printed Name: Position: Position: Date: Date: 188

H.9: Budget Utilization Request Republic of the Philippines my direct supervision LJ Supporting documents valid, proper and legal Agency Address No BUDGET UTILIZATION REQUEST Payee Office Address Responsibility . Account G, Particulars Code Amount Ti A. | Certified B. |Certified L_] charges to budget necessary, lawful and under Budget available and earmarked/utlized for the purpose as indicated above Signature Signature Printed Printed Name Position Position Head, Requesting Office/ Authorized Representative Head, Budget Unit/Authorized Representative Date Date 189

H.10: Disbursement Voucher Republic of the Philippines DEPARTMENT OF HEALTH Name of Hospital Printed Name: Position: Date: Address DISBURSEMENT VOUCHER MODE OF PAYMENT nm [| MDS Check [| Commercial Check ADA [| Other: }Date: ObR/BUR No.: Payee / Office: TIN/Employee No. Date: Responsibilty Center Address: Title; | Code: | Particulars Amount Amount Due == _|P A. Certified: Supporting documents complete and proper B. Approved for Payment Cash available Subject to ADA (where applicable) Signature: Signature: Printed Name: Position: (Head, Accounting Unit/Authorized Representative) Date: (Agency Head/Authorized Representative) Signature: Printed Name: C. Received Payment Date: Check/ADA No. Date: D. Journal Entry Voucher Bank Name: Date: OR No./other relevant documents issued: 190

H.11: Records of Checks Issued (RCI) REPORT OF CHECKS ISSUED Agency Name Period Covered: December 31, 2002 Sheet No. Bank Name/Account No. Report No. Check Nature of Amount Date No. DV No. Payee Payment 1/31/02 19]

H. 12: BIR Form No. 2306, Certificate of Final Tax Withheld at Source Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas Certificate of Final Tax Withheld At Source BIR Form No. 2306 September 2005 (ENCS) For the Period . |. ||, To fo Ne MM/DD/YY. Income Recipient/Payee Information Withholding Agent/Payor Information 3 TIN 1

1 1 For Non-Individuals ) 5 Payor's Name (For Non- Individuals)

Payee's Name (Last Name, First Name, Middle Name) For Individuals|7 _Payor's Name (Last Name, First Name, Middle Name) For Individuals » __ fr | 8 Registered Address 9 Registered Address

ata- Code Code 40 Foreign Address 410A Zip Code 10B ICRNo. (For Alien_Income Recipient Only) es ee : ) Nature of Income Payment ATC Amount of Payment Tax Withheld Total We declare, under the penalties of perjury, that this certificate correct pursuant to the provisions of the Nationa’ has Payor/Payor's Authorized Representative/Accredited Tax gent Signature Over Printed Name Tax Agent Accreditation No./Attorney's Roll No. (if applicable) CONFORME: Payee/Payee's Authorized Representative/Accredited Tax Agent Signature Over Printed Name | Internal Revenue Code, as amende Deon made in good faith, verified by us, and to the best Of our Knowledge and belief, is true and d, and the regulations issued under authority thereof. TIN of Signatory itle/Position of Signatory Date Signed Date of Issuance Date of Expiry TIN of Signatory Title/Position of Signatory Date Signed ‘ax Agent ‘Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry | declare, under the penalties of perjury, that the information herein stated are reported under BIR Form No. 41600 which have been filed with the Bureau of Internal Revenue. Payor/Payor's Authorized Representative/Accredited Tax Agent Signature Over Printed Name Tobe accomplished for Value-Added Tax/Percentage Tax Withholding (substituted filing) | declare under the penalties of perjury that | am qualified under substituted filing of Percentage Tax/Value Added Tax Returns (BIR Form 2551M/2550M/Q), since | have only one payor from whom | earn my income; that, in accordance with RR 14-2003, | have availed of the Optional Registration under the 3% Final Percentage Tax Wthholding/10% Final VAT Withholding in lieu of the 3% Percentage Tax/10% VAT in order to be entitled to the privileges accorded by the Substituted Percentage Tax Return/Substituted VAT Return System prescribed in the aforesaid Regulations; that, this Declaration is sufficient authority of the withholding agent to withhold 3% Final Percentage Tax/10% Final VAT from my sale of goods and/or services. TIN of Signatory Title/Position of Signatory Payee/Payee's Authorized Representative/Accredited Tax Agent Title/Position of Signatory Signature Over Printed Name ax Agent Accreditation No./Attorney's Roll No. (if applicable) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) TIN of Signatory Date of Issuance Date of Expiry Date of Issuance Date of Expiry 192

SCHEDULES OF ALPHANUMERIC TAX CODES ATC Nature of Income Payment IND T CORP 1 Tax Fringe Benefit if Alien individual employed by OBU's, Foreign Petroleum Service Contractors, & Subcontractors, & by Regional or Area Headquarters & Regional Operating Headquarters of Multinational Co., WF 320 including any of its Filipino employees occupying the same position 2 Payment of fringe benefits to Non-Resident Alien Not Engaged in Trade or Business (NRAETB) WF 330 3 Employees other than rank and file (Fringe Benefit Tax) WEF 360 Interest/Yield from Bank Deposits/Deposit Substitutes/Government Securities 4 Saving Deposit WI 161 WC 161 5 Time Deposit WI 161 WC 161 6 Government Securities WI 162 WC 162 7 Deposit Substitutes/Others WI 163 WC 163 8 Foreign Currency Deposits WI 170 WC 170 9 Preterminated Long Term Deposit/Investment WC 440 Less than three (3) years WI 440 Three (3) years to less than four (4) years WI 441 Four (4) years to less than five (5) years WI 442 All Others 10 Interest on foreign loans payable to NRFCs WC 180 11 Interest and other income payments on foreign currency transaction /loans payable to OBUs WC 190 12 Interest and other income payments on foreign currency transaction /loans payable to FCDUs WC 191 13 Cash dividend payment by domestic corporation to citizen & resident aliens/NRFC's WI 202 WC 212 14 Property dividend payment by domestic corporation to citizens & resident aliens/NRFC's WI 203 WC 213 15 Cash dividend payment by domestic corp. to NRFCs whose countries allowed tax deemed paid credit WC 222 16 Property dividend payment by domestic corp. to NRFCs whose countries allowed tax deemed paid credit WC 223 17. On other payments to NRFC WC 230 18 Cash dividend payment by domestic corporation to NRAETB WI 224 19 Property dividend payment by domestic corporation to NRAETB WI 225 20 Share of a NRAETB in the distributable net income after tax of a partnership (except General Professional Partnership) of which he is a partner, or share in the net income after tax of an association, WI 226 a joint account or a joint venture taxable as a corp., of which he is a member or a co-venturer 21 Distributive share of individual partners in a taxable partnership, association, WI 240 a joint account or a joint venture or consortium 22 Other royalty payments to citizens, resiaent aliens and NEAETE WI 250 Wc 250 (other than WI380 and WI 341) /domestic and resident foreign corporation 23 On prizes exceeding P10,000 & other winnings paid to individuals WI 260 24 Branch profit remittances by all corporations except PEZA/SBMA/CDA registered WC 280 25 On the gross rentals, lease and charter fees derived by non-resident owner or lessor of foreign vessels WC 290 26 On the gross rentals, lease and charter fees derived by non-resident lessor of aircraft, wc 300 machineries and other equipment 27 Payment to Oil Exploration Service Contractors/Sub-Contractors WI 310 WC 310 28 Payment to Filipinos or Alien individuals employed by Foreign Petroleum Service Contractors/ Subcontractors, Offshore Banking Units and Regional or Area Headquarters and Regional Operating WI 320 Headquarters of Multinational Companies occupying executive/managerial and technical positions 29 Payments to Non-Resident Alien Not Engaged in Trade or Business (NRAETB) except on sale of shares WI 330 in domestic corporation and real property 30 Payments to non-resident individual/foreign corporate cinematographic film owners, lessors or distributors WI 340 WC 340 31 Royalties paid to NRAETB on cinematographic films and similar works WI 341 32 Final Tax on interest or other payments upon tax-free covenant bonds, mortgages, deeds of trust or WI 350 other obligations under Sec. 57C_ of the National Internal Revenue Code of 1997 33 Royalties paid to citizens, resident aliens & non-resident alien engaged in trade or business (NRAETB) WI 380 on books, other literary works & musical compositions 34 Payments to taxpayer enjoying Preferential Tax Rates/Tax Treaty Rates WC 390 35 Informer's cash reward to individuals/juridical person WI 410 WC 410 36 Final Capital Gains Tax on Sale/Exchange or Other Disposition of Real Property WI 450 WC 450 For Business Tax 37 |VAT Withholding on Purchase of Goods - Govt. Withholding Agent WV 010 38 |VAT Withholding on Purchase of Services - Govt. Withholding Agent WV 020 39 |VAT Withholding on Purchase of Govenrment Public Work Contracts WV 030 40 |VAT Withholding on Purchase of Goods (with waiver of privilege to claim input tax credits) WV 014 41 |VAT Withholding on Purchase of Services (with waiver of privilege to claim input tax credits) WV 024 42 |Person exempt from VAT under Sec. 109 (v) WB 084 43 |Tax on Winnings and Prizes (Sec. 126) (double/forecast/quinella/trifecta bets) - Gov't. Withholding Agent (4%) WB 191 44 |Tax on Winnings and Prizes on horse races/owners of winning racehorses (Sec. 126) - Gov't. Withholding Agent (10%) WB 192 45 |Tax on Winnings and Prizes (Sec. 126 ) (double/forecast/quinella/trifecta bets) - Private Withholding Agent (4%) WB 193 46 |Tax on Winnings and Prizes on horse races/owners of winning racehorses (Sec. 126 ) - Private Withholding Agent (10%) WB 194 47 |VAT Withholding on Non-residents - Gov't. Withholding Agent WV 040 48 |VAT Withholding on Non-residents - Private Withholding Agent WV 050 fe he = Non-resident Alien Engaged in Trade or Business NRFC = Non- resident Foreign Corporation FCDU = Foreign Currency Deposit Unit NRANETB = Non-resident Alien Not Engaged in Trade or Business OBU = Offshore Banking Unit SBMA = Subic Bay Metropolitan Authority CDA = Clark Development Authority PEZA = Philippine Export Zone Authority 193

H. 13: BIR Form 2307, Certificate of Creditable Tax Withheld at Source Republika ng Pilipinas Certificate of Creditable Tax 2307 Kagawaran ng Pananalapi Kawanihan ng Rentas Internas W ith h e Id At S ource September 2005 (ENCS) 4 For the Period | | | From 1 n L r (MM/DD/YY) To if (MM/DD/YY) [Part Payee Information 2 Taxpayer Identification Number 3. Payee's Name (Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals) 4 Registered Address 4A Zip Code ga ai 4 rr 1 5 Foreign Address 5A Zip Code

Lal rn 1 L Payor Information |e Taxpayer — Ee a Identification Number "L._. al 4 Payor's Name |

(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals) 8 Registered Address | 8A Zip Code [|

PART Il Details of Monthly Income Payments and Tax Withheld for the Quarter Income Payments Subject to mc AMOUNT OF INCOME PAYMENTS Expanded Withholding Tax 14st Month of 2nd Month of 3rd Month of Total Tax Withheld the Quarter the Quarter the Quarter For the Quarter Total Money Pay Subject to W of Business Tax (Government & Private) Total We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by me, and to the best of my knowledge and belief, is true and correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Payor/Payor's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory (Signature Over Printed Name) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry Conforme: Payee/Payee's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed (Signature Over Printed Name) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry 194

SCHEDULES OF ALPHANUMERIC TAX CODES ncome Payments subject to Ex ande tthholding Tax ATC y' i P 9g oR 1 Professional/talent fees paid to juridical persons/individuals (lawyers, CPAs, etc.) -if current year's gross income does not exceed P720,000.00 W1010 WC 010 -if current year's gross income exceed P720,000.00 WIO01T WCU 2 Professional entertainers- W1020 -if current year's gross income does not exceed P720,000.00 -if current year's gross income exceed P720.000.00 WI 027 3 Professional athletes- WI 030 -if current year's gross income does not exceed P720,000.00 -if current year's gross income exceed P720,000.00 WI037 4 lovie, stage, radio, television and musical directors- WI 040 -if current year's gross income does not exceed P720,000.00 -if current year's gross income exceed P720,000.00 WI 047 5 Management & technical consultants -if current year's gross income does not exceed P720,000.00 WI050 -if current year's gross income exceed P720,000.00 6 Bookkeeping agents and agencies -if current year's gross income does not exceed P720,000.00 WI060 -if current year's gross income exceed P720,000.00 WI 067 7 Insurance agents & insurance adjusters -if current year's gross income does not exceed P720,000.00 WI070 -if current year's gross income exceed P720 000.00 WI0 8 Other recipient of talents fees- WI 080 -if current year's gross income does not exceed P720,000.00 -if current year's gross income exceeds P720,000.00 WI 087 9 Fees of directors who are not employee of the company -if current year's gross income does not exceed P720,000.00 Ww -if current year's gross income exceeds P720,000.00 WI 097 10_Rentals - Real Properties and Personal Properties, Poles, Satellites and Transmission facilities and Billboards WI 100 WC 10 Cinematographic film rentals WI110 WC W Wi 2 Prime contractors/Sub-contractors 120 WC 3_Income distribution to beneficiaries of estates & trusts 4 Gross commissions or service fees of customs, insurance, stock, real estate, immigration & commercial brokers & fees of agents of professional entertainers WI 140 WC 140 415 Payment to medical practitioners thru a duly registered professional artnershi, WI 147 16 Payments for medical/dental veterinary services thru hospita s/clinics/health maintenance organizations including direct payments to service providers -if current year's gross income does not exceed P720.000.00 WI 151 -if current year's gross income exceeds P720,000.00 WI150 17 Payment to partners in general professional partnership -if current year's gross income does not exceed P720,000.00 -if current year’s gross income exceeds P720,000.00 18 Income payments made by credit card companies to any business entity 19 Income payments made by the government to its local/resident suppliers of goods 20 Payments made by government offices on their purchases of goods and services from local/resident suppliers 21_ Payments made by top 10,000 private Corporations to their local/resident suppliers of goods 22 Payments made by top 10.000 rivate corporations to their local/resident suppliers of services 23 Additional payments to gov't. ersonnel from importers , shipping and airline com anies or their agents 24 Commissions, rebates, discounts and other similar considerations paid/granted to independent and exclusive distributors, medical/technical and sales reperesentatives and marketing agents and sub-agents of multi-level marketing companies = lasssssss oF Ni 3 a 25_Gross payments made to embalmers by funeral companies WI530 26 Payments made by pre-need companies to funeral parlors W535 WC 27_Tolling fee paid to refineries WI540 WC 540 28 Sale of Real Property (Ordinary Assel) 1.5% WI555 WCS 3% WI556 WC 5% WI 557 WC 6% WI558 WC 29 Income payments made to Suppliers of agricultural products W610 WC 30 Interest payments by any person other than those subject to final tax WI 620 WC 31_Income payments on purchases of minerals, mineral products & quar resources WI630 B—Money Payments Subject to Withholding of Business-Tax bet ax On Carriers and keepers of garages 33 Franchise Tax on Gas and Water Utilities WB 040 34 Franchise Tax on radio & TV broadcasting companies whose annual gross receipts does not exceed P10M WB 050 and who are not Value-Added Tax registered taxpayers Tax on life insurance premiums WB 070 6 _Tax on Overseas Dispatch, Messaq WB 090 ax on Banks and Non-Bank Financial Intermediaries Performing Quasi-Banking Functions 37 A. On interest, commissions and discounts from lending activities as well as income from financial leasing, on the basis of the remaining maturities of instrument from which such receipts are derived

Maturity period is five years or less 5% WB 301
Maturity period is more than five years 1% WB 303 38 Tax on royalties, rentals of property, real or personal, profits from exchange & all other items treated as gross income WB 103 under Section 32 of the Code 9

1% 39 On net trading gains within the taxable year on foreign Currency,debt securities, derivatives, and other WB 104 financial instruments 7% ‘Tax on Other Non-Banks Financial Intermediaries Not Performing Quasi-Banking Functions A. On interest, commissions and discounts from lending activities as well as income from financial leasing, on the basis of the remaining maturities of instrument from which such receipts are derived

Maturity period is five years or less 5% WB 108 41
Maturity period is more than five years 1% WB 109 42_B. On all other items treated as gross income under the code 5% WB 110 43 Business Tax on Agents of foreign insurance Co.- insurance agents 10% WB 120 44 Business Tax on Agents of foreign insurance Co.-owner of the propert 5% WB 127 145_ Tax on International Carriers WB 130 46_Tax on Cockpits WB 140 7 Tax on Cabaret, night and day club B 150 48 Tax on Boxing exhibitions 60 70 Xx On jai-alai and race tracks [ax on sale, barter or exchange of stocks listed & traded through Local Stock Exchange [ax on shares of stock sold or exchanged through initial and secondary public offering 9 49_Tax on Professional basketball games 2x on jai-alai and race tracks 33= |S553s Ny S -_Not over 25% 4% B 201

Over 25% but not exceeding 33 1/3 % 2% 202

Over 33 1/3% 1% 203 erson exempt from VAT under Sec. iovernment withholding agen

54 Person exempt from VAT under Sec. 1 Private withholding agent) 3% WB 082 55_Vat Withholding on Purchase of Goods with waiver of privilege to claim input tax credits) 10% WV 012 6 _ Vat Withholding on Purchase o rvices (wi i Drivi aim input tax i 10% WV 022 195

#14: BIR Form No. 1601-C: Monthly Remittance Return of Income Taxes Withheld (To be flog up by the BIR) DLN:

ps0c. =" Republika ng Pilipinas Monthly Remittance Return BIR Form No & Kauuinintn'sg Romas'intemas Of Income Taxes Withheld 1601-C on Compensation September 2001 (ENCS) Fillin all applicable spaces. Mark all appropriate boxes with an X Forthe Month iz ae Rain Yes. cl PSA OTe Tie Occupation Br wrotan agen as Tan Wane att lcd Nahe Vor ndiguanlagiiored Nome tor NonsToahaddai” JO Tolophon NOMEN? o ig Aides i Zip Code 2 Category of Withholding Agent ling of tax reliet under Special law 14 ATC Treaty? o » L lprivate [_} Goverment Kio ithes, apeciy [wwo1o | ar T Tax Fanaa

mount et CompersaTon cay Total Amount of Compensation 16 Hse Lees: Non Taxable Compensation a 7 Taxable Compan

18 Tax Required to bo Withhela a 19 Add/Less: Adjustment (from Item 25 of Section A) 2 0 Tax Require to be Withheld for Remittance Fa 11 Less: Tax Remitiad in Retusn Previously File, i this jean amended return 2 2 Tex St DvaOveromitance) ie ceases "Su sha Interest ce 80 urcharge ates omprom 38) as FI | sl ones ] 23D 24 24 Total Amount Stil Que/(Overremtiance) nike 2 ROR =e 2. cunobhvy) 1 a erates) | Stout Ba Tax One LOTT TINA ior tne Month for the Month Pram Year-End Adhsigent orm rat ro ina ‘oT peru, provisions Te over Printed "WA aapayer Authorized Raprosentatve le Position or signatory —— TIN of Tax Agent (Tapplicabley Tax Agent Accreditation No (applicable) Detalles of Payment ‘Stamp of Recewing el [ Bate Office and Date of lars, Agency, Number [uuy-38'|—v¥vy—| Amount, Receipt, [28 CashiBank cry Debit Momo | 19 Check 290 EE ap }0 Others 308 300) sec eo} jachine Validation/Revenue Offical Receipt Details (not fled with the bank) 196

BIR Form 1601-F (ENCS)Page 2 [Schedule Dafalle of Final Tax Based on Tax Treaty Rates [Treaty Goad AT Nature of income Payment ‘Amount of income Payment Rate “Tax Required To Be Withheld rota [Schoduto2 SCHEDULE OF TAX TREATY CODE "TREATY CODE | COUNTRY | TREATYGODE | COUNTRY | TREATY CODE ‘COUNTRY TREATY CODE | _ COUNTRY AU [Austrata 0K Denmark uP \Napan 36 Singapore at austia Fi Feiond KR |kKoroa eS Spain BH [Bobrain FR France my |Molaysio se sweden 8D [Bangladesh oe Germany nt |Netherianas on Switzerland Be —|Beigim HU Hungary NZ |Now Zealand 1 main ar [Braz IN Inca NO |Nomway os luntes Kingdom ca [canada 0 indonesia px [Pakistan us usa cn |oina i Israel 0 |Romenia vw vietnam cz|ozech Repub ft a Ru __|russio ATURE OF INCOME PAYMENT la interest on foreign loans payable to NRFCs 20% lwo veo itorest and otter Income payments on foreign curencytransactonsioans payable to OBUS 10% hwo 190 interest and other Income payments on foreign currency wansactonsloans payable to FCDUs 10% lworos |Cash dividend payment by domestic corporation to citizens and resident aliens/NRFCs i ewe zd Property dividend payment by domestic corporation to citizens and resident aliens/NRFCs soe Jwiaes Ewe ai [Gash dividend payment by domestic corporation to NRFCa whose couniios allowed tax deemed pal ced (subject to tax sparing ule) 15% lwo2ze Property cvidend payment by domestic corporation to NRFCs whose counties alloned tax deerhed paid ered (subject tax sparing ru 18% lwo zzs [Cash aividond payment by domestic corporation to NRAETB 2 [areas [Property divigend payment by domestic corporation to NRAETB 20% |wi2as Share of NRAETE in the distbutable netincome after tax fa partnership (except General Professional Partnership) of which he 6 apariner, or share | 04 | 3 inthe not income afer tax of an association, joint account ora joint venture taxable asa corporation of which he ia member ora cowenturer Disirbutive shore of individual partners in a taxable parinershi, association, jant account orjint vere or consortium 10% [wae [a Kinds of ally payments fo zens, resident aliens and NRAETE (other than WI 80 and WI 347), domestic and resident foreign corporations | ‘aux jw 260 |wo2e0 fon prizes exceeding F10,000& other winnings pad oindvvals 20% |wr2s0 [Branch prof remitances by al corporations except PEZA/SBMAICDA registered 18% lwo2e0 [on the gross rentals, lease and charter fees derived by nonresident owner or oss0r of fore vessels 15% we 290 [On the gross rentals, charters end other fees derived by non-resident lessor of aircraf, machineries and equipments 75% lwo 300 [on payments to ol exploration service contractos/sub-contracors o%[wiaio [cave Paymens o Fipinos or ation individuals employed by Foreign Petroleum Service GontracorsSub-contrators, Offshore Banking Units and Regional b |, 99 ‘roa Headquarters and Regional Operating Headquarters of Mulinaional Companies occupying executve/manageril and technical positions. [Payments to NRANETB except onsale of shares in domestic cor. and ree property 2am [sv [on_paymens to non-resident indviduaVioreign corporate cnematographic fim owners, lessor or dstibutore 5% fwroao [wc 90 [On other payments to NRFCs woz Royalties pad to NRAETB on crematographic fms and similar works 25% wae Final taxon Interest or other payments upon texte covenant bonds, morigages, deeds of tot or aer obligations under Sec. 576 ofthe son bwnaeo National intemal Revenve Code of 1097 Royates pad o citizens, resident aliens and NRAETS on books, other ierary works and musical compositions 75% [360 informers Cash Reward to indvdualsunaial persons 10% wieto [woaro

NRAETB - Non - resident allen engaged in trade or business within the Philippines.

NR. = Non-resident

NRANETB - Non - resident alien not engaged in trade or business within the Philippines © OBU - Offshore Banking Unit

NRFC — -Non- resident Foreign Corporations.
FCOU - Foreign Currency Depesit Unit 197

Monthly Remittance Return of Final Income Taxes Withheld Guidelines and Instructions Who Shall File This return shall be filed in triplicate by every withholding agent (WA)/payor who is either an individual or non-individual, required to deduct and withhold taxes on income payments subject to Final Withholding Taxes. If the Government of the Philippines or any political subdivision agency or instrumentality thereof, as well as a government-owned or controlled corporation, is the withholding agent/payor, the return may be made by the officer or employee having control of disbursement of income payments or other officer or employee appropriately designated for the purpose. If the person required to withhold and pay the tax is a corporation, the return shall be made in the name of the corporation and shall be signed and verified by the president, vice-president, or any authorized officer and countersigned by the treasurer or assistant treasurer. With respect to a fiduciary, the return shall be made in the name of the individual, estate or trust for which such fiduciary acts and shall be signed and verified by such fiduciary. In case of two or more joint fiduciaries, the return shall be signed and verified by one of such fiduciaries. When and Where to File and Remit The return shall be filed and the tax paid on or before the tenth (10") day of the month following the month in which withholding was made. The return shall be filed and the tax paid with the Authorized Agent Bank (AAB) of the Revenue District Office (RDO) having jurisdiction over the withholding agent's place of business/office. In places where there are no Authorized Agent Banks, the return shall be filed and the tax paid with the Revenue Collection Officer or the duly Authorized City or Municipal Treasurer within the Revenue District where the withholding agent’s place of business/office is located, who will issue a Revenue Official Receipt (BIR Form No.2524) therefor. Where the return is filed with an AAB, taxpayer must accomplish and submit BIR-prescribed deposit slip, which the bank teller shall machine validate as evidence that payment was received by the AAB. The AAB receiving the tax return shall stamp mark the word “Received” on the return and also machine validate the return as proof of filing the return and payment of the tax by the taxpayer, respectively. The machine validation shall reflect the date of payment, amount paid and transactions code, the name of the bank, branch code, teller’s code and teller’s initial. Bank debit memo number and date should be indicated in the return for taxpayers paying under the bank debit system. A taxpayer may file a separate return for the head office and for each branch or place of business/office or a consolidated return for the head office and all the branches/offices except in the case of large taxpayers where only one consolidated return is required. For Electronic Filing and Payment System (EFPS) Taxpayer The deadline for electronically filing and paying the taxes due thereon shall be in accordance with the provisions of existing applicable revenue issuances. Penalties There shall be imposed and collected as part of the tax: 1. A-surcharge of twenty five percent (25%) for each of the following violations: a. Failure to file any return and pay the amount of tax or installment due on or before the due date; b. Unless otherwise authorized by the Commissioner, filing a return with a person or office other than those with whom it is required to be filed; c. Failure to pay the full or part of the amount of tax shown on the return, or the full amount of tax due for which no return is required to be filed on or before the due date; d. Failure to pay the deficiency tax within the time prescribed for its payment in the notice of assessment. 198

A surcharge of fifty percent (50%) of the tax or of the deficiency tax, in case any payment has been made on the basis of such return before the discovery of the falsity or fraud, for each of the following violations: a. Willful neglect to file the return within the period prescribed by the Code or by rules and regulations; or b. In case a false or fraudulent return is willfully made. 3. Interest at the rate of twenty percent (20%) per annum, or such higher rate as may be prescribed by rules and regulations, on any unpaid amount of tax, from the date prescribed for the payment until the amount is fully paid. 4. Compromise penalty, Violation of Withholding Tax Provisions Any person required to withhold, account for, and remit any tax imposed by the National Internal Revenue Code or who willfully fails to withhold such tax, or account for and remit such tax, or aids or abets in any manner to evade any such tax or the payment thereof, shall, in addition to other penalties provided for under this Law, be liable upon conviction to a penalty equal to the total amount of the tax not withheld, or not accounted for and remitted. Any person required under the National Internal Revenue Code or by rules and regulations promulgated thereunder to pay any tax, make a return, keep any record, or supply correct and accurate information, who willfully fails to pay such tax, make such return, keep such record, or supply such correct and accurate information, or withhold or remit taxes withheld, or refund excess taxes withheld on compensation, at the time or times required by law or rules and regulations shall, in addition to the other penalties provided by law, upon conviction thereof, be punished by a fine of not less than ten thousand pesos (P 10,000.00) and suffer imprisonment of not less than one (1) year but not more than ten (10) years. Every officer or employee of the Government of the Republic of the Philippines or any of its agencies and instrumentalities, its political subdivisions, as well as government-owned or controlled corporations, including the Bangko Sentral ng Pilipinas, who, under the provisions of the Code, as amended, or regulations promulgated thereunder, is charged ith the duty to deduct and withhold any internal revenue tax and to remit the same in accordance with the provisions of the Tax Code, as amended, and other laws is guilty of any offense herein below specified shall, upon conviction of each act or omission, be fined in a sum not less than five thousand pesos (P 5,000) but not more than fifty thousand pesos (P 50,000) or imprisoned for a term of not less than six (6) months and one day but not more than ) years, or both: a) Those who fail or cause the failure to deduct and withhold any internal revenue tax under any of the withholding tax laws and implementing regulations; b) Those who fail or cause the failure to remit taxes deducted and withheld within the time prescribed by law, and implementing regulations; and c) Those who fail or cause the failure to file a return or statement within the time prescribed, or render or furnish a false or fraudulent return or statement required under the withholding tax laws and regulations. If the withholding agent is the Government or any of its agencies, political subdivisions or instrumentalities, or a government-owned or controlled corporation, the employee thereof responsible for the withholding and remittance of tax shall be personally liable for the additions to the tax prescribed by the National Internal Revenue Code. 199

Note: All background information must be properly filled up. 200 All returns filed by an authorized representative must attach authorization letter. All returns filed by an accredited tax representative on behalf of a taxpayer shall bear the following information : A. For CPAs and others (individual practitioners and members of GPPs): a.l1 Taxpayer Identification Number (TIN); and a.2 Certificate of Accreditation Number, Date of Issuance, and Date of Expiry. B. For members of the Philippine Bar (individual practitioners, members of GPPs): b.1 Taxpayer Identification Number (TIN); and b.2 Attorney’s Roll number or Accreditation Number, if any. Box No. | refers to transaction period and not the date of filing this return. The last 3 digits of the 12-digit TIN refers to the branch code. TIN = Taxpayer Identification Number In case of Large Taxpayer filing consolidated return, an accompanying schedule shall be attached with the following information: A. Month covered; B. Name and addresses of Head Office and branches/units; and C. Amount of withholding taxes to be remitted. The rates of the following transactions are as follows: ATC Nov. 1, 2005 to Dec. 31, 2008 Jan.1, 2009 *WC 212 35% 30%

WC 213 35% 30%
WC 230 35% 30%

H. 15: BIR Form No. 1601 F MTR of Final Taxes Withheld (To be filled up by the BIR)

DLN:

PSOC.

_Psic; Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas Monthly Remittance Return of Final Income Taxes Withheld BIR Form No. 1601-F September 2005 (ENCS) Fill in all applicable spaces. Mark all appropriate boxes with an "X”. or the Mon 2 men eturn? (MM LYYYY) is i Yes L} No r No, of Sheets Attached ay Any taxes Withheld?

[] ves L] No Part | Background Information ——$— 5 TIN 6 RDO Code a ~|__| 7 Line of B Occupation

| 8 Withholding Agent's Name (Last Name, First Name, Middle Name for Individuale)/(Regi tered Name for Non-Individuals ]® Telephone Number

1 1 i 4 1 u 10 Registered Addre: 11 Zip Code . a 12 Category of Withholding Agent 13 Are there payees availing of tax relief under Special Law

| Private [] Government or international Tax Treaty? C_ly¥es [_] No _ ifyes, specify [ Part Il = Computation of Tax NATURE OF INCOME PAYMENT ATC TAX BASE eee 76 RE WIHNELS 14 Total Tax Required to be Withheld Based on Regular Rates 14 15 Total Tax Required to be Withheld Based on Tax Treaty Rates(from Schedule 1 at the back) 15 16 Total (Sum of Items 14 and 15) 16 17 Less: Tax Remitted in Return P ly Filed, if this is an amended return 17 18 Tax Still Due (Overremittance) 18 19 Add: Penalties Surcharge Interest Compromise 19A ] 198[ ]1gcf 190| 20 Total Amount Still Due/(Overremittance) (Sum of Items 18 and 19D) zo | (declare, under the p of perjury, that this Teturn has been made in good faith, verified by me, and to the best of my knowledge and belief, is true and correct, Pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof 21 22 President/Vice President/Principal Officer/Accredited Tax Agent’ Treasurer/Assistant Treasurer Authorized Representative/Taxpayer (Signature Over Printed Name) (Signature Over Printed Name) Title/Position of Signatory TIN of Signatory Title/Position of Signatory Tax Agent Acc. No./Atty's Roll No.(if applicable) Date of Issuance Date of Expiry TIN of Signatory Details of Payment T Stamp oF Q ‘ | Receiving BUG ie moun and Date of Receipt ash/Bank 23A| 236 Number 23¢ 23D I} (RO's Signature/ Debit Memo 1 1 oo |

Bank Teller's Initial) 24 Check 24a 248 24C 24D |

L a

25 Others 25a, 258 sc | ; 7 25D l} Machine Validation/Revenue Official Receipt Details (If not filed with an Authorized Agent Bank) 201

H. 16: BIR Form No. 1604 CF Annual Information Return on Income Taxes Withheld (To be filled up by the BIR)

DLN: PsOoc: PSIC: . BIR Form No. Repuslitany Pilphas Annual Information Return C F Kagawaran ng Pananalapi of Income Taxes Withheld on = Kawanihan ng Rentas Internas . . . . July 1999 (ENCS) Compensation and Final Withholding Taxes Filin all applicable spaces. Mark all appropriate boxes with an “X”. 1 For the Year F Amended Return? || 8 No of Sheets Attached | | WYYY) Le a |}Y¥os No

n Parti Background Information 4 ie | 5 RDO =" 6 Line of Business/ ‘|

Occupation 7 Wi i ‘s N { Name, First Name, Middle Name for Individuals)/(Reaistered Name for Non-Individuals|8 Te sl va nY 1 1 9 Registered Address 10 ZipC : Hes 71 In case of overwithholding/overremittance after the year-end adjustment on compen If yes, specify have you released the refunds to your employe Yes No the date of refund 42 Total Amount of Overremittance| on 43 Month of First oe os of Withholding Agent Tax Withheld under compensation Overremittance Private Government Part li Sum miar of Rem itt an css chedule 1 Remittance per SCR fr orm No. 1e01-c | DATE OF [NAME OF BANK/BANK CODE/ TOTAL AMOUNT MONTH ReEMITTANCKH ROR NO., IF ANY TAXES WITHHELD ADJUSTMENT PENALTIES REMITTED JAN 2 ° ° ° FEB . . Fy ° MAR ° . * . APR : ° . . MAY ° ° . ° JUN ° . 5 . JUL . . ‘ 5 AUG ° : a . SEP : . * . OCT ° .

° NOV : : ° . DEC . ° © ° TOTAL ° . i ° Schedule 2 Remtttanece per BIR Form N o. 1601-F MONTH DATE OF | NAME OF BANK/BANK CODE/ TAXES PENALTIES TOTAL AMOUNT REMITTANC ROR NO., IF ANY WITHHELD REMITTED JAN . . . FEB .

MAR . a . APR . : ° MAY . : . JUN . a . JUL . A ° AUG ° * ° Sie . . 5 OCT . z= . NOV . Z ° DEC . 7 . TOTAL . . ° Schedule 3 Riemtittan ¢ e p-¢ BTR F orm N o. 1602 DATE OF, NAME OF BANK/BANK CODE TAXES TOTAL AMOUNT QUARTER PENALTIES REMITTAN ROR NO., IF ANY WITHHELD REMITTED 1ST QTR . . 5 2ND QTR . p

3RD QTR .

. 4TH QTR] . 5 < TOTAL . é . Schedule 4 Remittance 6 per 81K Fb -o fm No. 1603 QUARTER DATE OF, NAME OF BANK/BANK CODE] TAXES PENALTIES TOTAL AMOUNT REMITTAN ROR NO., IF ANY WITHHELD REMITTED 1ST QTR : é . 2ND QTR é . , QTR a ; . H QTR] : : : TOTAL 5 : . I declare, under the penalties of perjury that this return has been made in good faith, verified bytamp of Receiving Office and best of my knowledge and belief, is true and correct, pursuant to the provisions of the National Inter’ Date of Receipt Code, as amended. and the regulations issued under authority thereof. 15 16 Taxpayer/Authorized Agent Signature over Printed Name Title/Position of Signatory 202 ca

Part Il Alphabetical List of Emplo: es/ Pa BIR Form 1604-CF ENCS) - PAGE 2 : s from whom Taxes were Withheld (format only) | HOLDING TAX (Reported Under Form 2306) Under Form 2306) Schedule 5 ALPHALIST OF PAYEES SUBJECT TO FINAL WITH SEQ Taxpaye] NAME OF PAYEES] ADDRESS OF f statu ATC |NATURE OF INCOME AMOUNT OF RATE] AMOUNT OF TAX INO} Identificatf(Last Name, First Name PAYEES |istoresktence/ PAYMENT INCOME OF WITHHELD Number (TiMiddle Name for Individuals, ionalith) (Reter to BIR Form No. 1601}1 PAYMENT TAX (Not Creditable complete name for Non - individuals) i (2) (3) (4) (5) (6) 7) (8) (9) (10) [P P | | [| | | wa | | | || ally | | | | | | | | || | | | || | | | | | | | | [| || | [| i ———a o: a a3 [| | || an | | | | | || | | | | | | Total Pp Schedule 6 ALPHALIST OF EMPLOYEES OTHER THAN RANK AND FILE WHO WERE GIVEN FRINGE BENEFITS DURING THE YEAR (Reported SEQ] Taxpayer [Bat OF EBLOVEES PATE" ANGUNT OF} GROSEEE -UP | AMOUNT OF NO. Identification FRINGE BENEFIT MONETARY TAX WITHHELD Number (TIN) |Last Namel First Name | Middle Name VALUE (NOT CREDITABLE 4) (2) (a (3b) (3c) (4) (5) (6) (7) P P [P | | | | | | | | | | | | | | | | | | | | | | | | | | | | Total P Pe P

A - Citizens of the Philippine B - Resident Anen Individuals C - Non-resident Allen Engaged in Business D G - Non-resident Foreign Corp. ind subcontractors, offshore banking units and regi E- Domestic Corporation F - Resident Foreign Corp. H - Alien employees of oil exploration service contractors a jon resident Alien not Engaged in Business ional or area headquarters of multinational corporations 203

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BIR Form No. 1604-CF - Annual Information Return of Income Taxes Withheld on Compensation and Final Withholding Taxes Guidelines and Instructions Who Shall File This return shall be filed in triplicate by every employer or withholding agent/payor who is either an individual, estate, trust, partnership, corporation, government agency and _ instrumentality, government- owned and controlled corporation, local government unit and other juridical entity required to deduct and withhold taxes on compensation paid to employees and on other income payments subject to Final Withholding ‘Vaxes. The tax rates for and nature of income payments subject to withholding tax on compensation and final withholding taxes are printed in BIR Form 1601-C and 1601F, respectively. If the payor is the Government of the Philippines or any political subdivision or agency/instrumentality thereof, or government-owned and controlled corporation, the return shall be made by the officer or employee having control of the payments or by any designated officer or employee. If the person required to withhold and pay the tax is a corporation, the return shall be made in the name of the corporation and shall be signed and verified by the president, vice president or authorized officer and shall be countersigned by the treasurer or assistant treasurer. With respect to fiduciary, the return shall be made in the name of the individual, estate or trust for which such fiduciary acts, and shall be signed and_ verified by such fiduciary. In case of two or more fiduciaries, the retum shall be signed and verified by one of such fiduciaries, When and Where to File The return shall be filed on or before January 31] of the year following the calendar year in which the compensation payment and other income payments subjected to final withholding taxes were paid or accrued. The retum shall be filed with the Revenue Collection Officer or duly authorized City/Municipal Treasurer of the Revenue District Office having jurisdiction over the withholding agent's place of business/office. A taxpayer may file a separate return for the head office and for each branch or place of business/office or a consolidated retum for the head office and all the branches/offices except in the case of large taxpayers where only one consolidated retum is required. Penalty for failure to file information returns In the case of each failure to file an information return, statement or list, or keep any record, or supply any information required by the Code or by the Commissioner on the date prescribed therefor, unless it is shown that such failure is due to reasonable cause and not to willful neglect, there shall, upon notice and demand by the Commissioner, be paid by the person failing to file, keep or supply the same, One thousand pesos ( P 1,000.00) for each such failure: Provided, however, that the aggregate amount imposed for all such failures during a calendar year shall not exceed Twenty five thousand pesos (P 25,000.00). Attachments Required 1. Alphalist of Employees as of December 31 with No Previous Employer within the Year. 2. Alphalist of Employees as of December 31 with Previous Employer/s within the Year. 3. Alphalist — of Employees Terminated __ before December 31. 4. Alphalist of Employees Whose Compensation Income Are Exempt from Withholding Tax but Subject to Income Tax. 5. Alphalist of Employees other than Rank & File Who Were Given Fringe Benefits During the year, 6. Alphalist of — Payees Subjected to Final Withholding Tax. Note: All background information must be properly filled up. " The last 3 digits of the 12-digit TIN refers to the branch code. "Box No. | refers to transaction period and not the date of filing this return, " TIN= Taxpayer Identification Number. " The ATC in the Alphabetical List of Payees/Employees shall be taken from BIR Form Nos. 2316 and 2306. "Employees earning an annual compensation income of not exceeding P 60,000 from one employer who did not opt to be subjected to withholding tax on compensation shall be reported under Schedule 7.2 (Alphalist of — Employees Whose Compensation Income are Exempt from Withholding Tax But Subject to Income Tax) ENCS 205

H.17: List of Due and Demandable Accounts Payable (LDDAP) LIST OF DUE AND ACCOUNTS PAYABLE - INTERNAL CREDITOR Batch No. DEPARTMENT: AGENCY MOS-GSB BRANCH/MDS SUB-ACCOUNT NO.: FUND CODE — pesos NAME OF CREDITOR NO. GROSS | WITHOLDING | NET AMOUNT AMOUNT TAX APPROVED: ALLOTMENT PRIORITY NO. CLASS Certified Correct: Head, Accounting Head of the Agency 206

H.18: List of Not Yet Due and Demandable Obligations Agency Name List of Not Yet Due and Demandable Obligations Maintenance and Other Operating Expenses and Capital Outlay As of December 31, 90 days & Beyond 360 Name of Creditor ObR/BUR No. below 91 to 180 days| 181 to 270 days | 271 to 360 days days Total Certified Correct: Budget Officer/Head of Budget Unit 207

H. 19: Report of Collections and Deposits REPORT OF COLLECTIONS AND DEPOSITS Agency Name Report No. Sheet No. Official Receipt Number Payor Particulars Amount Summary: Collections per OR Nos. P 0.00 Deposits Date: P Date: 0.00 Balance P 0.00 208

#.20: Report of Disbursements REPORT OF DISBURSEMENTS Agency Name Report No. Sheet No. Date DV No. Fayed Nature of | Responsibility Amount Payment Center 1/31/02 209

H.21: Statement of Income and Expenses (Income Statement Approach) Agency Statement of Cash Flows Fiscal Year Ended December __, 20 Cash Flows from Operation: Net Subsidy over expenses Add/Deduct: Non-cash expenses, revenues, losses & gains included in the net income Addition: Depreciation expense Decrease in prepaid rent Decrease in spare parts inventory Decrease in other receivables Reversion of Prior Year’s Accounts Payable Increase in Performance Bonds Payable Increase in other payables Deduction: Increase in due from NGA Increase in prepaid rent Increase in spare parts inventory Increase in other receivables Decrease in accounts payable Net Cash Provided by Operation Certified Correct: Chief Accountant 210

H.22: Balance Sheet: Statement of Cash Flows (Balance Sheet Approach) Agency Statement of Cash Flows Fiscal Year Ended December _, 20 Cash Flow from Operating Activities: Increase in Due from NGAs Increase in Other Receivables Increase in Spare Parts Inventory Increase in Prepaid Rent Increase in Accumulated Depreciation — Building Increase in Accumulated Depreciation — Office Equipment Decrease in Accounts Payable Increase in Performance Bonds Payable Increase in Other Payables Increase in Government Equity Cash Provided by Operating Activities LS NNN NNN SF FO a! ae Nee FS Cash Flow from Investing Activities: Increase in Treasury Bills Increase in Stocks Increase in Bonds Increase in Other Marketable Securities Increase in Buildings Increase in IT Equipment and Software Increase in Office Equipment Cash Used in Investing Activities ( ) RLV VLE EL ES Na het oF Ye Cash Flow from Financing Activities: Increase in Loans Payable Increase in Mortgage/Bonds/Retirement Gratuity Payable Increase in Other Long-Term Liabilities Cash Used in Financing Activities ( ) Increase in Cash Add: Cash Balance, December 31, 20 Cash Balance, December 31, 20 Certified Correct: Chief Accountant 211

H.23 Statement of Accounts Receivable Agency SCHEDULE OF ACCOUNTS RECEIVABLE As of 1/31/2002 Account Code: Amount Due Name of Debtor Amount Current Past Due (In Alphabetical Remarks Order) Balance Less 31 ion 91 Toned Over 1 oar 2 | 3 years than 30 days days year years & days above Ls Ds 2B 4. as 6. ha 8. 9, 10. Ts, 12. 13. 14. LS. 16. iT. 18. Certified Correct: Chief Accountant pAW!

1.24: Statement of Accounts Payable Agency SCHEDULE OF ACCOUNTS PAYABLE As of January 31, 2002 Account Code: Name of Debtor (In Alphabetical Order) Amount Due Less Balance than Remarks Certified Correct by: Chief Accountant 213

BIR Alpha List ( Compensation VAT/E CT) A235; (To be filled up by the BIR)

DLN:

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PSic: : Monthly Remittance Return of BIR Form No. Republika ng Pilipinas Kauawaran ng Pananalep i Value-Added Tax and Other | 600 awanihan ni entas Internas . a Percentage Taxes Withheld Under RAs 1051, 7649 ,8241,8424 and 9337 September 2005 (ENCS) Fill in all applicable spaces. Mark all appropriate boxes with an “ Part! Background son 2 Amended Return? P No. of Sheets Attached Jal om For the Month (MM IYYYY) C J] ves LIN re [° “RDO ‘e 7 Line of TM Occupation 9—_ a Withholding Agent's Name (Last Name, First Name, Middle Name for individuais)/(Registered Name for Non-Individuals) : ned 41 Zip Codeia 410 Regi a 42 Category of Withholding Agent 43 Are there payees availing of tax relief under Special Law or L_] Private |] Government International Tax Treaty? [] Yes iam No If yes, specify Part Il ig Computation of Tax (Attach | sheet if y) TAX TAX NATURE OF INCOME PAYMENT ATC TAX BASE RATE TO BE WITHHELD. 44 Total Tax Required to be Withheld and Remitted 14 Previously Filed, if this is an amended return 15 16 45 Less: Tax Remitted in Return 17A 17B 18 Total Amount Still Due/(Overremittance) (Sum of Items 16 & 17D) penalties (Item 47D to 18) For late filers with overremittance, extend amount of t this return has been made in good faith, verified by me, an d, and the regu f the National Internal Revenue Code, as amende 20 Treasurer/Assistant Treasurer 46 Tax Still Due/(Overremittance)

Add: Penalties Surcharge Interest Compromise [Cid 170 18 'd to the best of my knowledge, and belief, lations issued under authority thereof. T declare, under the penalties of perjury, tha is true and correct, pursuant to the provisions 0’ President/Vice President/Principal Officer/Accredited Tax Agent/ Authorized Representative/Taxpayer (Signature Over Printed Name) (Signature Over Printed Name) Title/Position of Signatory TIN of Signatory Title/Position of Signatory Tax Agent Acc, No./Atty’s Roll No! if applicable) Date of Issuance Date of Expiry IN of Signatory Part Ill Details of Payment Stamp of Date Receiving Office/AAB DD YYYY Amount and Date of Receipt (RO's Signature/ Bank Teller's Initial) a

thorized Agent Bank) an 23 Others =~ 7Revenue Official Receipt Details (If not filed with an Au Machine Validation 214

BIRFORMNO. 1600 MONTHLY REMITTANCE RETURN OF VALLEADDED TAX AND OTHER PERCENTAGE TAXES WITHHELD

Vetutity pericdis five years or less | % GUIDELINES AND INSTRUCTIONS Schedule | ALPHANUIVERIC TAX CODES Tax NATURE OF PAYIVENT ATC NATURE OF PAYIVENT Tax atc APPLICAGLE TO GOVERNVENT WIFHOLDINGACENTS GLY. ha VAT Withholding on Purchase of Goods 5%| W010 ~ Maturity periods rrore than five years 1% | WB3%B VAT Withholding on Purchase of Savicss 5%| W0.0/B On dividends and equity shares and net incorre of subsidiaries 0% | W812 VAT Withhdding on Goverment Public Work Contrads 5% | Was C. Qhroatties, rentals of property, real or persona, profits from 7% | we1c3 Taxn caries and keepers of garages % | WE exchange and all cther iterrs treated as gross income under the Code Franchise Tax on Gas and Vater Uilities 2% _| WB040)D. On net tracing gains within the taxable year on foreign Franchise Taxon radio & TV broackasting companies whose and Qurrency, debt securities, derivatives and other sirrilar TTM% | W\B104 goss recaps donot exsed P10 M&whoare not VAT-regstered 3% | W806} _ firenda insturents ‘Taxon Other Non-Rarks Finandal Intermediaries Not Perfarring Taxoniife insurance premiurs 5% _| WB070] Quesi-Banking Functions ‘Taxon Overseas Dispatch, Message or Conversation 40% | weceo ‘A Qhirterest, Commissions and discounts fromlending activities fromthe Philippines @S well as income fromfirenda leasing, cn the basis of the Business Tax on Agents of foreign insurance oo.- insurance agents 10% | W812 rerraining returties of instrurent fromhich such receipts are derived Business Tax on Agents of foreign insurance co- owner of 5% | we121| ~Metuttyparicdis five years or less 5% | WB 108 the property ~ Maturity periods ore than five years 1% | W810 Tax Intemational Caries M% | WB19)/B Chall cther items treated as incorre uncer the cade 3% _| 8110 Taxcn Cocknits 18% | WB 140 APPLICABLE TOBOTH GOVERNVENT AND PRIVATE WITFHOLBING AGENTS Taxcn Coberet, Night and day dubs 18% | W819 VAT Withholding fromnonresidents (Goverment Withholding Agent) 10% | W040 Tax m Boxing etibitions 10% _| WB 160|VAT Withhdding from Nonresidents (Pivate Wthhdding Agent) 10% | W060 Taxon Professiond basketball gares 15% | WB 170 VAT Withhicing on Purchases of Goods (with waiver cf privilege to 10% wor Taxa - daa adrecetrads 30% | WB 180 Gaiminput tax credit) (creditable) Taxonsde, batter or echenge of stad listed & traded trough Hof AWB 209] VAT Withhocing on Purchases of Goods (with waiver of privilege to 10% wo Local Stock Exchange aiminput tax credit) (final) Taxon shares df stock sdder echangedtrouh VAT Withhcicing on Purchases of Sarvioes (with waiver of privilege to 10% woe initia and seconchay public offering daiminput tax credit) (editable
Ntover25% 4% | W821 VAT Withholding on Purchases of Sarvices (with waiver of pridiego to 10% woes ~ Over 25% but not Brneexing 33 13 % 2% | Wear daminput tax credit) (final)
Or B 13% 1% | B28 Persons Exes from VAT under Sec. 100y (crecitadle}-Govermert % wece0 ‘Taxon Banks and Non-Bank Rinandal Intermediaries Perforring Withholding Agent Qesi-Banking Fundions Persons Exenpt from VAT under Sac. 100 (creditable) Private 3% | waco ‘A Qhinterest, Commissions and discounts fromlending activities Withholding Agent 28 wal as incore fromfinanda leasing, on the basis of the rearing rraturities of instrurrent fromrich such receipts are derived Persons Exempt from VAT under Sec. 102 (fina) % | WOH 215

ALPHABETICAL LIST OF PAYEES Page _ FOR THE MONTH OF [| ,witmovons ee en WITHHOLDING AGENT NAME : MMYYYY)

2 |Schedule Il ALPHABETICAL LIST OF PAYEES FROM WHOM TAXES WERE WITHHELD (Attach additional sheet/s, if necessary) SEQ PAYEE DETAILS INCOME PAYMENT / HELD DETAI TAX TAX NO. TIN INDIVIDUAL / CORPORATION ¥ atc NATURE OF PAYMENT AMOUNT RATE TOE (1) (a) (3) (4) (5) (6) (7) (LAST NAME, FIRST NAME, MIDDLE NAME FOR INDIVIDUALS OR REGISTERED NAME FOR -INDIV! LL || BORRGaE | LU | a 216 1

H.26: BIR Form N . 2316, Annual Income Tax

DLN: Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas For Compensation Payment With or Without Tax Withheld Certificate of Compensation Payment/Tax Withheld BIR Form No. 231 October 2002 (ENCS) . ig For the Period

im, Details of Compensation Income and Tax Withheld from Present Employer _10,0,0 moun A. Non-Taxable/Exempt C 25 13th Month Pay and Other Benefits 26 SSS, GSIS, PHIC & Pag-ibig 26 Income Identification No. — ian

a! 4 Employee's Name (Last Name, First Name, Middle Name) 5 RDO Code ia — _—— Lf 6 Registered Address 6A Zip Code |

| = = 1 L 1 6B Local Home Address = _6C Zip Code 1 1 1 16D Foreian Address _ 6E Zip Code Contributions, & Union dues 27 Salaries & Other Forms of 27 Compensation 28 Total Non-Taxable/Exem pt 28 Compensation Income L IB. Taxable Compensation Income el a a ow REGULAR '7 Date of Birth (MM/DDIYYYY) 8 Telephone Number 29 Basic Salary 29 on oe aal L 1 : 9 Exemption Status 30 Representation 30 Single [J Head of the Family Married 9A Is the wife claiming the additional exemption for qualified dependent children? Yes LC] No 31 Transportation 31 10 Name of Qualified Dependent Children

Date of Birth (MM/DD/YYYY) ‘ ‘~~ "132. Cost of Living Allowance 32 1 1 — are 33 Fixed Housing Allowance 33

i eas 34 Others (Specify) 12 Other Dependent (to be accomplished if taxpayer is head of the family) 34A, 344 ji, ‘ Date of Birth Name of Dependent Relationship (MMIDDIYYYY) eleler. 34B 34B Employer SUPPLEMENTARY 13 Taxpaver ne le "435 Com on 35 Identification No. ‘ — (el fl — 14 Employer's Name 36 Profit Sharing 36 37 Fees Including Director's 37

: rees 15 Registered Address 15A Zip code 438 Taxable 13th Month Pay 38 : and Other Benefits Ll . — Loi 4 39 Hazard Pay 39 main employer _ Secondary employer 40 Others (Specify) Part Ill Employer Information (Previous)-1 16 Taxpayer cl 404 40A Identification No. ei =a I Nessa 17 Employer's Name 408 40B a TM 41 Total Taxable Compensation 41 18 Registered Address T8A Zip code Income _

_ iif 42 Taxable Compensat lon Income e — Employer Information (Previous)-2 from Present Employer 19 Taxpayer

Ee 43 Add: Taxable Compensation 43 Identification No.

Lt i z f 14 from Previous Employer (s) mployer's Name 44 Gross Taxable Compensation Income La 45 Less: Total Exemptions 45 21 Registered Address 21A Zip code 146 Less: Premium Paid on — a Health and/or Hospital 46 i

a oe Insurance (If applicable) Employer Information (Previous)-3 47 Taxable 47 22 Taxnaver aa! ‘| 4 Compensation Income IdentificationNo.

, , ae ae 11 48 Tax Due 23 Employer's Name 49 Amount of Taxes Withheld : 7

49A Present Emplover 49A

. 2 24 Registered Address 24A Zip code 49B Previous Employer(s) 498 50 Total Amount of Taxes 50

L Withheld Present Employer/ Authorized Agent Signature Over Printed Name CONFORME: 52 CTC No. Employee Signature Over Printed Name of Employee *ee Signe Place ofissue[SSSOSCS~SSY Ene ! declare, under the penalties of perjury, That This certiicate has Deen made in good Pursuant to the provisions of the National Internal Revenue Code, as amended, and the 51 faith, verified by us, and to the best of our knowledge and belief, is true and correct regulations issued under authority thereof. Date Signed a Date Signed [~~ a Date of Issue 53 Present Employer/ Authorized Agent Signature Over Printed Name (Head of Accounting/ Human Resource or Authorized Representative) To be accomplished under substituted filin "declare, under the penalties of periury, that the information herein stated are reported under BIR Form No. 1604CF which have been filed with the Bureau of Internal Revenue. ' declare,under the penalties o1 Periury that | am qualified under substituted filing of Income Tax Returns(BIR Form No. 1700), since | received purely compensation income rom only one employer in the Phils. for the calendar year; that taxes have been Correctly withheld by my employer (tax due equals tax withheld); that the BIR Form INo. 1604CF filed by my employer to the BIR shall constitute as my income tax return; and that BIR Form No. 2316 shall serve the same purpose as if BIR Form No. 1700 had been filed pursuant to the provisions of RR 3-2002, as amended. ee mployee ignature Over Printed Name aL?

H.27: Philhealth Claim Form 1 218 This form may be reproduced and is NOT FOR SALE PHILHEALTH — CLAIM FORM 1 Revised May 2000 Note: This form together with Claim Form 2 should be filed with PhilHealth within 60 calendar days from date of discharge. PART 1 MEMBER'S CERTIFICATION (Member to Fillin All Remsiindigent to be Assisted by Hospital Representative)

Type of Membership [[]Employect{ ]Private Sector{ ]Govt. Sector individually paying ]Sett-employed ( Jorw'{ Jotners | Jowwa Di inaigent (1 RetireePensioner:{ jsss({ Josts{ JMilitary[ ) Judiciary wertitcotiono. LL | tL ttt tititittt
Name of Member
Date of Birth CVLELELP EL TIPPEE Le mmddyyyy First Name
Civil Status
Sex LL TT ee Cy Male FLEE LEP L LEE d (married [L] widower CO Female
Address of No., Street Barangay CPP ELELLEL ELLE LVL ttt it) DEEL Municipality/City Province Zip Code TYP TELLL EEL LEE EELELEE LEE Le —— First Name Lit iti titi Li | ritLLL Lit titi ti ttt it iddle Name CLLLLLLLEL IEEE PLL Ei Net Apetcabe 8, Name of Patient (Patient is the Member
Date of Birth Last Name PL FLLEELELI LE LIL tit mmddyyy¥/¥ First Name LLL t ttt 10. Age 11.5% 7 Mate FIL LELE LILLIE tt tL L Female
Relationship of Patient to Member ( Check applicable box if patient is a dependent ) CLesitimate spouse who is not an NHIP Member. [_Jrarent who is 60 years old and above, not an NHIP member/retireedpensioner and oO Unmarried and unemployed, legitimate, legitimated, wholly dependert on me tor support. acknowledged and illegitimate or legally adoptedistep (unmarried child 21 years old & above with physicals mental disability, congenttal or child, below 21 years old. acquired and whoily dependent on me tor support.
CERTIFICATION of MEMBER; | certify that the foregoing information are true and correct and that the three(3) applicable monthly coriributions had been paid within six(6) month prior to the month of this confinement. Signature of Member Printed Name & Signature of Witness to Thumbmark if unable to write, affix Right thumbmark PART ll - EMPLOYER'S CERTIFICATION (For employed members onty)
Registered Name of Employer TT TLE LELL LILI ILI Litt tii titi Wertiication No. of Employer | | | Lt LL LLLLtttit
Address of Employer ( No., Street, Barangay Municipality;city, Province, Zip Code ) No., Street Barangay CUP ELLL LLU LE LIV Ltd DELL Municipality/City Province Zip Code TT LLELL ELE LEE LE) LA
CERTIFICATION of EMPLO'ER: This is to certify that three(3) applicable monthly cortributions ‘were collected during the six(6) month period prior to the month of this confinement and that the data supplied by the mentber on Part fare true and fe with our jlable records. Signature Over Printed Name of Authorized Representative Date Signed Official Capactty acess ay ens mmm NI Sa SS eal Member's Copy This portion should be pletely filled up, d by the ital and given to member ACKNOWLEDGEMENT RECEIPT Name of Member - SSS/GSISIMECPhilHeatth No Narne of Patiert : Confinement Period : Name of Hospital : PhilHeaith Forms Received by : Address of Hospital : Date :

IMPORTANT

For currently employed member, the original and properly accomplished Form 1 is sufficient. In case item no. 16 ( Certification of Employer} is not properly accomplished { ex. separated from employment, but contribution is still qualified for the confinement period } submit RF-1 and ME-5 and/or applicable receipts
Beneficiary/Hospital representative to attach the following supporting document/s for a) Individually paying (voluntary, selFemployed or OF WV members), any of the following: / Official Receipts of PhilHealth accredited collecting banks or PhilHealth Bank Receipts (PBR) vf Duly validated MLS ( Contributions Payment Return Form } for individually paying members starting January 2000 / Official Receipts issued by PhilHealth ( for over the counter payments } b) SSS/GSIS Retirees, any of the following: v Latest pension voucher vv Copy of bank account passbook (with pages indicating name of pensioner and latest pension entry } Retirement Certificate issued by the GSISYSSS c) AFP/PNP Retirees, any of the following: General or Special Orders Vv Latest pension voucher Vv Certification of 120 monthly Medicare/NHIP contributions from the GSIS or from previous employer / Senice record d) Retired Judges, any of the following: / Certificate of retirement from the Office of the Court Administration (OCA) vf Certification of 120 monthly Medicare/NHIP contributions from the GSIS or from previous employer Vv Service record

S35 partial disability pensioners - certificate from SSS indicating coverage/period of pension f} Dependents of a,b,c, d ande- approved M1b or E1/E4 for SSS members or SPOUSE - copy of marriage contract CHILD = - copy of birth or baptismal certificate llegitimate/Legitimated child - birth certificate acknowledged by the father/mother or notarized affidavit of support Legally adapted child - legal adoption paper or notarized affidavit that child is legally adopted Step-child — *birth or baptismal certificate with copy of marriage contract or “affidavit by the step-mother or step-father PARENT - affidavit of support ( original or Certified True Copy } g) OWA member/dependent - Certified True Copy of Medicare Eligibility Certificate (MEC } Legend: RF-1

Quarterly Remittance Report forrn ME-5
Contributions Payment Return form for employed sector MIS — - Contributions Payment Return form far individually paying members M1b
Membership Data Record form for individually paying E1
5833 Membership form for new member E4
S55 Member's Data Ammendment form 219

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EZ: Registry of Allotments and Obligations (RAO)

—— —.__________=—SsAGENCY) a ae oe REGISTRY OF ALLOTMENTS AND OBLIGATIONS | | a { a _SheetNo. 1 Date OBR | | Account Allotment

Obligations Balance a No. Code Received Incurred 221

| Statement of Allotments/Obligations and Balances (SAOB) ees ae _ _ BAR NO. 4

Department of Health _ NATIONAL CHILDREN'S HOSPITAL 264 E. Rodriguez Sr. Blvd. Quezon City Fund 101 STATEMENT OF ALLOTMENTS, OBLIGATIONS & BALANCES Lo as of Object Allotment Obligations Incurred Unobligated of Balance of P/A/P / ALLOTMENT CLASS Exp. Received This Report To Date Allotment REMARKS I - CURRENT YEAR BUDGET Personal Services-100 A. Salaries (Itemized Positions) __ (Step Increment) Sub-Total Itemized Positions B. Other Compensation PERA Additional Compensation RATA Subsistence & Laundry Allowance |Clothing Allowance Hazard Risk Pay Productivity Incentive Bonus Year End Bonus & Cash Gift Pag-ibig Medicare / Phil. Health E.C.LP. Sub-Total Other Compensation

= is Automatic Appropriations-100 Retirement & Life Insurance Premium 10% Inc. RLIP Sub-Automatic Appropriations TOTAL PERSONAL SERVICES : "

: Maintenance and Other Operating Expenses-200 Travelling Expense fo Training Expense Communication Expense Repairs and Maintenance Expense Supplies and Materials Expense Utility Expense Fidelity Bond Prem. & Ins. Exp. Advertising Expense Professional Services Subscription Expense [ TOTAL M.O.O.E. CAPITAL OUTLAY-300 Buildings and Structure Outlay Public Infrastructure Hospital Equipment Other Buildings & Structures Outlay TOTAL C.O.

e i paws

STATUS OF FUNDS OF Sn -_ Congressman/Senator _ - As of a a Sn }) | | Pe PPAR a ~[sheetNo [| DATE REF. | Acct. Name of Obligation BALANCE es Code} Patient Incurred [| a ee _ a 225

Statement of Priority Development Assistance F und (PDAF) Utilization Object Allotment Obligations Incurred Unobligated of Balance of P/A/P / ALLOTMENT CLASS Exp. Received This Report To Date Allotment REMARKS II - SPECIAL PURPOSE FUNDS Miscellaneous Personnel Benefits Fund Sub-Total M.P.B.F. Contingent Fund Sub-Total Contingent Fund e Funds Total Special Purpos III-SUB-ALLOTMENT-DOH Total Sub-Allotment TOTAL CURRENT YEAR RELEASES IV-PRIOR YEAR'S BUDGET (Cont. Appropriation) MOOE | Sub-Total Regular PDAF Sub-Total PDAF CAPITAL OUTLAY 213 Sub-Total Capital Outlay. TOTAL PRIOR YEAR'S BUDGET GRAND TOTAL

|Certified Correct: -——s Budget Officer ~ Submitted By: Agency Head — 224

ae Work and Financial Plan (Form 1) DEPARTMENT OF HEALTH Work and Financial Plan CY WFP Form I [=a —a ree oe Central Office [J] Center for Health Development Hospital NATIONAL CHILDREN'S HOSPITAL GOAL I: GOAL 2: GOAL 3: GOAL 4: GOAL 5: GOAL 6:

GOALS and OBJECTIVES Objective 1.1 Objective 2.1 Objective 6.1 MAJOR FINAL OUTPUT 1 (GOAL 1) INDICATORS Approved by: Agency Head 220

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L10: Financial Report of Operation FINANCIAL REPORT OF OPERATION For the Quarter Ending Department of Health Logo Name of Hospital Fund 101 Available Allotment Obligations Unobligated Program / Activity ri Balance This Incurred Balance of Project Previous Quarter Allotment Allotment Class Quarter (as of Dec.) TOTAL (This Quarter) Remarks (1) (2) (3) (4) (5) (6) (7) Current Year Budget GASS Personal Services MOOE Capital Outlay Sub-total SARO-DBM Personal Services MOOE (PDAF) Capital Outlay Sub-total Sub-Allotment-DOH Personal Services MOOE Capital Outlay Sub-total TOTAL CURRENT YEAR BUDGET Prior Year's Budget (Cont. Appro-) GASS Personal Services MOOE Capital Outlay Sub-total SARO-DBM Personal Services MOOE (PDAF) Capital Outlay Sub-total Sub-Allotment-DOH Personal Services MOOE Capital Outlay Sub-total TOTAL PRIOR YEAR'S BUDGET GRAND TOTAL Certified Correct: Submitted By: Budget Officer Date Agency Head 230

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18: Appropriations and Obligations 238 CY APPROPRIATIONS AND OBLIGATIONS as of DEPARTMENT OF HEALTH AGENCY: Capital PARTICULARS PS MOOE Outlay TOTAL A. APPROPRIATIONS REGULAR APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office [AUTOMATIC APPROPRIATIONS. Custom Duties and taxes Retirement and Life Premium Special Accounts in the General Fund Grant Proceeds Others - Please specify CONTINUING APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office Priority Development Fund Calamity Fund Others - Please specify SPECIAL PURPOSE FUNDS AL GU Contingency Fund Miscellaneous Personnel Benefit Fund Pension and Gratuity Fund Priority Development Fund E-Government Fund Calamity Fund Unprogrammed Fund Others - Please specify IB. RELEASES REGULAR APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office [AUTOMATIC APPROPRIATIONS Custom Duties and taxes Retirement and Life Premium Special Accounts in the General Fund Grant Proceeds Others - Please specify CONTINUING APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office Priority Development Fund Calamity Fund Others - Please specify SPECIAL PURPOSE FUNDS AL GU Contingency Fund Miscellaneous Personnel Benefit Fund Pension and Gratuity Fund Priority Development Fund E-Government Fund Calamity Fund Unprogrammed Fund Others - Please specify Page 1 of 2

CY APPROPRIATIONS AND OBLIGATIONS DEPARTMENT OF HEALTH AGENCY: NATIONAL CHILDREN'S HOSPITAL PARTICULARS PS MOOE Capital Outlay TOTAL C.UNRELEASED APPROPRIATIONS (A-B) REGULAR APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office [AUTOMATIC APPROPRIATIONS Custom Duties and taxes Retirement and Life Premium Special Accounts in the General Fund Grant Proceeds Others - Please specify CONTINUING APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office Priority Development Fund Calamity Fund Others - Please specify SPECIAL PURPOSE FUNDS AL GU Contingency Fund Miscellaneous Personnel Benefit Fund Pension and Gratuity Fund Priority Development Fund E-Government Fund Calamity Fund Unprogrammed Fund Others - Please specify ID. OBLIGATIONS REGULAR APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office AUTOMATIC APPROPRIATIONS. Custom Duties and taxes Retirement and Life Premium Special Accounts in the General Fund Grant Proceeds Others - Please specify CONTINUING APPROPRIATIONS Regular Approp. (Built In Approp) Sub-Allotment from Central Office Priority Development Fund Calamity Fund Others - Please specify SPECIAL PURPOSE FUNDS AL GU Contingency Fund Miscellaneous Personnel Benefit Fund Pension and Gratuity Fund Priority Development Fund E-Government Fund Calamity Fund Unprogrammed Fund Others - Please specify IE. UNUSED APPROPRIATIONS Unobligated Allotment (B-D) Unreleased Appropriations ( C ) Prepared By: Budget Officer Noted By: Agency Head Page 2 of 2 239

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E2233 Operational Plan 244 DEPARTMENT OF HEALTH OPERATIONAL PLAN FISCAL YEAR OPLAN Form | [1 Central Office [Center for Health Development Hospital GOAL I: GOAL 2: GOAL 3: GOAL 4: GOAL 5: GOAL 6: Objective 1.1 Objective 2.1 Objective 3.1 Objective 4.1 Objective 5.1 Objective 6.1 MAJOR FINAL OUTPUT 1 (GOAL 1) MAJOR FINAL OUTPUT 2 (GOAL 2) MAJOR FINAL OUTPUT 3 (GOAL 3) MAJOR FINAL OUTPUT 4 (GOAL 4) MAJOR FINAL OUTPUT 5 (GOAL 5) MAJOR FINAL OUTPUT 6 (GOAL 6) Name of Hospital INDICATORS Approved by: Agency Head

fy es Operational Planning Matrix (OPLAN) Sackesianneiiamnenmeeemneee OPLAN Form 2.a OPERATIONAL PLANNING MATRIX (CORE PLAN-GAA Appropriation) CHD/Hospital/Bureau /Center/Service/Unit / Office : Period Covered : ACTIVITIES PER Time Frame RESOURCE REQUIREMENTS MAJOR FINAL OUTPUT Targets Item AC Cost/GAA Other Source (1) (2) (3) (4) (5) (6) (7) Approved By: Agency Head 245

23: Budget proposal (OPLAN Form 3) BUDGET PROPOSAL FORM Name of Hospital OPLAN Form 3 AC PARTICULARS CY CY CY PERSONAL SERVICES Salaries and Wages-Regular Pay Step Increment PERA Additional Compensation Allowance Representation Allowance Transportation Allowance Clothing / Uniform Allowance Hazard Pay Christmas Bonus Cash Gift Productivity Incentive Benefits Other Bonuses and Allowances Retirement Life Insurance Prem. PAG-IBIG Contributions PhilHealth Contributions ECC Contributions Subsistence and Laundry Allowaces Longevity Pay Other Personnel Benefits TOTAL P.S. 246

1.24: Budget Proposal Form (OPLAN Form 3) BUDGET PROPOSAL FORM Name of Hospital OPLAN Form 3 AC PARTICULARS CY CY CY MAINTENANCE & OTHER OPERATING EXPENSES Travelling Expenses - Local Training Expenses- Local Water Electricity Cooking Gas Telephone Expenses Landline Telephone Expenses Mobile Internet Expense Cable, Satellite Expense Postage and Deliveries Subscription Expense Advertising Expense Rent Expense Insurance Expense Taxes, Duties and Fees Fidelity Bond Premium Office Supplies Expense Other Supplies Expense Drugs and Medicines Expense Medical Supplies Expenses Laboratory Supplies Expense Food and Non-Food Expense Gasoline, Oil & Lubricants Printing & Binding Expense General Services Janitorial Services Security Services Building Maintenance Hospitals and Health Center Maintenance Other Structure Maintenance Firefighting Equipment & Accessoories Maintenance IT Hardware & Software Maintenance Motor Vehicles Maintenance Office Equipment Maintenance Furniture and Fixtures Maintenance Repairs & Maintenance-Hospital Equipment Repairs & Maintenance-Medical/ Laboratory Equipment Repairs & Maintenance-Other Machineries & Equipment Other Maintenance & Other Operating Expenses TOTAL M.O.O.E. 247

BUDGET PROPOSAL FORM Name of Hospital OPLAN Form 3 AC PARTICULARS CY CY CY FIXED ASSETS Land Land Improvements Electrification, Power and Energy Structures Leasehold Improvements Office Buildings Hospitals and Health Center Other Structures IT Equipment and Software Hospital Equipment Medical /Laboratory Equipment Motor Vehicles Office Equipment Other Equipment Furniture and Fixtures Books Other Fixed Assets TOTAL F.A. TOTAL P.S. TOTAL M.O.O.E. TOTAL F.A. OVERALL TOTAL APPROVED BY: 248 AGENCY HEAD

Appendix J Various Forms Used by Billing/Claims Department/Section dT: Charge Slip Republic of the Philippines DEPARTMENT OF HEALTH AGENCY NO Date? oo... CHARGE SLIP Patient's Name? ooo eccccccccssssseeeseesseseesseecsc.. Health Record No.: ................ In-Patient [ ] Out-Patient [ ] Service/Ward: ooo... eecccssssetessssesssseeceess ccc. CHING oe cccccccecececeseeseeeeesc.. ROOM NOL? ose eecseeesseecsssesstesensessseecees ccc. Emergency Room [ ] QUANTITY UNIT NATURE OF CHARGE UNIT PRICE TOTAL COST TOTAL Prepared by: Cost Center 249

J.2: Statement of Account Name of Hospital Address PATIENT'S STATEMENT OF ACCOUNT NAME OF PATIENT DATE/TIME PREPARED ADDRESS HOSPITAL NO: DATE/TIME ADMITTED ACCOUNT NO: DATE/TIME DISCHARGFED DEPARTMENT/WARD. : NO. OF DAYS STAY ROOM/BED NO. ADMITTING PHYSICIAN PHIC MEMBERSHIP: MSS CLASSIFICATION ADMITTING DIAGNOSIS ATTENDING PHYSICIAN TENTATIVE DIAGNOSIS FINAL DIAGNOSIS ICD 10 CODE SUMMARY OF CHARGES DEBIT CREDIT BALANCE/ AMOUNT TO BE PAID 121 A-5 121 A-6 Due from PHIC PLEASE PAY AT THE CASHIER/COLLECTION UNIT. GET THE OFFICIAL RECEIPT Prepared by: APPROVED: eS a Billing Clerk Head, Billing and Claims Date Prepared Date Signed 250

SAV 94} JO Jory SUP] pur SuIIIg ‘peoH OD Sug — Se Ee SE :poaoiddy ‘JO9LIOD polpn.sadg ‘Aq poredaig Auojeuoge} Agoyeuogey Auoyeuoge} Abojoipey (S¥) I2I ABojoipey g/g ASojoipey (S¥) Iz AUVNWNS (WIM) pasapuay sypigq fo uodey Aysuop 7 “YDINIPAW/ Sbinug (5-¥) Ill pay/sinug (9-¥) us | v-9es | I pan/snug | woasy | 10K 251

Suaquial jd 42 SadAy sayyo Jo} pasn Giurag si wo} awes ay) -3)0N pauedad, a}eq] sue[Q pue Sul ‘PeOH ‘Spungad [eyidsoy uo pue aGpajmouy jeuosuad Aw uo paseq jQauuDa pUe aNd} ale BAOgE payeys WO!eUWIOAL! PUB SWNIEYS |e YEU Ajjsad OF SI SI) INIVd WldSOH SISONSVIG IWNId "SSauppy “DN UOHeNpauaay yeydsoy 0} diysuoiyelay) daquiay 49 alley ‘ON yyeaytyd 439N3W SIS ~ LSI WLLIWSNVYL Aug Biseg ‘oquesy) “PAG MES BOL Buipjing 4aquaq) ayeysAyly NOWVYOdNOS JINVUNSNI HLTWSH INiddl Hd saulddiyty ayy 40 ayjqnday) IS1T [DUMMUSUDAT tL va

Appendix K Various Forms Used by Cash Management Department/ Section K.1: Official Receipt ACCOUNTABLE FORM No. 51-C Revised January, 1992 (ORIGINAL) Qificial Receipt oF the ry Republic of the Philippines 5 N°? 3478610. G Agency "4% Payor Nature of Account 77 Collection Code Amount fie flblt fh Ain |F_ AAS CY i oe | fe aaa laws BA — a ead TOTAL a a a

ee as ans

Amount in Words a rey: . AotbeHe fl = CashY “ro Number |} Date [J Check CJ Money Order . (7 Received the amount stated above. EPIFAHIA Oo. CRUE CASHIER it ecting Clfhcer NOTE: Write the number and date of this receipt on the back of check or money order received. 253

K.2:Cash Receipt Registry (CRR) CASH RECEIPTS RECORD Agency Accountable Officer Station Official Designation Reference/ Date OR No./ Name of Nature of Debit Credit Undeposited DS Payor Collection Collections 1/31/02 CERTIFICATION | hereby certify that the foregoing is a correct and complete record of all collections and deposits had by me in my capacity as of during the period from to , inclusive, as indicated in the corresponding columns. Name and Signature 4/31/2003 Date For Accountable Officers’ Use 254

K.3:Advice of Checks Issued and Cancelled (ACIC) LANDBANK OF THE PHILIPPINES ACIC No.: BRANCH NAME OF AGENCY AGENCY CODE: ADDRESS FLIND CODE: AREA CODE ALLOCATION NO.: ADVICE OF CHECKS ISSUED AND CANCELLED ACCOUNT NO. CHECK NO. DATE OF ISSUE PAYEE AMOUNT | ALLOTMENT | REMARKS TOTAL ACIC AMOUNT: AMOUNT IN WORDS: CANCELLED CHECKS CHECK NO CHECK | REMARKS DATE CERTIFIED CORRECT: VERIFIED BY: RECEIVED BY: APPROVED BY: POSTED BY: DELIVERED BY: Head of Agency For LBP use only 20

K.4. Cash Disbursement Record (CDR) CASH DISBURSEMENTS RECORD Agency Accountable Officer Station Official Designation Reference/ tet: vil Cash Cash Date Payroll No./ | Name of Payee | payment Advance | Disbursements | Advance DV No. y Received Balance 1/31/02 CERTIFICATION Thereby certify that the foregoing is a correct and complete record of all checks issued by me in my capacity as of during the period from 1/1/2003 to 12/31/2003, inclusive, as indicated in the corresponding columns. Name and Signature 1/31/2003 Date For Accountable Officers’ Use 256

K.5. Petty Cash Voucher (PCV) [ PETTY CASH VOUCHER No.: (Agency) Date: Payee/Office : Responsibility Center Address 5 Code: |. To be filled up upon request Il. To be filled up upon liquidation Particulars Amount B Total Amount Granted ae Total Amount Paid per OR No. Amount Refunded/ (Reimbursed P A_| Requested by: C Received Refund Name of Requestor Approved by: Reimbursement Paid Immediate Supervisor Petty Cash Custodian B | Paid by: D L] Liquidation Submitted: Petty Cash Custodian LJ Reimbursement Received Cash Received by: by: Signature over Printed Name of Payee Signature of Payee Date: Date: 257

K.6. Petty Cash Replenishment Report (PCRR) PETTY CASH REPLENISHMENT REPORT Agency Name Sheet No. Date Petty Cash Particulars Amount Voucher No. Prepared by: Received by: Disbursing Officer Accounting Clerk 258

K.7. Check Disbursement Record CHECK DISBURSEMENTS RECORD Agency Accountable Officer Official Designation : Station Check NCA Bank/NCA Date No. Date —— Nature of Received | Checks Balance Released y Payment /Deposit Issued Made 01/31/02 1/31/03 CERTIFICATION capacity as of 12/31/2003, inclusive, as indicated in the corresponding columns. I hereby certify that the foregoing is a correct and complete record of all checks issued by me in my during the period from 1/1/2003 to 1/1/2003 Date Name and Signature 259

K.8. Liquidation Report No.: LIQUIDATION REPORT Date: Responsibility Center (Agency) Code____ PARTICULARS AMOUNT

) TOTAL AMOUNT SPENT —_» AMOUNT OF CASH ADVANCE PER DV NO. — DTD. AMOUNT REFUNDED PER OR NO. —» DTD AMOUNT TO BE REIMBURSED eo Correctness of the above data Claimant A | Certified: |B | Certified: Purpose of travel/cash advance duly accomplished Immediate Supervisor | C| Certified: Supporting documents complete and proper JEV No Head, Accounting Unit 260

paijs-a (991YO e[qeiunosoy Jo ainjeusig 2 ouieN) A0qD polsad ay} SuLinp aut Kq Passafsud] Puv panss? ‘padiaraa suof ‘AUD Suluulsaq ays fo ssaujras409 ay] puv FIQPIUNOID ]]D fo Juaumaynys anal D $1 Sulosasof ays wyy Kfijaaa Agasay J ‘NOLLVOIAILYAD — OL Wwo1y ‘ON [BOS darsnpouy OL WoL] “ON [BLI9S SAIsnoUT OL WOOL] “ON OL WoL] “ON AIC) ee SWUOA ATAV.INAODOV YOU ALITIAVINNODOV AO LYOdAe [BLI9S$ SAISNPOUT [elas dAISNOU] “ON Y ULIO JO OUR NY aounvg suipuy panss] jdia3ay aun suluuisag 07° qyuo| Aus y Aypiqnjunozoy fo aoday AqyJUuopy ‘6 °Y 261

Appendix L Various Forms used by Human Resource Management Dept. /Section L.1. Appointment Form KSS PORMABLE. 33 (Nerebisa!998) REPUBLIC OF THE PHILIPPINES <a Department of Health AGENCY Name of Agency Manila Ginoong/Gng/ Bb: Mr./Mrs./Ms. Kayo ay nahirang na You are hereby appointed as May katayuang sa with as (Status) at the (Agency) sa pasahod na piso with a compensation of pesos per ( *With SQL subject to availability of quarters.) Ito ay magkakabisa sa petsang pagganap ng tungkulin subalit di aaga sa petsa ng pagpirma ng The effectivity date of this appointment shall be the date of actual assumption by the appointee but not earlier that the date of issuance of Puno ng taggapan o appointing authority: The appointment which is the date signing of the appointing authority: Ang appointment na ito ay bilang kapalit ni This appointment is (Original, Promotion, etc) na at ayon sa Plantilla (Previous incumbent) (Resigned, retired, etc.) Aytem Blg. Pahina Item No. Page — Sumasainyo, Very truly yours, Puno ng Taggapan Petsa ng Pagpirma Date of Signing Awtorisadong Opisyal Kamisyan ng Serbisya Sibil Authorized Official/Civil Service Commission Petsa Date 262

SERTIPIKASYON Ito ay pagpapatunay na lahat ng dapat gawin at mga kailangang dokumento para sa appoitment na ito ay ayon sa CSC MC. No. 40) s. 1998 ay nasunod, nerebisa ko at napatunayang nasa ayos. Ang posisyon ay nalathala sa noong (The position was published on This is to certify that all requirements and supporting papers to MC # 40 s. 1998 have been complied with reviewed and found to be in order. Head, HRMO SERTIPIKASYON Ito ay pagpapatunay na ang nahirang ay nagdaan sa pagsusulit sa Personnel Selection Promotion Board at kuwalipikado. This is to certify that the appointee has heen screened and found qualified by the Promotion/Personne| Board. Chairman MGA NOTASYON ANUMANG BURA 0 PAGBABAGD SA AKYONG GINAWA NG KOMISYON NG SERBISYO SIBIL AY MAGPAPAWALANG BISA SA PAGHIRANG NGA ITO MALIBAN KUNG ANG PAGBABAGD AY NASULAT NA KINUMPIRMA NG KOMISYON, PETSA NG PAGLABAS SA KSS/KOMISYON 263

L2e Personal Data Sheet 264 'S FORM 212 Revised 2005) 2. SURNAME FIRST MAPAC PAROLE NAME _ 4, DATE OF BIRTH [irra yyy) PERSONAL DATA SHEET i | 75. RECIDENTIAL ADMIRESS §. PLAGE OF RIRTIE bee CMe Fame 6, SOX [7 civil StAtUs ae . z pen Uisingla Cl Widowed BP CODE Cnaniad Ca Separated 17, TELEPHCNE NO. DhAnnuted ‘=!Others, specily _ FE DERMANENT ADDRESS Pare oe 8 CITIZENSHIF 9. HEXGHY (ta) 10. WEIGHT (3) BP CODE 44, BLOOD TYPE 49, TELEPIKONE NO 12. GSIS JONG. 4. PHILHEARTH NO. 20. £-MAIL ADDRESS (if any) 21. CELLPHONE ND. {it any) | 22. AGENCY EMPLOYEE NO. 18 S8SNO. SPOUSC'S SURNAME 2a. TN 96, NAME OF CHILD (Wrtte hus! name aad Mist ol!) DATE SF BRTH (nemta'yyyy) — FURST WAME { MIDGIE BAME — OCCUPATION aaa } bAELOVER.BUS. NAME AUSINESS ADDRESS TELEPHONE #10, {Continue on ate shee! Wrecessaty) SURHAME ae Jeohae weston FIRST MAME ' MIDOLE NAME i aeueeremenetsay 0 eens mneemnsner ae we ne perme yea | MIGHESTGRADE, |" MNCLUSIVE OATES OF NAME CF SCRCOL GEE COURSE GRAQUATED Levels ATTENDANCE (Cahira in fe) fywite in (of) ié gradvatad)| UNITS EARNED — (fi gradwated)) nx gramuated) From To CLEMENTARY east 7

SECONDARY VOCATIONAL —_ —_ ~ } pa shane 3 co anemone ee | a ——f ee —————— GRADUATE SfUBIES ae —-——f-— 4 — a rr i Weantr aa an sanavate xbwedt if nonstate

IV. CIVIL SERVICE ELIGIBlLiry i oh asa sae! "CAREER SERVICE/RA 190 (BOARD BAR) PLACE OF EXAMINATION / CONFERMENT — ee UNDER SPECIAL LAWS/ CES/ CSEE CONFERMENT NUMBER nine |7 |

lL (Continue on separate sheet f necessa'y) 0 q a 30. — POSITION TITLE DEPARTMENT AGENCY JOFFICE ‘COMPANY | won | terer "| staTU3 oor From To ane eli laine outs aii (Yas / Noy f / f ‘ ae bey k r Gk foe (of Y tf of po} ior yp a tt Py t & Y ios@ 1 ff i o¢ f of rea a ~~] ae i 7 ro i fof ae ro in tof an i f/o7 in } rt M4 an | f 7 fF ied | (Continue an separete sheet H necessary) 265

Vi-VOLUNTAR YWORK'OR INVOLVEMENT IN CVC / NON-GOVERNMENT / PEOPLE / VOLUN FARY-ORGANIZATION/S 16 P INCLUSIVE DATES Ky] NAME & AODRESS OF ORGANIZATION a a ; (Wie in ful) (mmddyy) HOURS POSITION / NATURE OF WORK From To i ! i ! Y Ff io] / t ! } } ! i ! if if (Continue on separate sheet if necessary) RAINING PROGRA art fro b inost re INCLUSIVE DAT! ATTE 32. TITLE OF SEMINAR/CONFERENCEAVORKSHOP/SHORTM COURSES cen inieund NUMBER OF CONDUCTED! SPONSORED BY (Write in taf) HOURS (Write in futl) From To io? oak /---- — tot rod rot fh ff | to? tof f i ied } i i i roof 14 { boa fod ZZ ee i ne sicathdiai a t od i @ toa tof a | tof lS a RR a eR er ai | rasan —— a ae nme / 4 i 4 be a i nN ree ne mR wrens ———— oo == bo ! } NN aes eS OES FE Se ene Se eR — qf if eens arene te ee = Sarees ome ee a {Continue on seperate sheet if Hi oF Bae ASSOCIA TIONIORGANIZATION (Weite in full) NON-ACADEMIC DISTINCTIONS / RECOGNITION: (Write in full) ee { (Continue on separate sheet if necessary) PC EAR 919 (Benicar YON) Dano Tata 266

ps Ae you related by consanguinity or affinity any of the following ing: —_ 3. Wilt: the third degree (for National Goverment Employees): appointing authonty, recammending authorily, chief of office/oureau/department or person wio has immediate Supervision aver you in the Office, Bureau or Department where you wil be appointed? CHYES GINO It YES, give details: S ad

ae rs) Ra S c 2 <ai s

a S &g ay ES 3 ee ee b. Have you evey been guilty or any acininistrative offense’? ee en eee og 5. Within the fourth degrse (lor Local Government Employees}: CIYES CINO appointing auibority or recommending authorty where you vail be appoitited? li YES, give detaits: Woe | CHYES C¥No 7 ~ EYES, give cataits: YES MNS fF YES, give detalis: Montalto eepatngpeinenneetntee ieee 38. Have you aver Sean suiteicted of ory cine or vidlation oF any law, decree, ordinance oF rayulation oy aiy voutl or tibural? CHYES [INO YES, give details: 39. Have you ever Seen separated fom tha sence in any o* te following modes: resignation, fetiemeni, uropped from ihe rolls, dismissal, termination, end of fern, finished contract, AWO),. oF phased oul, in the public or private sactey? CHYES CIND it YES, give detaus 4o, Have you ever been a candidale ma natonel or local etection (except Barangay election)? CHYES CIno IVES, give details. “1. Pursuant to: (a) Indigenous Peapie’s Act (RA 8374); (0) Magna Carta far Disabled Persons (RA 7277); ard (c} Solo Parants Welfare Act of 200) {RA 8972), please answer the folowing Items: @ Are you a member of any indigenous grou? b. Are you differently abled? 5. Are you a solo parent? CIYES No IF YES, please specify; . CIYES Gao IfYES, please specify CIYES CINO YES, please specify. ee ee ee 42, REFERENCES (Person not related by Consanguinity or affinity to appticans / S0pointee) NAME ADDRESS oe Serine a —cmtintnrenmeinaes TEL. NO: ———| 10 picture laker witha the last 4 months — 2f em, K4.6 em {passport siz} 43, | declare under oath that this Personal Dela Sheet has bean accomplished by me, and Is a true, correct and complete statement pursuant ta the provisiong of perfinent faws, rules and regulations of the Republic of the Compiter generated Of xeTOx CODy af picture Philippines, 4s not accaptatia i also authorize the agency head / aulhoyized representative to verify / vaitdate the contents stated heralin. | trust that_this inforraation shall remain confidentiay, PHOTO ia COMMUNITY TAX CERTIFICATENG : iSSUED AT SIGNATURE (Sign Inside the box) | ! j ISSUED ON (muvddiyyyy) DATE ACCOMPLISHED RIGHT THUMBMARK Z07

L.3.:_ Position Description Form Rapubde: of tre 2hylip oles Department of Keah SAN LAZARD HOSPITA: Mantia POSITION DESCRIPTION FORM te Nama of Employes » 2, Damunment/agency Sumeme Given Narne Mi : tir 3 Bureciu/Office . & Decarment/Branen/ Division ‘ ies ON S: Work Station/Place cf Work . §6 Classic tion o¢ Postion oe eee Fn nD Occupational service (.6ave Blank: 8, Gccupathonat Group(Leave Blark) 9a} tren No. Sy Carn No. oan Salary/Aanum Of) Ctner al FY : Authored ; Camper sation : Actual ‘ “ TO BE FILLED OUT BY IMMEDIATE SUPERVISOR .

i Desctipe briefly tne general f urctlor of the alvistony unt, ren el eal \2 Descrie briefly ine general function of the posite en oe ene

NS 1S Stetermmen of Dutles ancl Responsibilities (List Gown below sterting trom ih most to tre iecst Mpotiant Duthas. if more space Is needed, use adcitional sneer J Percentage of working ime BRA, mra's8 268

14 Postion We oF Immediaie Supe veor : TS Fasition The of Next Wisker SU vervisor R Names,Position Titles Gnd item Nurabers of those you Treaty supervise 14." Mackiésequioments 1ools ote W860 regularly Hy wis Derkirmance of work TOT CSnteets 19. Wirking Condition Occasiona: Freauent ; Generat Public = / f f f Norma! Working Condition / f Other Agencies / f / , Fie Work f i Supervisors Z f f y Fidic Ta9 a i Monagement FA t / / Exoous to varieo é / Oiners(Specity) —/ / / 4 Others Soacily} é ? ZO i certity that the above crewere are accurate Grd Compers Date signature of Empioyee <li3) Indicate he réqured quahication by years arc’ hic! af education corsiaeraad Ir Alling usa vacancy “or this pesition. (Keep the POS IGA IN mind rate: than tre Quaiifications of the INCUM bent} Education Experence :; <[0) Ticenie or Sertiicare to ce ie WOT IF anh! Ze. lceanify that the Gbove orswers are Gecurale nine! comptlete. bare Signcivre of Immediate Suparviscr Pasition Title 8 Approved : — a a mn met at Data dignctura of Agency Hecd ie 269

L.4.: Application for Leave Form CS. Form No. 6 Revised 1984 APPLICATION FOR LEAVE

OFFICE / AGENCY
NAME (Last) (First) (Middle)
DATE OF FILING
POSITION
SALARY August 1, 2008 DETAILS OF APPLICATION |
a) TYPE OF LEAVE
b) Where leave will be present (] Vacation Leave (1) In case of Vacation Leave [] to seek employment (] Within the Philippines [] Others (] Abroad (Specify) {]sick (2) In Case of Sick Leave [|Maternity []In Hospital ( Specify ) [JOthers ( Specify) []Out Patient ( Specify ) c) NUMBER OF WORKING DAYS APPLIED d) COMMUTATION FOR: {] Requested {] Not Requested INCLUSIVE DATES ( Signature of Applicant ) [ DETAILS OF ACTION ON APPLICATION “| 7, a) CERTIFICATION OF LEAVE CREDITS
b) RECOMMENDATION AS OF (] Approval (] Disapproval due to Vacation Sick Total Days Days Days ( Personnel Officer ) ( Authorized Official )
c) APPROVED FOR :
d) DISAPPROVED DUE TO: days with pay days without pay Others ( Specify ) (Signature) Date : ( Authorized Official ) 270

E58 Leave Card Index SAN LAZARO HOSPITAL EMPLOYEE'S LEAVE CAKD Name Unit Position

ETD _. Status te VACATION LEAVE: StCK LEAVE PARTICULARS ABS. é} ABS. ABS. ~@| ABS. s XK sc EMARKS fe) EARNED] UND. UND, RNED] UND. vam UND. “ WP lam | WoP wip {or woP a BAL, BROUGHT FORWARD a a i ae ek ns,

— — —~t 4. 3 i ee ee eee T ee ee ee, | ee a ea (eee ‘ a oo ——}---— ee — aie --+4~~- re ——— a ; ee pe __ Se eee ee _ 4 i event nena}

7 titi aaaey sii + t = oe ene ! — ! i en en 7 «zal t
— —— ——— ——4_...

a ee, Sn ae anes inate Miia — —— er 4- _ iL =a _

== ete eon — aol | ae pees

oe

rmacies

ee Ce a ee Baers — \ renee _ Pei meth ummesiees a waters reancerasececenat len .

= : aeons

= SO ———— i ae . 2. re <0 ee ee een eee BAL. CARRIED FORWARD /mfid 271

Service Record Index L.6 EMPLOYEES'S SERVICE RECGHD Civ. Sra (Abreitce dnatual) Caro fSacee ind Name (PAINT of TYPE) (Pinca) Yo te Birvu: PS oe Place og Age ec) ADDRESS -~ FO NOT PILL — SERVICE . T as a AUnchuaen Bote) RECOED OF APPOINTMENT OPFICEESTITY | LEAVE OF} SUP AR ATION | : ee ee ee ee | eam oria : =f BEWMABKSB T eae ; 3 ou ' RRANCH | ABSES WI ‘7 + 4 FROM t ya RESIGNA PEIN gtatus | EALARY | DIVISION | i WO PAY | pare | CAUER |. { m si a a Ni ee eee ar, Vinss Lwgys1 Teacncz Substitute| PL449,p 6. Divinon wf Cavite | Manca aie 3 i oqwaver | Tyansfor
; t ae Example Ont Viz Preasr.t Citk Perrencn!| PISSO,p « | Bureus of Custome Netional| Nore | _ ~ j , y a | | | i : i PA:

L.7.:_ Sworn Statement of Assets, Liabilities and Net Worth Baseline Declaration Form (1/8/2008) SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE (Required by R.A. No. 6713) As of (Baseline Declaration) Note: Please write your responses in AIL CAPITAL Jetiers using ONLY BALL PEN to avoid blotting. A. DECLARANT’S PERSONAL INFORMATION AND EMPLOYMENT ‘For Joint filing, make 2 entries for Name, Position, Deciarant’s Annual Gross Salary, Name of Agency, and Office Address Aunual Gross Saiary refers to ALL amounts received by declarant from Go! tre me See eS Yo. of age living in declarant’s tr i ual Gross Family Income _ innual Gross Family fa come refers to income of J ta : ua spo use, and dectarant’s children below 18 i “ ~ Sn ae ne ~ i — — SJflam marricd, [2] 1am not married. [2] L have ne children below 18 years of age living in my household. Spouse Information: Name: _ Company: _ 8. ASSETS, LIABILITIES, AND NET WORTH eee instruction for all assets: Declare assets whether the declaranU/spouse/child is the legal owner (name appearing on the instrument of title) or the beneficial owner (property is in the name of another person but ownership pertains to declarant/spouse/child, under a trust arrangement).

Real Properties and Vehicles of Declarant/Spouse/Declarant’s Children Below 18 Years of Age Living in the Household of Declarant, (Use additionat sheet if necessary) Thave no real properties to declare owned by me/ my spouse/my children below 18 years of age living ui my household ‘a I have no vehicles to dec owned by me/my spouse/my children below 18 years of age livin Ki eS oF P Sas =a SPR TTT Type of Vehicle and ion

ee Te Se A Se Se A

Investments, Other Personal Properties, and Liabilities of Declarant/Spouse/Declarant’s Children Below 18 Years of Age Living in the Household of Declarant Thave no investments to declare owned by me/my spouse/my children below 18 years of age living in my household Thave no personal properties to declare owned by me/my spouse/my children below 18 yrs of age tiving i my bouseho [lt have no liabilities to declare pertaining to me/my spouse/ow children below 18 years of age living in my household Instructions: Deciare each Asset Kem (lavestment and Other Personal Property) with a fair market value of PhpS0,000 or more as the date of declaration, even if the same was acquired at no cost or at less cast. Declare each Liabihty ttem with an outstana'it balance of Php$0,000 or more as of the date of declaration. Items with less value may be dectared in lump sum as “Others However, if “Others” amounts to more than Php 100,000, each item must be listed. Put a check mark on the items to be declared, a1 make (he corresponding entry for the actual Acquisition Cost or Outstandin alanee, as a plicable. _ BZA investment item SP Aquisition Gost [22 B24 Investe Stocks (equily paid) _ en ie . ee Bonds }Mutualfunds te Trust funds es Private insurance (premiums pd) | —— Spd) | fae Ua . remiums. a Equity in partnerstups 273

| fh 274 "TJ cash on hand/B “E} Deposits/advanced payments on | leases/rentals [Jewelry 7 Mortgage payables ate POUR et a oce E ‘Declarant, Spau: _ Child (Pat Name! | [ze | t } Baseline Declaration Form (1/8/2008) ank accounts Ce 2) Personal loans Lj Receivables i _| $7 Bank loans Accounts payables [J Furniture, antiques EI GSIS, PAGIBIG loans Surety liabilities Guaranty liabilities Judgment debts 3] Loans from other institutions Others Se aticeien 3. Net Worth: Declarant/Spouse/Deciarant’s Children Below 18 Years of Age in Declarant’s Household B1 Total Rea! Properties and Motor Vehicles “B21. | add. _ Total investments a

B22 © «| ~~ Total Other Personal Properties | 7 deduct: Total Liabilities _ oo | Acquisition costs of Real Properties and Vehicles, and Investments and Other Personal Properties; less total outstanding balance of Liabilities C. BUSINESS INTERESTS AND FINANCIAL CONNECTIONS OF DECLARANT/SPOUSE/DECLARANT’S CHILDREN BELOW 18 YEARS OF AGE LIVING IN THE HOUSEHOLD OF DECLARANT (USE ADDITIONAL SHEET IF NECESSARY) Instruction: Declare each Item which generates gross annual receipts of Php 50,000 or more. Items with less value may be declared in lump sum as “Others”. However, if “Others” amounts to more than Php 100,000, each item must be jisted ["] Lhave no business interests and financial connections to declare pertaining to me/tny spouse/ my children below 18 years of aye living in ny household. a i : a D. DECLARANT’S RELATIVES IN THE GOVERNMENT (USE ADDITIONAL SHEET IF NECESSARY) Instruction: Up to the 4” civil degree of relationship, either of consanguinity or affinity, including bilas, inso and balae t don’t know of an ME? BUT ye pe

aine of Rejatives) " f | —. STATEMENT : ‘nares (hereby certify to the best of my knowledge and information that these are complete and true statements of my assets, liabilities, net worth, business interests, aad financial connections, including those of my spouse and my children below 18 years of age living in my household, and the nanes of my relatives in the Government, as of 88 required by and in accordance witht Republic Act No, 6793. / further certify that no assets, liabilities, business interests, financial connections, and relatives in the Government other tian ose declared Peiein are Known to me, my spouse, and my children below 18 years of age living in my household. | hereby authorize the Ombudsman or his duly authorized representative to obtain and secure from all appropriate government ayencis, including ie Bureau of Infernal Revenue, such documents that may show such assets, liabilities, net worth, business interests, and financial connections, including those of my spouse and my children below 18 years of age living in my househo!d, covering previous vears, including the ysar | first assumed office in Gavernment. | further undertake to produce all supporting documents for each of the entries herein made when required. Declarant’s Signature: a Cate TIN; — Community Tax Cart No: _ Issued In: scsi WORUOO OTT ooo ocean eee In case of igint filing: Spouse's Signature: Fra 1 a __. Date nS, Saeateereeiacs” HUNT isis

_ Issued In: Issued On: Community Tax Cert No: SUBSCRIBED AND SWORN TO before me on this day of | eeeneeesemannnenil a. a affiant(s) exhibiting his/her/their Community Tax Certificate(s) as indicated above

Appendix M Various Forms used by General Services M.1. Engineering: Job Order Request Republic of tre Philippines Department of Heath SAN LAZARO HOSPITAL Engincering wid Maintenance Department JOB OROER (it House} Date ofRequest: __ Site of Vverk _ Kind of VYork { ) Electrica! ¢ Weiding { ) Carpentry (

) Mechanical ( ) Plumbing { } Refigeration & Aceon ( ) Painting ( ) Fintshing Scope of vvark: Requested By: Approved: “(Name & Signaiure)_ ELEONORITA &, REYES ~ Gasignationy Administrative Officer V (This portion to be fied-up by Eng’g & Maintenance Staff) Received by. Remarks: Name & Signature Te aanaas _— Dato Republic of the Phiippines Departinent of Heath SAN LAZARO HOSPITAL Engineering and Maintenance Department No. 1Oo8 OROER — {in House) Date of Request : _ Site of Work Kind of Work ‘() Electrical { ) Wekling ( ) Carpentry { ) Machanicaj ( ) Phanbing ( ) Refigeration & Aircon ( ) Painting ( ) Finishing Scope of Wark: Requested By: Approved: (Neme & Signature} ELEONORITA E. REYES ( bor) Administrative Offcer V {This portion to be fBed-up by Eng’g & Maintenance Staff Recelved by: Remarks: Name & Signature Designatien Date 275

M.2. 276 Request for Vehicle Name of the Agency Address VEHICLE REQUISITION FORM A. TO BE FILLED BY REQUESTING OFFICE Office: | Funding Source: | Place’s to be visited, Inclusive Dates af Vravel. ' Time of Departure: Purpose of Travel: Justification for the Use of Government Vehicle: _ Name of Authorized Passengers: Note: All passengers must sign in the Driver’s Trip Ticket Requested By: Approved By: Signature over Printed Name Head of Office‘Authorized Representative Date Date B. TO BE FILLED BY TRANSPORT MANAGEMENT UNIT This request shall he forwarded ta the Iransport Management Unit at least bee (2) working days prior fo the departure date and must be supported by a duly approved Travel Authority, snhject to the provisions under DO Nea 2006-0073 dated November 23, 2006. Furthermore, travels chargeuble azuinst Foreign Assisted Prajects are not allowed to withdraw fuels and other supplies’services from the centralized guaranty deposit fer gasoline, lubricants and other lube buy services per DO No, 2006-006) dated Octoher 11, 2016 Received by. Date: Time: ACTION TAKEN VRE Control No: TA¢40/-2007- Recommendation for | | Approval [| Disapproval due to Approved by: Chief Adwinictrative Officer Date

Appendix N Benchbook Indicators N.1. Leadership and Management 3.1. The Management Team: to the values and goals, Goal: The organization is effectively and efficiently governed and managed according to ensure that care produces the desired health outcomes and is responsive to patients’ and community needs. Activities Indicator Bub 1.. The provider organization’s management team provides leadership, act according to the organization’s policies and has overall responsibility for the organization’s operation, the quality of its service and its resources. (Note: the organization’s management team may consist of the Hospital Director or Chief of Hospital or Chief Health Officer together with administrative officer and/or service heads) Percentage of staff who are aware of their leadership team. The organization’s management team ensures there are effective working relationship within the organization, with the community and with other relevant organizations and individuals. Percentage of staff satisfaction specific on interpersonal relationship. Terms of reference, membership and procedures are defined for the meetings of all committees within the organization. Minutes of the meetings are recorded and confirmed. Percentage of committees with recorded minutes of meeting. The organization’s management team regularly assesses its own performance and the performance of the organization. Percentage of implemented organizational plans. The organization develops and implements policies and procedures covering major services and aspects of operations. Criteria: "The Organization develops _ its mission, vision and corporate goals based on agreed upon values. " The organization’s by-laws, policies and procedures support care delivery Percentage of personnel knowledgeable on VMO. Bit

and are consistent with its goals, statutory requirements, accepted standards and its community and regional responsibilities. Compliance with the organization’s policies and procedures occurs throughout the organization. Policies and procedures are reviewed and revised as necessary. The organization communicates its policies and procedures to all levels of the workforce. 3.2. External Services Goal: The organization ensures that services provided by external contractors meet the appropriate standards. ee Documented agreements and contracts cover external service providers and specify that the quality of services provided must be consistent with appropriate nominated standards. 278 Percentage of external service providers with contracts/agreements.

N.2. Human Resource Management 4.1. Human Resource Planning Goal: The organization provides the right number and mix of competent staff to meet the needs of its internal and external customers and to achieve its goal. Activities Indicator 4.1.1. Planning ensures that appropriately trained and qualified (and where relevant credentialed) staff are available to undertake the type and level of activity performed by the organization. This includes those who are consulted when suitable expertise is not available within the organization. Criteria: "The organization defines the qualifications and competencies of its staff. "The organization documents and follows policies and procedures for hiring, credentialing and privileging of its staff. Percentage of positions with job description. . Workload monitoring’ and reference to appropriate guidelines is used to ensure that appropriate staff numbers and skill mix are available to achieve desired patient and organizational outcomes. Criteria:

Staff numbers and skill mix are based on actual clinical needs. (Note: The hospital may document and analyze information from daily patient loads, utilization rates of services, turnaround times, etc. to determine staff size and mix) " Appropriate policies and procedures are followed to temporarily compensate for and to definitively address inadequacies in _ staff numbers or expertise. Percentage of incidences that adjustments of staff were made to compensate for needs. 219

4.2. Staff Recruitment, Selection, Appointment and Responsibilities Goal: The organization appoints staff through a recruitment, selection and appointment procedure that complies with the statutory requirements and its consistent with the organization’s human resource policies. (Note: Staff in this context refers to employees, contractors and other service providers.) 4.2.1. The recruitment, selection and appointment/reappointment ensures appropriate competence, training, experience, licensing and credentialing of all appointees. Criteria:

The organization defines, disseminates, and ensures compliance with policies and procedures for recruiting, selecting and appointing personnel. " The recruitment and selection process in open and transparent, is consistent with legal and ethical requirements and allows fair and unbiased evaluation of the qualifications and competencies of all applicants. = Relevant staff members participate in developing and implementing the process of recruitment, selection and appointment. = The process of selection and appointment and evidence of compliance with selection or appointment standards by the staff are documented. " The currency of relevant licenses is routinely monitored to facilitate renewal.
Evidence for continuing education and training of the staff is routinely monitored and assessed. Percentage of staff that passed the selection board/committee. — 4.2.2. On appointment, staff members receive a written statement of their accountabilities and responsibilities that specifies their role and how it contributes to achieving the organizational goals and maintaining quality of care. The statements are reviewed as necessary. Criteria: = Written job descriptions are given to and discussed with all the newly appointed staff members. Percentage of staff knowledgeable of their job description. 280

care and or services they give and for their delineated responsibilities, Criteria: " The organization ensures the accountabilities and responsibilities of staff are consistent with their qualifications, training, experience, registration and licensure. (Note: Logbooks of procedures documents the identities of the staff who did the procedures. All entries in the medical chart are legally signed by the originators and dated.) | 4.2.3 Staff members are accountable for the Percentage of patient’s chart with signature of accountable person. 4.2.4. All services are provided by staff members with appropriate qualifications, experience or training. Criteria:

All doctors, nurses, and midwives providing clinical care have current licenses and documented evidence of appropriate training and experience. All administrative, business and technical services staff have current licenses and documented evidence of appropriate training and experience. Percentage of staff with current licenses. 4.3. Training and Development organizational needs. Goal: A comprehensive program of staff training and development meets individual and 4.3.1. Educational needs of the organization and all staff are met through relevant orientation, training and developmental programs. Criteria: " The organization assesses the educational needs of its management and staff and identifies and/or provides resources to meet them. " Policies and procedures for orienting new management staff are documented and followed. " The organization evaluates the effectiveness of these programs to ensure that they meet organizational community and individual needs. " Percentage of personnel who attended. " Percentage of staff who passed through the orientation. 4.3.2. The organization clearly defines the lines of authority and supervision and ensures compliance to them. Percentage of staff who knows their accountability and responsibility. 281

Criteria: « Staff, including trainees, volunteers, new graduates and external contractors are adequately supervised by qualified staff. = Staffs are provided with documented job description outlining accountabilities and responsibilities. 282

N.3. Information Management

Data Collection, Aggregation and Use 7 Goal: Patient care, management of services, education and research are facilitated by the collection and aggregation of data. — Activities Indicator 5.1.1. Relevant, accurate, quantitative and Percentage of data collected in compliance qualitative data are collected and used in a to policies and procedures. timely and efficient manner for delivery of patient care and management services. Criteria: " The organization defines the relevant aspects of its operation from which data will be collected. " The organization defines data sets, data generation, collection and aggregation methods and qualified staff who are involved in each stage. " The organization defines policies and procedures to monitor and improve the accuracy, completeness and reliability of relevant quantitative and qualitative data relating to its operation. " The organization provides resources and opportunities for management and staff to use data in their decision and policy making activities. " Policies and procedures that govern record storage, retention and disposal are documented and followed. 5.1.2. The collections of data and reporting of | Percentage of compliance to information comply with professional | Philhealth/DOH required reports. Standards, statutory and Philhealth requirements. Criteria: " The organization collects and submits reports required by the Department of Health and Philhealth. 5.1.3. Every patient has a sufficiently detailed Percentage of patient chart with complete medical chart to assist with continuity of | data documented accurately and legibly. care, education, research, evaluation and medico-legal and statutory requirements. Criteria: " Care providers document details in the medical chart. All entries are contemporaneously accomplished, accurate, legible, dated and signed with L designation. (Note: The documentation | _| 283

— of care in the medical chart is sufficient for any member of the healthcare team to understand care plans and care given. Clinical pathways are an excellent way to achieve its purpose. « Medical charts are routinely checked for completeness and accuracy and action is taken to improve their quality. 5.1.4. Data in the medical charts are coded and indexed to ensure the timely production of quality patient care information and reports to Philhealth. Criteria: » Data from the medical charts are routinely collected, aggregated and reported for use in quality improvement activities, for administrative purposes and for mandatory reporting to the Department of Health and Philhealth. (Note: Data from medical charts are used in peer review, medical audits, variance analysis, quality circle meetings, etc. = Percentage of chart accurately coded in accordance with Philhealth requirements. = Percentage of minutes showing actual analysis of data/information from medical charts. Goal: 5.2. Record Management Integrity, safety, access and security of records are maintained and statutory requirements are met. 5.2.1. Clinical records are readily accessible to facilitate patient care while being kept confidential and safe, meeting all relevant statutory requirements and codes of practice. Criteria: = When patients are admitted or are scen for ambulatory or emergency care, the medical charts documenting any previous care can be quickly retrieved for review, updating and contemporaneous use. = The organization has policies and procedures and devotes resources including infrastructure, to protect records and medical chars against loss, destruction, tampering and unauthorized access or use. = Only authorized individuals make entries in the medical chart. Percentage of chart retrieved within required time based on policies. 284

N.4. Safe Practice and Environment 6.1. Patient and Staff Safety functional and effective environment of care. Goal: Patients, staff and other individuals within the organization are provided a safe, Activities Indicator 6.1.1. The organization plans a safe and effective |

environment of care consistent with the mission, services and with laws and regulations. Criteria: "The — organizational environment complies with structural standard and |

safety codes as prescribed by law. (Note: The organization maintains current licenses and permits that ensure safe and effective operation. Such permits include, but are not limited to, occupancy, electrical, — plumbing, radiation safety, fire safety., occupational safety, food storage and handling and waste disposal) " Management plans exist for the safe and efficient use of medical equipment according to specifications. Percentage of compliance of organizational environment with structured standard and safety codes of laws and regulations, e.g. current licenses of hospital and safety permits of medical equipment. Percentage of equipment/machines with operating manuals. 6.1.2. The organization provides a safe and|

effective environment of care consistent with its mission and services, laws and regulations. Criteria:

Policies and procedures that address safety, security, control of hazardous |

materials and _ biological wastes, emergency and disaster preparedness, fire safety, radiation safety and utility |

systems are documented and implemented.

Policies and procedures for the safe and efficient use of medical equipment | * according to specifications are documented and implemented. . " The design of patient areas provides sufficient space for safety, comfort and |

privacy of the patient and for emergency use.

All personnel understand and fulfil their role in safe practice. "Risks are identified, assessed and Percentage of compliance to organizational documented policies and procedures on hazardous materials/biological wastes, emergency preparedness, fire safety, radiation safety and utility systems. Percentage of compliance with documented policies and procedures on use of medical equipment. Percentage compliance of patient areas with designed space provisions for safety, patient comfort/privacy and emergency care Percentage of staff who understand and fulfil their role in safe practice Percentage of identified safety risks that were controlled. Percentage of security incidents coordinated through policies and procedures. 285

appropriately controlled. Where elimination or substitution is not possible, adequate warning and protection devices are use. « A coordinated security arrangement in the organization assures protection of patients, staff and visitors. 6.1.3. The organization routinely collects and evaluates information to improve the safety and adequacy of the environment of care. Criteria: = The effectiveness of safety procedures and devices are routinely _ tested, monitored and improved. = An incident reporting system identifies potential harms, evaluates causal and contributing factors for the necessary corrective and preventive action. " Percentage of maintenance report and analyzed and acted upon, « Percentage of safety procedures and devises tested, monitored and improved. " Percentage of reported potential harm acted upon. 6.2. Maintenance Goal: A comprehensive maintenance program ensures a clean and safe environment. 6.2.1. Emergency light and/or power supply, water and ventilation systems are provided in accordance with relevant statutory requirements, codes of practice. Percentage of compliance with emergency light and/or power supply, water and ventilation systems in accordance with statutory requirements, codes of practice, or manufacturers specifications. 6.2.2. Regular maintenance of grounds, facilities and equipment in accordance with relevant statutory requirements, codes of practice, or manufacturer’s specifications, ensures the environment is clean and safe. Percentage of equipment, facilities and grounds maintained in accordance with statutory requirements. 6.2.3. Equipment is serviced only by people trained in the maintenance of that equipment. Registers and records of equipment and related maintenance are kept. Percentage of equipment trained people. serviced by 6.2.4. Current information and scientific data from manufacturers concerning their products are available for reference and guidance for the operation and maintenance of plant and equipment. Percentage of products with available current information and scientific data e.g. . operating manuals. 6.3. Infection Control Goal: Risks of acquisition and transmission of infections among patients, employees, physicians and other personnel, visitors and trainees are identified and reduced. 6.3.1. An interdisciplinary infection control program ensures the prevention and control of infection in all services. Percentage of compliance to infection control policies. 286

6.3.2. The organization uses a coordinated system wide approach to reduce the risks of noso-comial infections. Criteria: "The organization undertakes case finding and identification of noso- comial infections. = The organization takes steps to prevent and control outbreaks of noso-comial infections. Percentage of reported noso-comial infection acted upon. 6.3.3. The organization uses a coordinated system-wide approach to reduce the risks of infection the staff are exposed to in the performance of their duties. Criteria: = There are programs for prevention and treatment of needlestick injuries, and policies and procedures for the safe disposal of used needles are documented and monitored. "There are programs for the prevention of transmission of airborne infections, and risks from patients with signs and symptoms suggestive of tuberculosis or other communicable diseases are managed according to established protocols. Percentage of compliance to policies and procedures for used needles and sharps. Percentage of compliance on established policies and procedures or protocols on management of communicable diseases. 6.3.4. Cleaning, disinfecting, drying, packaging and sterilizing equipment and maintenance of associated environment, conforms to relevant statutory requirements and codes of practice, Percentage of conformity with statutory requirements and codes of practice. 6.3.5. The organization reports when appropriate information about infections both internally and to public health agencies. Percentage of compliance with DOH requirement on reportable diseases. 6.4. Equipment and Supplies Goal: The provision of equipment and supplies supports the organization’s role. 6.4.1. Planning of facilities and selection and acquisition of equipment and supplies involves inputs from relevant staff and is undertaken by appropriately qualified personnel. Criteria: = Appropriate equipment and supplies that support the organization’s role and level of service are provided. Consideration is given to at least: © The intended use o Cost benefits Percentage of appropriate equipment and supplies provided considering the intended use, cost benefit, infection control, safety, waste creation and disposal and storage. 287

o Infection control o Safety o Waste creation and disposal o Storage 6.4.2. Specialized equipment is operated according to specification and only by appropriately trained staff. Percentage of compliance with specification by trained staff. 6.4.3. Items designated by the manufacturer for single use are not reused unless the organization has specific policies and guidelines for safe reuse incorporating relevant statutory requirements and code of practice. Percentage compliance with policies, procedures and guidelines fo safe reuse. 6.5. Energy and Waste Management Goal: The organization demonstrates its commitment to environmental issues by considering and implementing strategies to achieve environmental sustainability. 6.5.1. The handling, collection, and disposal of waste conform to relevant statutory requirements and codes of practice. Percentage of conformity to policies and procedures on waste disposal. 6.5.2. The organization implements a waste disposal program which involves reuse, reduction and recycling. Percentage of conformity to policies and procedures on waste disposal. 288

Appendix O Various Forms Used by Information Management (Based on the Information Security Policies and Procedures Manual for Hospital Operations and Management Information System (HOMIS), Department of Health) 0.1. Confidentiality and Security Statement of Understanding Name of Hospital Address LOGO CONFIDENTAILITY AND SECURITY STATEMENT OF UNDERSTANDING Section A. Employee and supervisor shall address each with an initial. Employee | Supervisor | Security and Confidentiality supportive D I have been advised to the location and have access to the National Statutes and/or Administrative Rules. I have been advised of the location of and have access to the Core Hospital Policies, Protocols and Procedures I have been advised of the location of and have access to the supplemental operating procedures. Position Related Security and Confidentiality Responsibilities I have been given copies or been advised of the location of the following specific National Statutes and/or Administrative Rules that pertain to my _ position responsibilities I have been given copies or been advised of the location of the following specific core hospital policies, protocols and procedures that pertain to my position responsibilities. I have been give copies or been advised of the location of the following specific supplemental operating procedures that pertains to my position responsibilities. I have received instructions for maintaining the physical security and protection of confidential information which are in place in my immediate work environment. 289

I have been given access to the following sets of confidential information Penalties for Non Compliance I have received the Hospital Personnel Handbook and understands the disciplinary actions associated with a breach of confidentiality I understood that a security violation may result in disciplinary action ranging from reprimand to dismissal. I understand my professional responsibility and procedures to report suspected or known security breaches. The Purpose of this statement of understanding is to emphasize that access to all confidential information regarding an employee or held in client health records is limited and governed by state laws. Information which is confidential includes the client’s name, social security number, address, medical, social and financial data and services received. Data collection by interview, observation or review of documents shall be in a setting that protects client’s privacy, Information discussed by health team members shall be held in strict confidence, shall be limited to information related to the provision of care to the client, and shall not be discussed outside the department. Signature of Employee over printed name Signature of Supervisor Date Date 290

Section B. Information Resource Management (initial each item, which applies) Employees has access to computer related media Yes. Have employee read and sign section B. No. It is not necessary to complete section B. Understanding of computer related crimes act, if applicable. The Hospital has authorized you to have access to sensitive data through the use of computer related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media.) Computer crimes are a violation of the hospital’s disciplinary standards and departmental discipline. I have read the above statements and by my signature acknowledge that I have read and understood it. I understand that a security violation may result in disciplinary action against me according to hospital policy. The minimum information resource management requirements are:

Personal passwords are not to be disclosed. There may be supplemental operating procedures that permit shared access to electronic mail for the purpose of ensuring day-to-day operations of the department.
Information, both paper based and electronic based, is not to be obtained for my own or another person’s personal use.
Hospital data, information and technology resources shall be used for official state business purposes only.
Only approved software shall be installed on hospital computers. 5 Access to and use of internet from a hospital computer shall be limited to official state business purpose only.
Copyright law prohibits the unauthorized use or duplication of software. Signature of Employee over Printed Name Signature of Supervisor over Printed Name Date Date

0.2. Information Custodian Delegation of A uthority Name of the Hospital Address LOGO 5 has been delegated custodial (Designee’s Full Name(First Middle Last) ( GSIS number) authority for the information set (s): (List specifically) Responsibilities include maintaining information in accordance with rules, regulations and hospital policies, protocol and procedures. I have been provided with a copy of the Hospital Information Security Policies, Protocols and Procedures, including the Authority for Information Security reference. I understand that a violation of the hospital’s information security policies may result in disciplinary action against me according to hospital policy. Designee’s Signature Date Supervisor’s Signature Date (Please print name) 292

Appendix P Proposed Organizational Structure under the Department of Health Rationalization Plan (DOH RAT Plan) <<< P.1. Proposed Organogram for Level 3 (Non Corporate) Hospital, 100-200 Beds Proposed Organogram Level 3 Non-Corporate Hospital 100,150, 200 Bed Office of the Chief of Hospital Integrated Hospital Operations Continuous Quality & Management Program Improvement (CQI Program) (IHOMP Unit) and Patient Safety Legal Affairs Internal Audit Professional Education and Training [ Researon | | Non- Bids & Awards Committee Medical | | Nursing Medical : Hospital Operations and Nursing Service Medical Service Patient Support Service 203

P.2._ Proposed Organogram for Administrative Service (Hospital Operation and Patient Support Service for Level (Non Corporate) Hospital, 100-200 beds Office of the Chief of Hospital Hospital Operations and Patient Support Service Accounting Human Resource Budget Procurement Cash Operation Property and Supply Billing and Claims Engineering & Facilities Management L Equipmentt/Building Maintenance Waste Mgt. Transport Services General Services Linen/Laundry Housekeeping Solid Waste Mgt. Waste Water Mgt. Security 294

P3.é Proposed Organogram for level 4 (Non Corporate) Hospital (Teaching and Training), 200-500 Beds Proposed Organogram (Teaching & Training) Level 4 Non:Corporate Hospital 200-500 Bed Office of the Medical Center Chief Integrated Hospital Operations Continuous Quality & Management Program Improvement (CQ| Program) (IHOMP Unt) and Patient Safety Legal Affairs Internal Audit Professional Education and Tring Research | No. Bids & Awards Committee Medical | | Nursing Metical Hospital Nursing Medical Finance Operations and Service Service Service Patient Support Service 295

P.4.: Proposed Organogram for Administrative Service for Level 4 Non Corporate Hospital (Teaching and Training) 200-500 Beds Office of the Medical Center Chief Hospital Operations and Patient Support Service Human Resource Procurement Property & Supply Engineering & Facilities Management Equipment/Bldg.Maintenance Waste Mgt. Transport Services General Services Linen/Laundry Housekeeping Solid Waste Mgt. Waste Water Mgt. Security 296

pag Proposed Organogram for Finance Service for Level 4 Non Corporate Hospital (Teaching and Training) 200-500 Beds Office of the Medical Center Chief Finance Service Accounting Budget Cash Operation Billing and Claims 297

Manual of Organization and Management of the Administrative and Finance Service for Hospitals

Document Info

a Table 4.2 Standard Staffing Pattern for Level 2 Hospitals

PATIENT SUPPORT SERVICES | ADMITTING AND INFORMATION r | | Administrative Officer V 18 -; Administrative Officer III ros pt 1 | 1 fo [ 0 _| Administrative Officer II Pau fo Po ft ft Administrative Assistant | 1 Communication Operator II rel p4 p44 | 4 [4 a ee i a a Qa.2 5 an

5 io}

[a <x Q 2 ce Q Qo

ei

Provides services/inputs to Internal Clients

e Prudent physical and environmental measure for the hardware, software and data within its purview shall be provided.

Availability of cash

Availability of cash

Remittance list of mandatory deductions (Based on Payroll and Voucher)

Compensation

Expanded Creditable Tax

BIR Form No. 2306

Certificate of VAT/Final Tax

BIR Form No 2307 Certificate of Creditable Tax Withheld for distribution to suppliers

PHIC Claim Form 1

Department/Section Head Responsible to

Chief of the AFS Expects services/inputs from

Clinical Areas Revenue Centers Medical Social Service Provides services to Internal Clients

e Conducts account monitoring and analysis regularly. n letters on a monthly basis. « Prepares and sends appropriate collectio Standard Operating Procedures bution of Charge Slip

ADMITTING AND INFORMATION Function This office directs and controls the centralized registration and documentation of admission and discharges of patients including giving of information. Headed By

Department/Section Head Responsible to

Chief of the AFS Receives inputs from

Patient’s companion ER Nursing staff for unaccompanied patients Clinical Areas Security External and Internal Clients Provides services/inputs to Internal Clients

Medical Social Service Billing and Claims Medical Records Medical and Nursing Clinical Areas Security Service IHOMP designated System Administrator Statistical unit External Clients

NUTRITION AND DIETETICS Function This Department/Section directs, maintains and ensures the Provision of safe, high quality and nutritious food to patients and personnel. Headed By

Department/ Section Head Responsible to

Chief of the AFS Expects inputs from

Procedures Person/s Responsible

If available, issues the Supplies and materials to Engineering unit concerned, then proceed to procedure No. 9.

a fF FLOWCHART OF LINEN PRODUCTION/ISSUANCE

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Appendix G Sample Formula for Costing LUNG CENTER OF THE PHILIPPINES PATHOLOGY AND LABORATORY DEPARTMENT COSTING TEST FOR LEPTOSPIROSIS IL OVERHEAD Area

39.5 sq. m. Overhead/Day

175,891,054.45

8,688.80 sq. m. 20,243.42 sq. m. 12 mos.

724.06

24.13/day 30 days

24.13/day x 25 sq. m.

603.25/day 24 hrs.

25.14/hr

0.41/min. 60 mins. FORMULA: Overhead= Total MOOE of the previous year Total sq. m. of LCP

.41/ min. x 45 mins. Overhead= 18.45 Il. DIRECT MATERIALS Cost per kit of 30 test

FORMULA: Direct materials Total cost of direct and indirect materials Total Direct Materials

P__304.83 Il. DIRECT LABOR Med. Tech II

P 32,590.05

32,590.05

1,481.37/day 22 days 8 hrs.

185.1 7/hr

3.09/min. 60 mins.

3,09/min x 45 mins. FORMULA: Direct Labor

Gross salary of employee 22 days /8 hrs. of work x Total hours to finish procedure Cost of Direct Labor

H.8 Obligation Request Republic of the Philippines Department of Health Name of Hospital Address OBLIGATION REQUEST NO. Payee: Office: Address: Responsibility Account Center PARTICULARS P.P.A.| Code Amount TOTAL

Lal rn 1 L Payor Information |e Taxpayer — Ee a Identification Number "L._. al 4 Payor's Name |

mount et CompersaTon cay Total Amount of Compensation 16 Hse Lees: Non Taxable Compensation a 7 Taxable Compan

n Parti Background Information 4 ie | 5 RDO =" 6 Line of Business/ ‘|

° NOV : : ° . DEC . ° © ° TOTAL ° . i ° Schedule 2 Remtttanece per BIR Form N o. 1601-F MONTH DATE OF | NAME OF BANK/BANK CODE/ TAXES PENALTIES TOTAL AMOUNT REMITTANC ROR NO., IF ANY WITHHELD REMITTED JAN . . . FEB .

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