BUPATI BANDUNG PROVINSI JAWA BARAT PERATURAN BUPATI …

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B U P A T I B A N D U N G P R O V I N S I J A W A B A R A T

P E R A T U R A N B U P A T I B A N D U N G N O M O R 2 2 T A H U N 2 0 1 9

T E N T A N G

P E T U N J U K T E K N I S P E N G G U N A A N J A S A P E L A Y A N A N B A G I P E G A W A I P U S K E S M A S Y A N G M E N E R A P K A N P O L A P E N G E L O L A A N K E U A N G A N B A D A N

L A Y A N A N U M U M D A E R A H D I K A B U P A T E N B A N D U N G

M e n i m b a n g : a .

D E N G A N R A H M A T T U H A N Y A N G M A H A E S A ,

B U P A T I B A N D U N G ,

b a h w a u n t u k m e l a k s a n a k a n k e t e n t u a n P a s a l 2 3 a y a t ( 2 ) h u r u f c P e r a t u r a n M e n t e r i D a l a m N e g e r i N o m o r 7 9 T a h u n 2 0 1 8 t e n t a n g B a d a n l a y a n a n U m u m D a e r a h , p e r l u a d a n y a p e n g a t u r a n m e n g e n a i k e t e n t u a n p e n g g u n a a n B i a y a j a s a p e l a y a n a n ;

b . b a h w a b e r d a s a r k a n p e r t i m b a n g a n s e b a g a i m a n a d i m a k s u d d a l a m h u r u f a , p e r l u m e n e t a p k a n P e r a t u r a n B u p a t i t e n t a n g P e t u n j u k T e k n i s P e n g g u n a a n J a s a P e l a y a n a n b a g i P e g a w a i p a d a U n i t P e l a k s a n a T e k n i s D i n a s y a n g M e n e r a p k a n P o l a P e n g e l o l a a n K e u a n g a n B a d a n L a y a n a n U m u m D a e r a h d i K a b u p a t e n B a n d u n g .

M e n g i n g a t : 1 . U n d a n g - U n d a n g N o m o r 1 4 T a h u n 1 9 5 0 t e n t a n g P e m b e n t u k a n D a e r a h - d a e r a h K a b u p a t e n D a l a m L i n g k u n g a n P r o v i n s i J a w a B a r a t ( B e r i t a N e g a r a T a h u n 1 9 5 0 ) s e b a g a i m a n a t e l a h d i u b a h d e n g a n U n d a n g - U n d a n g N o m o r 4 T a h u n 1 9 6 8 t e n t a n g P e m b e n t u k a n K a b u p a t e n P u r w a k a r t a d a n K a b u p a t e n S u b a n g d e n g a n m e n g u b a h U n d a n g -U n d a n g n o m o r 1 4 T a h u n 1 9 5 0 t e n t a n g P e m b e n t u k a n D a e r a h - d a e r a h K a b u p a t e n D a l a m L i n g k u n g a n P r o v i n s i J a w a B a r a t ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 1 9 6 8 N o m o r 3 1 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 2 8 5 1 ) ;

2 . U n d a n g - U n d a n g N o m o r 1 7 T a h u n 2 0 0 3 t e n t a n g K e u a n g a n N e g a r a ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 0 3 N o m o r 4 7 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 4 2 8 6 ) ;

3 . U n d a n g - U n d a n g N o m o r 2 5 T a h u n 2 0 0 9 t e n t a n g P e l a y a n a n P u b l i k ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 0 9 N o m o r 1 0 4 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 5 0 3 8 ) ;

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4 . U n d a n g - U n d a n g N o m o r 3 6 T a h u n 2 0 0 9 t e n t a n g K e s e h a t a n ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 0 9 N o m o r 1 4 4 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 5 0 6 3 ) ;

5 . U n d a n g - U n d a n g N o m o r 2 3 T a h u n 2 0 1 4 t e n t a n g P e m e r i n t a h a n D a e r a h ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 1 4 N o m o r 2 4 4 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 5 5 8 7 ) s e b a g a i m a n a t e l a h d i u b a h d e n g a n P e r a t u r a n P e m e r i n t a h P e n g g a n t i U n d a n g - U n d a n g N o m o r 2 T a h u n 2 0 1 4 t e n t a n g P e r u b a h a n a t a s U n d a n g -U n d a n g N o m o r 2 3 T a h u n 2 0 1 4 t e n t a n g P e m e r i n t a h a n D a e r a h ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 1 4 N o m o r 2 4 6 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 5 5 8 9 ) ;

6 . P e r a t u r a n P e m e r i n t a h N o m o r 2 3 T a h u n 2 0 0 5 , t e n t a n g P e n g e l o l a a n K e u a n g a n B a d a n L a y a n a n U m u m ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 0 5 N o m o r 4 8 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 4 5 0 2 ) s e b a g a i m a n a t e l a h d i u b a h d e n g a n P e r a t u r a n P e m e r i n t a h N o m o r 7 4 T a h u n 2 0 1 2 t e n t a n g P e r u b a h a n A t a s P e r a t u r a n P e m e r i n t a h N o m o r 2 3 T a h u n 2 0 0 5 , t e n t a n g P e n g e l o l a a n K e u a n g a n B a d a n L a y a n a n U m u m ( L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 1 2 N o m o r 1 7 1 , T a m b a h a n L e m b a r a n N e g a r a R e p u b l i k I n d o n e s i a N o m o r 5 3 4 0 ) ;

7 . P e r a t u r a n M e n t e r i D a l a m N e g e r i N o m o r 1 3 T a h u n 2 0 0 6 t e n t a n g P e d o m a n P e n g e l o l a a n K e u a n g a n D a e r a h s e b a g a i m a n a t e l a h d i u b a h b e b e r a p a k a l i t e r a k h i r d e n g a n P e r a t u r a n M e n t e r i D a l a m N e g e r i N o m o r 2 1 T a h u n 2 0 1 1 t e n t a n g P e r u b a h a n k e d u a a t a s P e r a t u r a n M e n t e r i D a l a m N e g e r i N o m o r 1 3 T a h u n 2 0 0 6 t e n t a n g P e d o m a n P e n g e l o l a a n K e u a n g a n D a e r a h ;

8 . P e r a t u r a n M e n t e r i K e s e h a t a n N o m o r 7 5 T a h u n 2 0 1 4 t e n t a n g P u s a t K e s e h a t a n M a s y a r a k a t ;

9 . P e r a t u r a n M e n t e r i K e s e h a t a n R e p u b l i k I n d o n e s i a N o m o r 2 1 T a h u n 2 0 1 6 T e n t a n g P e n g g u n a a n D a n a K a p i t a s i J a m i n a n K e s e h a t a n N a s i o n a l U n t u k J a s a P e l a y a n a n K e s e h a t a n D a n D u k u n g a n B i a y a O p e r a s i o n a l P a d a F a s i l i t a s K e s e h a t a n T i n g k a t P e r t a m a M i l i k P e m e r i n t a h D a e r a h

9 . P e r a t u r a n M e n t e r i D a l a m N e g e r i R e p u b l i k I n d o n e s i a N o m o r 7 9 T a h u n 2 0 1 8 T e n t a n g B a d a n L a y a n a n U m u m D a e r a h ( B e r i t a N e g a r a R e p u b l i k I n d o n e s i a T a h u n 2 0 1 6 N o m o r 7 6 1 ) ;

1 0 . K e p u t u s a n M e n t e r i K e s e h a t a n N o . 8 5 7 / M e n k e s / S K / I X / 2 0 0 9 t e n t a n g P e d o m a n P e n i l a i a n K i n e r j a S u m b e r D a y a K e s e h a t a n d i P u s k e s m a s ;

1 1 . P e r a t u r a n D a e r a h K a b u p a t e n B a n d u n g N o m o r 1 2 T a h u n 2 0 1 6 t e n t a n g P e m b e n t u k a n d a n S u s u n a n P e r a n g k a t D a e r a h ( L e m b a r a n D a e r a h K a b u p a t e n B a n d u n g T a h u n 2 0 1 6 N o m o r 1 2 ) s e b a g a i m a n a t e l a h d i u b a h d e n g a n P e r a t u r a n D a e r a h N o m o r 1 5 T a h u n 2 0 1 8 t e n t a n g P e r u b a h a n a t a s P e r a t u r a n D a e r a h K a b u p a t e n B a n d u n g

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N o m o r 1 2 T a h u n 2 0 1 6 t e n t a n g P e m b e n t u k a n d a n S u s u n a n P e r a n g k a t D a e r a h ( L e m b a r a n D a e r a h K a b u p a t e n B a n d u n g T a h u n 2 0 1 8 N o m o r 1 5 ) ;

M E M U T U S K A N :

M e n e t a p k a n : P E T U N J U K T E K N I S P E N G G U N A A N J A S A P E L A Y A N A N B A G I P E G A W A I P U S K E S M A S Y A N G M E N E R A P K A N P O L A P E N G E L O L A A N K E U A N G A N B A D A N L A Y A N A N U M U M D A E R A H D I K A B U P A T E N B A N D U N G

B A B I K E T E N T U A N U M U M

P a s a l 1

D a l a m P e r a t u r a n B u p a t i i n i , y a n g d i m a k s u d d e n g a n :

1 . D a e r a h a d a l a h K a b u p a t e n B a n d u n g ;

2 . P e m e r i n t a h d a e r a h a d a l a h B u p a t i d a n P e r a n g k a t D a e r a h s e b a g a i u n s u r p e n y e l e n g g a r a p e m e r i n t a h a n d a e r a h ;

3 . B u p a t i a d a l a h B u p a t i B a n d u n g ;

4 . D i n a s a d a l a h D i n a s K e s e h a t a n K a b u p a t e n B a n d u n g ;

5 . P u s a t K e s e h a t a n M a s y a r a k a t y a n g s e l a n j u t n y a d i s e b u t p u s k e s m a s a d a l a h f a s i l i t a s p e l a y a n a n k e s e h a t a n y a n g m e n y e l e n g g a r a k a n u p a y a k e s e h a t a n m a s y a r a k a t d a n u p a y a k e s e h a t a n p e r s e o r a n g a n t i n g k a t p e r t a m a , d e n g a n l e b i h m e n g u t a m a k a n u p a y a p r o m o t i f d a n p r e v e n t i f , U n t u k m e n c a p a i d e r a j a t k e s e h a t a n m a s y a r a k a t y a n g s e t i n g g i -t i n g g i n y a d i w i l a y a h k e r j a n y a .

6 . B a d a n L a y a n a n U m u m D a e r a h U P T P u s k e s m a s , y a n g s e l a n j u t n y a d i s e b u t B L U D - U P T P u s k e s m a s a d a l a h P u s k e s m a s y a n g m e n e r a p k a n P o l a P e n g e l o l a a n K e u a n g a n B a d a n L a y a n a n U m u m D a e r a h ;

7 . P e g a w a i a d a l a h P e g a w a i N e g e r i S i p i l m a u p u n N o n P e g a w a i N e g e r i S i p i l y a n g b e k e r j a d i B L U D - U P T P u s k e s m a s .

8 . P e n d a p a t a n B L U D a d a l a h s e m u a p e n e r i m a a n d a l a m b e n t u k k a s d a n t a g i h a n B L U D y a n g m e n a m b a h e k u i t a s d a n a l a n c a r d a l a m p e r i o d e a n g g a r a n b e r s a n g k u t a n y a n g t i d a k p e r l u d i b a y a r k e m b a l i .

9 . D a n a K a p i t a s i a d a l a h b e s a r a n p e m b a y a r a n p e r - b u l a n y a n g d i b a y a r d i m u k a k e p a d a F K T P b e r d a s a r k a n j u m l a h p e s e r t a y a n g t e r d a f t a r t a n p a m e m p e r h i t u n g k a n j e n i s d a n j u m l a h p e l a y a n a n k e s e h a t a n y a n g d i b e r i k a n .

1 0 . T i m P e n i l a i J a s a P e l a y a n a n K e s e h a t a n , a d a l a h t i m y a n g d i b e n t u k d i p u s k e s m a s d a n d i t e t a p k a n o l e h K e p a l a U P T P u s k e s m a s .

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B A B I I P E M A N F A A T A N P E N D A P A T A N J A S A P E L A Y A N A N

B a g i a n K e s a t u S u m b e r P e n d a p a t a n J a s a P e l a y a n a n

P a s a l 2

P e m b a g i a n j a s a p e l a y a n a n b a g i p e g a w a i d i p e r o l e h d a r i p e n d a p a t a n B L U D - U P T P u s k e m a s y a n g b e r s u m b e r d a r i :

a . J a s a p e l a y a n a n ;

b . H a s i l k e r j a s a m a d e n g a n p i h a k l a i n n y a ; d a n c . L a i n - l a i n p e n d a p a t a n B L U D y a n g s a h .

P a s a l 3

( 1 ) P e n d a p a t a n B L U D - U P T P u s k e s m a s y a n g b e r s u m b e r d a r i j a s a p e l a y a n a n s e b a g a i m a n a d i m a k s u d d a l a m P a s a l 2 h u r u f a m e r u p a k a n i m b a l a n y a n g d i p e r o l e h d a r i l a y a n a n y a n g d i b e r i k a n k e p a d a m a s y a r a k a t .

( 2 ) P e n d a p a t a n B L U D - U P T P u s k e s m a s y a n g b e r s u m b e r d a r i H a s i l k e r j a s a m a d e n g a n p i h a k k e t i g a s e b a g a i m a n a d i m a k s u d d a l a m P a s a l 2 h u r u f b , d a p a t b e r u p a p e r o l e h a n d a r i k e r j a s a m a o p e r a s i o n a l , s e w a m e n y e w a d a n u s a h a l a i n n y a y a n g m e n d u k u n g t u g a s p o k o k d a n f u n g s i B L U D ;

( 3 ) P e n d a p a t a n B L U D - U P T P u s k e s m a s y a n g b e r s u m b e r d a r i L a i n - l a i n P e n d a p a t a n B L U D - U P T P u s k e s m a s y a n g s a h s e b a g a i m a n a d i m a k s u d d a l a m P a s a l 2 h u r u f c , a n t a r a l a i n b e r u p a :

a . H a s i l p e n j u a l a n k e k a y a a n B L U D - U P T P u s k e s m a s y a n g t i d a k d i p i s a h k a n ;

b . H a s i l p e m a n f a a t a n k e k a y a a n B L U D - U P T P u s k e s m a s ;

c . J a s a g i r o ;

d . P e n d a p a t a n b u n g a ; e . K e u n t u n g a n s e l i s i h n i l a i t u k a r r u p i a h t e r h a d a p m a t a

u a n g a s i n g ; d a n

f . K o m i s i , p o t o n g a n a t a u p u n b e n t u k l a i n s e b a g a i a k i b a t d a r i p e n j u a l a n d a n / a t a u p e n g a d a a n b a r a n g d a n / a t a u j a s a o l e h B L U D - U P T P u s k e s m a s .

B a g i a n K e d u a P e n e t a p a n J a s a P e l a y a n a n

P a s a l 4

( 1 ) P e n e t a p a n b e s a r a n j a s a p e l a y a n a n b e r d a s a r k a n j u m l a h p e n d a p a t a n p e r t a h u n p a d a t a h u n b e r j a l a n d i B L U D - U P T P u s k e s m a s .

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( 2 ) B e s a r a n j a s a p e l a y a n a n d i k l a s i f i k a s i k a n s e b a g a i b e r i k u t

a . J u m l a h p e n d a p a t a n B L U D - U P T P u s k e s m a s k u r a n g d a r i R p . 1 . 0 0 0 . 0 0 0 . 0 0 0 , 0 0 ( s a t u m i l y a r ) d a p a t m e n g a l o k a s i k a n j a s a p e l a y a n a n d e n g a n b e s a r a n p a l i n g t i n g g i 3 5 % ( t i g a p u l u h l i m a p e r s e n ) d a r i t o t a l p e n d a p a t a n ;

b . J u m l a h p e n d a p a t a n B L U D - U P T P u s k e s m a s R p . 1 . 0 0 0 . 0 0 0 . 0 0 0 , 0 0 ( s a t u m i l y a r ) s a m p a i d e n g a n R p . 2 . 5 0 0 . 0 0 0 . 0 0 0 , 0 0 ( d u a m i l y a r l i m a r a t u s j u t a r u p i a h ) d a p a t m e n g a l o k a s i k a n j a s a p e l a y a n a n d e n g a n b e s a r a n p a l i n g t i n g g i 3 0 % ( t i g a p u l u h p e r s e n ) d a r i t o t a l p e n d a p a t a n ,

c . J u m l a h p e n d a p a t a n B L U D - U P T P u s k e s m a s l e b i h d a r i R p . 2 . 5 0 0 . 0 0 0 . 0 0 0 , 0 0 ( d u a m i l y a r l i m a r a t u s j u t a r u p i a h ) d a p a t m e n g a l o k a s i k a n j a s a p e l a y a n a n d e n g a n b e s a r a n p a l i n g t i n g g i 2 5 % ( d u a p u l u h l i m a p e r s e n ) d a r i t o t a l p e n d a p a t a n .

( 3 ) K e t e n t u a n s e b a g a i m a n a d i m a k s u d p a d a a y a t ( 2 ) , u n t u k B L U D - U P T P u s k e s m a s : a . T a n p a r a w a t i n a p d e n g a n p o n e d m e n d a p a t

t a m b a h a n j a s a p e l a y a n a n p a l i n g b a n y a k 5 % ( l i m a p e r s e n ) d a r i t o t a l p e n d a p a t a n , d a n

b . R a w a t i n a p m e n d a p a t t a m b a h a n j a s a p e l a y a n a n p a l i n g b a n y a k 1 0 % ( s e p u l u h p e r s e n ) d a r i t o t a l p e n d a p a t a n .

P a s a l 5

( 1 ) P e m a n f a a t a n b e s a r a n j a s a p e l a y a n a n k e s e h a t a n s e b a g a i m a n a d i m a k s u d d a l a m P a s a l 4 t e r b a g i a t a s : a . 9 0 % ( s e m b i l a n p u l u h p e r s e n ) u n t u k J a s a P e l a y a n a n

y a n g d i b a y a r k a n k e p a d a p e g a w a i ; d a n b . 1 0 % ( s e p u l u h p e r s e n ) d i a l o k a s i k a n u n t u k

k e p e n t i n g a n : 1 . P e m b i n a a n ; 2 . P e n g h a r g a a n ; 3 . k e g i a t a n s o s i a l ; d a n 4 . k e g i a t a n l a i n n y a y a n g t i d a k t e r a n g g a r k a n .

( 2 ) P e n e t u a n p e n g a l o k a s i a n p e m a n f a a t a n j a s a p e l a y a n a n s e b a g a i m a n a d i m a k s u d p a d a a y a t ( 1 ) h u r u f b d i t e t a p k a n d e n g a n K e p u t u s a n K e p a l a P u s k e s m a s s e l a k u P i m p i n a n B L U D .

P a s a l 6

( 1 ) J a s a p e l a y a n a n d i b e r i k a n k e p a d a p e g a w a i b e r d a s a r k a n : a . p e n i l a i a n k i n e r j a ; b . j e n i s k e t e n a g a a n ; d a n c . j a b a t a n d a l a m S t r u k t u r O r g a n i s a s i P u s k e s m a s

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( 2 ) T a t a c a r a p e r h i t u n g a n j a s a p e l a y a n a n s e b a g a i m a n a d i m a k s u d p a d a a y a t ( 1 ) , d i a t u r d a l a m l a m p i r a n I y a n g m e r u p a k a n b a g i a n t a k t e r p i s a h k a n d a r i P e r a t u r a n B u p a t i i n i

B A B I I I H A K D A N K E W A J I B A N

P a s a l 7

( 1 ) B L U D - U P T P u s k e s m a s b e r k e w a j i b a n : a . m e m b e n t u k d a n m e n e t a p k a n T i m P e n i l a i J a s a

P e l a y a n a n ; b . m e n g e l o l a p e n d a p a t a n j a s a p e l a y a n a n B L U D

P u s k e s m a s s e s u a i p e r a t u r a n y a n g b e r l a k u ; c . m e n e t a p k a n b e s a r a n j a s a p e l a y a n a n b e r d a s a r k a n h a s i l

r e k o n s i l i a s i d e n g a n D i n a s K e s e h a t a n ; d . m e n y u s u n d a n m e n e t a p k a n p e m b a g i a n j a s a

p e l a y a n a n u n t u k s e m u a p e g a w a i d i P u s k e s m a s d a n j a r i n g a n n y a ; d a n

e . m e n i n g k a t k a n m u t u p e l a y a n a n d a n p r o f e s i o n a l i s m e p e l a k s a n a p e l a y a n a n k e s e h a t a n .

( 2 ) B L U D - U P T P u s k e s m a s b e r h a k :

a . m e m p e r o l e h b i a y a o p e r a s i o n a l y a n g d i b u t u h k a n P u s k e s m a s d a n j a r i n g a n n y a ; d a n

b . m e m p e r o l e h j a s a p e l a y a n a n s e s u a i k e t e n t u a n y a n g b e r l a k u .

B A B I V M E K A N I S M E P E N I L A I A N D A N P E M B A Y A R A N

B a g i a n K e s a t u M e k a n i s m e P e n i l a i a n

P a s a l 8

( 1 ) P e g a w a i y a n g d i n i l a i m e n y a m p a i k a n l a p o r a n p e l a k s a n a a n t u g a s a t a u c a p a i a n k i n e r j a k e p a d a T i m P e n i l a i J a s a P e l a y a n a n .

( 2 ) P e n i l a i a n d i l a k s a n a k a n p a l i n g l a m b a t p a d a t a n g g a l 5 b u l a n b e r i k u t n y a , d e n g a n f o r m a t p e n i l a i a n s e b a g a i m a n a t e r c a n t u m d a l a m L a m p i r a n I I d a n m e r u p a k a n b a g i a n t i d a k t e r p i s a h k a n d a r i P e r a t u r a n B u p a t i i n i .

( 3 ) T i m P e n i l a i J a s a P e l a y a n a n m e n y a m p a i k a n h a s i l p e n i l a i a n k e p a d a K e p a l a D i n a s m e l a l u i K a s u b a g T U B L U D - U P T P u s k e s m a s .

B a g i a n K e d u a M e k a n i s m e P e m b a y a r a n

P a s a l 9

( 1 ) P e m b a y a r a n j a s a p e l a y a n a n d i l a k s a n a k a n p a d a b u l a n b e r i k u t n y a , s e s u a i d e n g a n p e r h i t u n g a n d a r i p e n d a p a t a n j a s a p e l a y a n a n p a d a b u l a n y a n g b e r s a n g k u t a n .

7

( 2 ) P e m b a y a r a n j a s a p e l a y a n a n s e b a g a i m a n a d i m a k s u d p a d a a y a t ( 1 ) d i l a k s a n a k a n s e t e l a h d i l a k u k a n r e k o n s i l i a s i d a t a r e a l i s a s i p e n d a p a t a n B L U D U P T P u s k e s m a s o l e h D i n a s d a n d i t u a n g k a n d a l a m B e r i t a A c a r a s e b a g a i m a n a t e r c a n t u m d a l a m l a m p i r a n I I I d a n m e r u p a k a n b a g i a n t i d a k t e r p i s a h k a n d a r i p e r a t u r a n b u p a t i i n i .

( 3 ) B L U D - U P T P u s k e s m a s m e n y u s u n d a f t a r n o m i n a t i f p e n e r i m a j a s a p e l a y a n a n d e n g a n f o r m a t s e b a g a i m a n a t e r c a n t u m d a l a m l a m p i r a n I V d a n m e r u p a k a n b a g i a n t i d a k t e r p i s a h k a n d a r i P e r a t u r a n B u p a t i i n i .

( 4 ) P e l a k s a n a a n p e r t a n g g u n g j a w a b a n p e m b a y a r a n j a s a p e l a y a n a n s e b a g a i m a n a d i m a k s u d p a d a a y a t ( 1 ) s a m p a i d e n g a n a y a t ( 3 ) s e s u a i k e t e n t u a n y a n g b e r l a k u .

B A B V

P E M A N T A U A N , E V A L U A S I D A N P E L A P O R A N P a s a l 1 0

D i n a s m e l a k u k a n p e m a n t a u a n d a n e v a l u a s i s e c a r a b e r k a l a t e r h a d a p p e l a k s a n a a n p e m a n f a a t a n j a s a p e l a y a n a n d i p u s k e s m a s .

P a s a l 1 1

P u s k e s m a s m e l a p o r k a n h a s i l p e l a k s a n a a n p e m a n f a a t a n j a s a p e l a y a n a n s e t i a p 3 ( t i g a ) b u l a n s e k a l i k e p a d a K e p a l a D i n a s

B A B V I K E T E N T U A N P E N U T U P

P a s a l 1 2

P a d a s a a t P e r a t u r a n B u p a t i i n i m u l a i b e r l a k u , P e r a t u r a n B u p a t i i n i , m a k a P e r a t u r a n B u p a t i B a n d u n g N o m o r 9 T a h u n 2 0 1 5 t e n t a n g P e t u n j u k T e k n i s P e n g g u n a a n J a s a P e l a y a n a n B a g i P e g a w a i P a d a U n i t P e l a k s a n a T e k n i s D i n a s P e l a y a n a n K e s e h a t a n Y a n g M e n e r a p k a n P o l a P e n g e l o l a a n K e u a n g a n B a d a n L a y a n a n U m u m D a e r a h D i K a b u p a t e n B a n d u n g ( B e r i t a D a e r a h K a b u p a t e n B a n d u n g T a h u n 2 0 1 5 N o m o r 9 ) , d i c a b u t d a n d i n y a t a k a n t i d a k b e r l a k u l a g i .

P a s a l 1 3

P e r a t u r a n B u p a t i i n i m u l a i b e r l a k u s e j a k t a n g g a l 2 J a n u a r i 2 0 1 9

8

A g a r s e t i a p o r a n g m e n g e t a h u i n y a , m e m e r i n t a h k a n p e n g u n d a n g a n P e r a t u r a n B u p a t i i n i d e n g a n p e n e m p a t a n n y a d a l a m B e r i t a D a e r a h K a b u p a t e n B a n d u n g .

D i t e t a p k a n d i S o r e a n g

D i u n d a n g k a n d i S o r e a n g p a d a t a n g g a l 2 6 A p r i l 2 0 1 9

B E R I T A D A E R A H K A B U P A T E N B A N D U N G T A H U N 2 0 1 9 N O M O R 2 3

9

P E N J E L A S A N A T A S

P E R A T U R A N B U P A T I B A N D U N G N O M O R 2 2 T A H U N 2 0 1 9

T E N T A N G P E T U N J U K T E K N I S P E N G G U N A A N J A S A P E L A Y A N A N B A G I P E G A W A I

P U S K E S M A S Y A N G M E N E R A P K A N P O L A P E N G E L O L A A N K E U A N G A N B A D A N L A Y A N A N U M U M D A E R A H D I K A B U P A T E N B A N D U N G

I . U M U M D a l a m r a n g k a m e n i n g k a t k a n l a y a n a n k e s e h a t a n y a n g l e b i h e f e k t i f ,

e f i s i e n , e k o n o m i s t r a n s p a r a n d a n b e r t a n g g u n g j a w a b d e n g a n m e m p e r h a t i k a n a s a s k e a d i l a n , k e p a t u h a n d a n m a n f a a t s e j a l a n d e n g a n p r a k t e k b i s n i s y a n g s e h a t , P e m e r i n t a h K a b u p a t e n B a n d u n g t e l a h m e n e t a p k a n 6 2 ( e n a m p u l u h d u a ) P u s a t K e s e h a t a n M a s y a r a k a t p a d a D i n a s K e s e h a t a n K a b u p a t e n B a n d u n g s e b a g a i U n i t P e l a k s a n a T e k n i s D a e r a h ( U P T D ) y a n g m e n e r a p k a n P o l a P e n g e l o l a a n K e u a n g a n B a d a n L a y a n a n U m u m D a e r a h ( P P K - B L U D ) .

B e r d a s a r k a n k e t e n t u a n P a s a l 3 a y a t ( 1 ) P e r a t u r a n M e n t e r i K e s e h a t a n R e p u b l i k I n d o n e s i a N o m o r 2 1 T a h u n 2 0 1 6 T e n t a n g P e n g g u n a a n D a n a K a p i t a s i J a m i n a n K e s e h a t a n N a s i o n a l U n t u k J a s a P e l a y a n a n K e s e h a t a n D a n D u k u n g a n B i a y a O p e r a s i o n a l P a d a F a s i l i t a s K e s e h a t a n T i n g k a t P e r t a m a M i l i k P e m e r i n t a h D a e r a h , D a n a K a p i t a s i y a n g d i t e r i m a o l e h F K T P d a r i B a d a n P e n y e l e n g g a r a J a m i n a n S o s i a l K e s e h a t a n d i m a n f a a t k a n s e l u r u h n y a u n t u k p e m b a y a r a n j a s a p e l a y a n a n k e s e h a t a n d a n d u k u n g a n b i a y a o p e r a s i o n a l p e l a y a n a n k e s e h a t a n

P e m b e n t u k a n p e r a t u r a n b u p a t i m e n g e n a i P e t u n j u k T e k n i s P e n g g u n a a n J a s a P e l a y a n a n B a g i P e g a w a i P u s k e s m a s Y a n g M e n e r a p k a n P o l a P e n g e l o l a a n K e u a n g a n B a d a n L a y a n a n U m u m D a e r a h D i K a b u p a t e n B a n d u n g d i h a r a p k a n d a p a t m e m b e r i k a n p e d o m a n d a l a m m e l a k s a n a k a n p e m b a g i a n j a s a p e l a y a n a n b a g i p e g a w a i P u s k e s m a s y a n g d i p e r o l e h d a r i p e n d a p a t a n B L U D P u s k e s m a s s e h i n g g a j a s a p e l a y a n a n m a m p u m e n i n g k a t k a n p r o f e s i o n a l i s m e p e l a k s a n a p e l a y a n a n k e s e h a t a n d i P u s k e s m a s , m e n i n g k a t k a n m u t u p e l a y a n a n k e s e h a t a n y a n g d i b e r i k a n o l e h p e l a k s a n a p e l a y a n a n d i P u s k e s m a s d a n j a r i n g a n n y a d a n m e n i n g k a t k a n k i n e r j a p e l a y a n a n k e s e h a t a n d i t i n g k a t P u s k e s m a s d a n j a r i n g a n n y a .

I I . P A S A L D E M I P A S A L P a s a l 1

C u k u p j e l a s . P a s a l 2



C u k u p j e l a s .

10

P a s a l 5 A y a t ( l )

H u r u f a C u k u p j e l a s .

H u r u f b A n g k a 1

Y a n g d i m a k s u d d e n g a n P e m b i n a a n a d a l a h p e m b i n a a n y a n g d i l a k u k a n o l e h P e m e r i n t a h D a e r a h , P e m e r i n t a h D a e r a h P r o v i n s i d a n P e m e r i n t a h P u s a t .

A n g k a 2 Y a n g d i m a k s u d d e n g a n P e n g h a r g a a n a d a l a h p e m b e r i a n a t a s p r e s t a s i y a n g d i c a p a i o l e h p e g a w a i p u s k e s m a s m e l a l u i t a h a p a n s e l e k s i .

A n g k a 3 Y a n g d i m a k s u d d e n g a n K e g i a t a n s o s i a l a d a l a h s e g a l a k e g i a t a n s o s i a l b a i k i n t e r n a l p u s k e s m a s m a u p u n k e g i a t a n s o s i a l y a n g d i l a k u k a n d i w i l a y a h k e r j a p u s k e s m a s m a u p u n K a b u p a t e n B a n d u n g .

A n g k a 4 Y a n g d i m a k s u d d e n g a n K e g i a t a n l a i n n y a y a n g t i d a k t e r a n g g a r k a n s e b a g a i m a n a d i m a k s u d d a l a m p a s a l 7 a y a t ( 2 ) a d a l a h s e g a l a k e g i a t a n y a n g t i d a k t e r a k o m o d i r d a l a m R B A B L U D P u s k e s m a s .

A y a t ( 2 ) C u k u p j e l a s .

P a s a l 6 C u k u p j e l a s .



P a s a l 9 C u k u p j e l a s

P a s a l 1 0 C u k u p j e l a s .




T A M B A H A N B E R I T A D A E R A H K A B U P A T E N B A N D U N G N O M O R 1 9

11

L A M P I R A N P E R A T U R A N B U P A T I B A N D U N G N O M O R 2 2 T A H U N 2 0 1 9 T E N T A N G P E T U N J U K T E K N I S P E N G G U N A A N J A S A P E L A Y A N A N B A G I P E G A W A I P U S K E S M A S Y A N G M E N E R A P K A N P O L A P E N G E L O L A A N K E U A N G A N B A D A N L A Y A N A N U M U M D A E R A H D I K A B U P A T E N B A N D U N G

LAMPIRAN I PERATURAN BUPATI BANDUNG NOMOR 22 TAHUN 2019 TENTANG PETUNJUK TEKNIS PENGGUNAAN JASA PELAYANAN BAGI PEGAWAI PUSKESMAS YANG MENERAPKAN POLA PENGELOLAAN KEUANGAN BADAN LAYANAN UMUM DAERAH DI KABUPATEN BANDUNG

TATA CARA PERHITUNGAN JASA PELAYANAN

A. Ketentuan Umum Pembayaran jasa pelayanan kesehatan pada tenaga kesehatan dan tenaga non kesehatan PNS di masing-masing Puskesmas ditetapkan dengan mempertimbangkan : a. Jenis ketenagaan dan/ atau jabatan b. Kinerja Pegawai c. Variabel Penambah d. Variabel Pengurang

Pembayaran jasa pelayanan kesehatan pada tenaga kesehatan dan tenaga non kesehatan Non PNS di masing-masing Puskesmas ditetapkan dengan mempertimbangkan : a. Jenis ketenagaan dan/ atau jabatan b. Kinerja Pegawai c. Variabel Penambah d. Variabel Pengurang e. Disiplin / Kehadiran

B. Perhitungan Ja sa Pelayanan Kesehatan Bagi Tenaga Kesehatan Dan Tenaga Non Kesehatan 1. V a r i a b e l P e m b a g i a n J a s p e l K e s e h a t a n

Jen i s Ketenagaan dan atau jabatan; masing-masing tenaga di puskesmas diberi nilai sebagai berikut:

NO PENDIDIKAN BOBOT TAMBAHAN POINT NON PNS

1 Tenaga Medis (dr/ drg) 150 50 2 Apoteker/ Perawat Ners 100 30 3 Tenaga Kesehatan (Min S I / D4) 80 20 4 S I Non kesehatan 60 15 5 Tenaga Kesehatan (D3) 60 15 6 Tenaga Non Kesehatan (D3) 50 10

7 Asisten Tenaga Kesehatan (SPK/ SMK KESEHATAN / D1 KESEHATAN) 50 10

8 Tenaga Non Kesehatan dibawah D3 (KCPK/SMU plus) 25 10

9 SMU 20 5 10 SMP atau yang lebih rendah 15 5

C a t a t a n : Gelar D3/S1 petugas Puskesmas harus sesuai dengan SK Kenaikan Pangkat terakhir yang

diakui oleh BKPSDM.

b. Kinerja / Produktivitas Pegawai Penilaian terhadap kinerja/produktivitas merupakan representasi output (hasil) kerja pegawai/petugas puskesmas. Variabel tersebut terdiri dari unsur- unsur yang merupakan tugas pokok uraian pekerjaan dari masing -masing SDM

NO KELOMPOK / JENIS SDM UNSUR VARIABEL

KINERJA / PRODUKTIVITAS NILAI TARGET BOBOT

I KELOMPOK P R O F E S I

J u m l a h p a s i e n d i l a y a n i ( d a l a m d a n l u a r g e d u n g ) t e r m a s u k p e n g i s i a n r e k a m m e d i s d a n / a t a u e n t r y d a t a k e d a l a m S I M P U S r a t a - r a t a p e r h a r i

J m l p a s i e n d i l a v a n i d i m 1 b i n

> 5 0 1 0


J m l p a s i e n d i l a v a n i d i m 1 b i n 4 1 - 5 0 8


J m l p a s i e n d i l a v a n i d i m 1 b i n 3 1 - 4 0 6 j u m l a h h a r i k e r j a 2 1 - 3 0 4 j u m l a h h a r i k e r j a

1 1 - 2 0 2 j u m l a h h a r i k e r j a

1 - 1 0 1 M e l a k u k a n r u j u k a n i n t e r n a l P u s k e s - m a s

r a t a - r a t a p e r h a r i ( k l i n i k s a n i t a s i , g i z i , 3 - > _ 5 o r g 3

P e n y a k i t M e n u l a r d a n P e n y a k i t T i d a k M e n u l a r , d a n l a i n - l a i n ) 1 - 2 o r g 1

> 5 k l 4 P e n y u l u h a n k e l o m p o k d i d a l a m / l u a r 4 - 5 k l 3

g e d u n g ( j u m l a h p e r b u l a n ) 2 - 3 k l 2 1 Ul i i

1 Dokter Umum 2 4 k l A 4 Dokter Umum

R e f l e k s i D i s k u s i K a s u s ( j u m l a h p e r 3 k l 3

b u l a n ) 2 k l 2 b u l a n ) l k l 1

> 4 k a l i 4 J u m l a h k u n j u n g a n r u m a h / h o m e 3 k a l i 3

v i s i t e ( j u m l a h p e r b u l a n ) 2 k a l i 2

1 k a l i 1 c a t a t a n : 1 k a l i k u n j u n g a n u n t u k 4 r u m a h

> = 5 k l 5

M e l a k u k a n t i n d a k a n U G D / m e n o l o n g p e r s a l i n a n ( j u m l a h p e r b u l a n )

4 k l 4 M e l a k u k a n t i n d a k a n U G D / m e n o l o n g

p e r s a l i n a n ( j u m l a h p e r b u l a n ) 3 k l 3

M e l a k u k a n t i n d a k a n U G D / m e n o l o n g p e r s a l i n a n ( j u m l a h p e r b u l a n )

2 k l 2

1 k l 1 M e l a k u k a n j a g a m a l a m d i U G D / D T P /

P O N E D ( j u m l a h p e r b u l a n ) s e t i a p k a l i j a g a 2

M e l a k u k a n j a g a s o r e d i U G D / D T P / P O N E D ( j u m l a h p e r b u l a n ) s e t i a p k a l i j a g a 1

K e t e r a n g a n : U n t u k v i s i t e p a s i e n r a w a t i n a p , 1 o r g p a s i e n s e b a n d i n g d e n g a n 5 o r g p a s i e n r a w a t j a l a n

j u m i a n p a s i e n a i i a y a n i ( a a i a m o a n m a r g e d u n g , b u k a n t i n d a k a n ) r a t a - r a t a p e r h a r i t e r m a s u k p e n g i s i a n r e k a m m e d i s d a n A T A U E N T R Y S I M P U S

> 2 0 1 0 j u m i a n p a s i e n a i i a y a n i ( a a i a m o a n m a r g e d u n g , b u k a n t i n d a k a n ) r a t a - r a t a p e r h a r i t e r m a s u k p e n g i s i a n r e k a m m e d i s d a n A T A U E N T R Y S I M P U S

1 5 - 1 9 8

j u m i a n p a s i e n a i i a y a n i ( a a i a m o a n m a r g e d u n g , b u k a n t i n d a k a n ) r a t a - r a t a p e r h a r i t e r m a s u k p e n g i s i a n r e k a m m e d i s d a n A T A U E N T R Y S I M P U S 1 0 - 1 4 6

J m l p a s i e n d i l a v a n i d i m 1 b i n 5 - 9 4 j u m l a h h a r i k e r j a 1 - 4 2

> 5 k l 4 P e n y u l u h a n k e l o m p o k d i d a l a m / l u a r 4 - 5 k l 3

g e d u n g ( j u m l a h p e r b u l a n ) 2 - 3 k l 1 1 k l 1

X R e f l e k s i D i s k u s i K a s u s ( j u m l a h > 4 k l 4

Dokter Gigi p e r b u l a n ) 1 - 3 k l 2

2 Dokter Gigi J u m l a h frekuensi p e m b i n a a n U K G M D

d a n U K G S ( J u m l a h p e r b u l a n )

> _ 4 k a l i 4 J u m l a h frekuensi p e m b i n a a n U K G M D

d a n U K G S ( J u m l a h p e r b u l a n ) 3 k a l i O o

J u m l a h frekuensi p e m b i n a a n U K G M D d a n U K G S ( J u m l a h p e r b u l a n )

1 - 2 k a l i 2

M e l a k u k a n t i n d a k a n e k s t r a k s i / > 1 0 k a l i 4 t u m p a t a n t e t a p ( r a t a - r a t a p e r h a r i ) 5 - 9 k a l i 3


j u m l a h h a r i k e r j a

1 - 4 k a l i 1

M e l a k u k a n t i n d a k a n s c a l l i n g ( j u m l a h p e r b u l a n )

> 1 0 k a l i 4 M e l a k u k a n t i n d a k a n s c a l l i n g

( j u m l a h p e r b u l a n ) 5 - 9 k a l i 3

M e l a k u k a n t i n d a k a n s c a l l i n g ( j u m l a h p e r b u l a n )

1 - 4 k a l i 1

J u m l a h p a s i e n y a n g d i b e r i k a n A s u h a n K e p e r a w a t a n r a t a - r a t a p e r h a r i

> 5 0 1 0 J u m l a h p a s i e n y a n g d i b e r i k a n A s u h a n

K e p e r a w a t a n r a t a - r a t a p e r h a r i 4 1 - 5 0 8

J u m l a h p a s i e n y a n g d i b e r i k a n A s u h a n K e p e r a w a t a n r a t a - r a t a p e r h a r i

3 1 - 4 0 6

J m l p a s i e n d i b e r i k a n A s k e p d i m 1 b i n 2 1 - 3 0 4

j u m l a h h a r i k e r j a 1 1 - 2 0 2

1 - 1 0 1

> 5 k a l i 6

5 k a l i 5

J u m l a h k u n j u n g a n r u m a h ( h o m e 4 k a l i 4

v i s i t e ) j u m l a h p e r b u l a n 3 k a l i 3

2 k a l i 2

1 k a l i 1

3 Perawat, Ners c a t a t a n : 1 k a l i k u n j u n g a n u n t u k 4 r u m a h Perawat, Ners > 7 k l 8

P e n y u l u h a n k e l o m p o k d i d a l a m / l u a r 5 - 6 k l 6 g e d u n g ( j u m l a h p e r b u l a n ) 3 - 4 k l 4

1 - 2 k l 2 > 5 k a s u s 6

R e f l e k s i D i s k u s i K a s u s ( j u m l a h p e r b u l a n )

4 k a s u s 4 R e f l e k s i D i s k u s i K a s u s ( j u m l a h p e r

b u l a n ) 3 k a s u s 3

R e f l e k s i D i s k u s i K a s u s ( j u m l a h p e r b u l a n )

2 k a s u s 2 1 k a s u s 1

M e l a k u k a n j a g a m a l a m d i U G D / D T P / P O N E D ( j u m l a h p e r b u l a n ) s e t i a p k a l i j a g a 2


4. Apoteker

J u m l a h p e l a k s a n a a n D i s p e n s i n g p a d a p a s i e n ( R a t a - r a t a l e m b a r R e s e p / h a r i )

> 7 9 1 0

4. Apoteker


6 0 - 7 9 8

4. Apoteker

J u m l a h p e l a k s a n a a n D i s p e n s i n g p a d a p a s i e n ( R a t a - r a t a l e m b a r R e s e p / h a r i ) 4 0 - 5 9 6

4. Apoteker


2 0 - 3 9 4

4. Apoteker


< 2 0 2

4. Apoteker

P e m b e r i a n p e l a y a n a n f a r m a s i k l i m s : k o n s e l i n g p a d a p a s i e n d a n f a r m a s i k h u s u s [ H o m e c a r e ; S w a m e d i k a s i ;

A m b u l a t o r y S e r v i c e ; R e m o t e S e r v i c e ; P e l a y a n a n P a l i a t i i ] ( J u m l a h p e r b u l a n )

> 6 k a l i 6

4. Apoteker



5 k a l i 5

4. Apoteker



4 k a l i 4

4. Apoteker



3 k a l i 3

4. Apoteker


A m b u l a t o r y S e r v i c e ; R e m o t e S e r v i c e ; P e l a y a n a n P a l i a t i i ] ( J u m l a h p e r b u l a n ) 2 k a l i 2

4. Apoteker



1 k a l i 1

4. Apoteker P e n y u l u h a n p e n y e b a r a n i n f o r m a s i k e l o m p o k d a n a t a u p e n g a h d i a n

m a s y a r a k a t d i d a l a m / l u a r g e d u n g ( P e r B u l a n )

5 k a l i 5 4. Apoteker P e n y u l u h a n p e n y e b a r a n i n f o r m a s i k e l o m p o k d a n a t a u p e n g a h d i a n


4 k a l i 4 4. Apoteker P e n y u l u h a n p e n y e b a r a n i n f o r m a s i

k e l o m p o k d a n a t a u p e n g a h d i a n m a s y a r a k a t d i d a l a m / l u a r g e d u n g ( P e r

B u l a n )

3 k a l i 3


m a s y a r a k a t d i d a l a m / l u a r g e d u n g ( P e r B u l a n ) 2 k a l i 2



1 k a l i 1

4. Apoteker

K o n s u l a s i d a n P e n y e b a r l u a s a n i n f o r m a s i d e n g a n p e t u g a s k e s e h a t a n ( P e r B u l a n )

> 4 k a l i 4

4. Apoteker

K o n s u l a s i d a n P e n y e b a r l u a s a n i n f o r m a s i d e n g a n p e t u g a s k e s e h a t a n ( P e r B u l a n ) i - o K a u z

4. Apoteker

P e n c a t a t a n d a n p e l a p o r a n k e g i a t a n p e n g e l o l a a n p e r b e k a l a n k e f a r m a s i a n

— 1

> 5 l a p 5

4. Apoteker


3 - 4 l a p 4

4. Apoteker

P e n c a t a t a n d a n p e l a p o r a n k e g i a t a n p e n g e l o l a a n p e r b e k a l a n k e f a r m a s i a n 2 l a p 3

4. Apoteker


1 l a p 2

I I KELOMPOK TENAGA KEPERAWATAN

1 Perawat (D3, SPK)

J u m l a h p a s i e n d i l a v a n i ( d a l a m d a n l u a r g e d u n g ) t e r m a s u k e n t r y d a t a k e d a l a m S I M P U S r a t a - r a t a p e r h a r i



> 5 0 1 0

1 Perawat (D3, SPK)




4 1 - 5 0 8

1 Perawat (D3, SPK)




3 1 - 4 0 6

1 Perawat (D3, SPK)




2 1 - 3 0 4

1 Perawat (D3, SPK)




1 1 - 2 0 2

1 Perawat (D3, SPK)



j u m l a h h a r i k e r j a 1 - 1 0 1

1 Perawat (D3, SPK)

J u m l a h p a s i e n d i b e r i k a n A s u h a n K e p e r a w a t a n I n d i v i d u r a t a - r a t a p e r h a r i .

> 1 0 4

1 Perawat (D3, SPK)


7 - 1 0 3

1 Perawat (D3, SPK)

J u m l a h p a s i e n d i b e r i k a n A s u h a n K e p e r a w a t a n I n d i v i d u r a t a - r a t a p e r h a r i . 4 - 6 2

1 Perawat (D3, SPK)


1 - 3 1

1 Perawat (D3, SPK)

J u m l a h k u n j u n g a n r u m a h / h o m e v i s i t ( A s k e p K e l u a r g a ) j u m l a h p e r b u l a n

5 k a l i 5

1 Perawat (D3, SPK)


4 k a l i 4

1 Perawat (D3, SPK)


3 k a l i 3

1 Perawat (D3, SPK)


2 k a l i 2 1 Perawat (D3, SPK)


1 k l 1 1 Perawat (D3, SPK)

c a t a t a n : 1 k a l i k u n j u n g a n u n t u k 4 r u m a h

1 Perawat (D3, SPK)

P e n y u l u h a n K e l o m p o k d i d a l a m / l u a r g e d u n g ( A s k e p K e l p ) p e r b u l a n

> 6 k a l i 6

1 Perawat (D3, SPK)


5 - 6 k a l i 5

1 Perawat (D3, SPK)

P e n y u l u h a n K e l o m p o k d i d a l a m / l u a r g e d u n g ( A s k e p K e l p ) p e r b u l a n 3 - 4 k a l i 3

1 Perawat (D3, SPK)


1 - 2 k a l i 1

1 Perawat (D3, SPK)

J u m l a h t i n d a k a n d i U G D s e l a m a 1 b u l a n

> 1 5 5

1 Perawat (D3, SPK)


1 1 s / d 1 5 4

1 Perawat (D3, SPK)

J u m l a h t i n d a k a n d i U G D s e l a m a 1 b u l a n 5 s / d 1 0 3

1 Perawat (D3, SPK)


1 s / d 5 1

1 Perawat (D3, SPK)

M e l a k u k a n j a g a m a l a m d i U G D / D T P / P O N E D ( j u m l a h p e r b u l a n ) s e t i a p k a l i j a g a 2

1 Perawat (D3, SPK)


2 Pe rawat gigi

J u m l a h p a s i e n d i l a y a n i ( d a l a m d a n l u a r g e d u n g , b u k a n t i n d a k a n ) r a t a - r a t a p e r

h a r i ( u n t u k p e l a y a n a n t e r t e n t u ) D A N A T A U E N T R Y S I M P U S

J m l n a s i e n d i l a v a n i d i m 1 b i n j u m l a h h a r i k e r j a

> 2 0 1 0

2 Pe rawat gigi




1 5 - 1 9 8

2 Pe rawat gigi




1 0 - 1 4 6

2 Pe rawat gigi




5 - 9 4

2 Pe rawat gigi



J m l n a s i e n d i l a v a n i d i m 1 b i n j u m l a h h a r i k e r j a 1 - 4 2

2 Pe rawat gigi

P e n y u l u h a n k e l o m p o k d i d a l a m / l u a r g e d u n g p e r b u l a n

> 4 k a l i 4

2 Pe rawat gigi


3 k a l i 3

2 Pe rawat gigi

P e n y u l u h a n k e l o m p o k d i d a l a m / l u a r g e d u n g p e r b u l a n 2 k a l i 2

2 Pe rawat gigi


1 k a l i 1

2 Pe rawat gigi

P e l a y a n a n a s u h a n k e s e h a t a n g i g i d a n m u l u t d i s e k o l a h ( U K G S ) p e r b u l a n

> 4 s k l h 4

2 Pe rawat gigi


3 s k l h 3

2 Pe rawat gigi

P e l a y a n a n a s u h a n k e s e h a t a n g i g i d a n m u l u t d i s e k o l a h ( U K G S ) p e r b u l a n 2 s k l h 2

2 Pe rawat gigi


1 s k l h 1 2 Pe rawat gigi

P e l a y a n a n a s u h a n k e s e h a t a n g i g i d a n m u l u t d i m a s y a r a - k a t / p o s y a n d u

( U K G M D ) p e r b u l a n

2 4 P o s y 4 2 Pe rawat gigi



3 p o s y 3

2 Pe rawat gigi


( U K G M D ) p e r b u l a n 2 p o s y 2

2 Pe rawat gigi



1 p o s y 1

2 Pe rawat gigi

M e m b a n t u m e l a k u k a n t i n d a k a n e k s - > 1 0 k a l i 4

hari) Jml pasien dilavani dim 1 bin

jumlah hari kerja

o - y Kan 2 hari) Jml pasien dilavani dim 1 bin

jumlah hari kerja 1 - 4 kali 1

Membantu melakukan tindakan scalling i i i m l f l n TTPT H i i l f l n

> 10 kl 4 Membantu melakukan tindakan scalling

i i i m l f l n TTPT H i i l f l n 5 - 9 k l 2 Membantu melakukan tindakan scalling

i i i m l f l n TTPT H i i l f l n

1 - 4 kl 1

3 Bidan

Jumlah pasien dilayani (dalam dan luar gedung) termasuk pengisian rekam medis DAN ATAU ENTRY SIMPUS. (ANC, PNC,

KB, BBL, Imunisasi, MTBS, SDIDTK) rata-rata per hari

> 15 org 6

3 Bidan

Jumlah pasien dilayani (dalam dan luar gedung) termasuk pengisian rekam medis DAN ATAU ENTRY SIMPUS. (ANC, PNC,

KB, BBL, Imunisasi, MTBS, SDIDTK) rata-rata per hari iu - io org C

D

3 Bidan

Jml pasien dilavani dim 1 bin jumlah hari kerja

; — n 5 - 9 org

A •T

3 Bidan

Jml pasien dilavani dim 1 bin jumlah hari kerja 1-4 org o o

3 Bidan

Jumlah pertolongan persalinan di Puskesmas (jumlah per bulan)

> 5 bulin Q o

3 Bidan

Jumlah pertolongan persalinan di Puskesmas (jumlah per bulan) o — o D u n n O

3 Bidan

Jumlah pertolongan persalinan di Puskesmas (jumlah per bulan)

1 9 V m l i n i - z D u n n

A •f

3 Bidan

Penyuluhan kelompok di dalam/luar gedung (jumlah per bulan)

> 6 k a l i A O

3 Bidan


o - o K a i l c O

3 Bidan

Penyuluhan kelompok di dalam/luar gedung (jumlah per bulan) ^ A I ro l i

o - *+ K a i l o o

3 Bidan


L - z K A N 1 1 3 Bidan

Jumlah pasien diberikan Asuhan Kebidanan (Askeb) Individu (rata-rata per

hari)

*> I n -* i u e D

3 Bidan


hari)

7 i n / — iu A

3 Bidan


hari) T O O O

3 Bidan


hari) 1 9 1 - o z

3 Bidan

Jumlah kunjungan rumah/home visite (Askeb) jumlah per bulan

^_ o K A I I c o

3 Bidan


A I ro l i • ? K A I I

A

3 Bidan

Jumlah kunjungan rumah/home visite (Askeb) jumlah per bulan o K a n o O

3 Bidan


2 kali 2

3 Bidan


1 kali 1

3 Bidan

Melakukan jaga malam di UGD / DTP / PONED (jumlah per bulan) setiap kali jaga 2

3 Bidan

Melakukan jaga sore di UGD / DTP / PONED (jumlah per bulan) setiap kali jaga 1

3 Bidan

catatan : 1 kali kunjungan untuk 4 rumah

4 Bidan Desa

Jumlah pasien dilayani (dalam dan luar gedung) termasuk pengisian rekam

medis. (ANC, PNC, KB, BBL, Imunisasi, MTBS, SDIDTK) rata-rata per hari


> 15 org 4

4 Bidan Desa




10 - 15 org 3

4 Bidan Desa




5 - 9 org 2

4 Bidan Desa



Jml pasien dilavani dim 1 bin jumlah hari kerja 1 -4 org 1

4 Bidan Desa


hari)

> 10 5

4 Bidan Desa


hari) 7 - 1 0 4

4 Bidan Desa


hari) 4 - 6 3

4 Bidan Desa


hari) 1 - 3 2

4 Bidan Desa

Jumlah pertolongan persalinan per bulan di Faskes pemerintah selama jam kerja

(Puskesmas/ Polindes/ Poskesdes)

> 5 bulin 8

4 Bidan Desa


(Puskesmas/ Polindes/ Poskesdes) 3 - 4 bulin 6

4 Bidan Desa


(Puskesmas/ Polindes/ Poskesdes) 2 bulin 4

4 Bidan Desa


(Puskesmas/ Polindes/ Poskesdes) 1 bulin 2

4 Bidan Desa Melaksanakan Kelas Ibu Hamil dan atau

Kelas Ibu Balita per bulan

75-100% posy 6 4 Bidan Desa Melaksanakan Kelas Ibu Hamil dan atau

Kelas Ibu Balita per bulan 50-74% posy 4 4 Bidan Desa

Melaksanakan Kelas Ibu Hamil dan atau Kelas Ibu Balita per bulan

10-50% posy 2

4 Bidan Desa

Jumlah penyuluhan Kelompok di dalam dan di luar gedung (jumlah per bulan)

> 4 kali 4

4 Bidan Desa


3 kali 3

4 Bidan Desa

Jumlah penyuluhan Kelompok di dalam dan di luar gedung (jumlah per bulan) 2 kali 2

4 Bidan Desa


1 kali 1

4 Bidan Desa

Jumlah kunjungan rumah/home visit (Askeb) jumlah per bulan

> 4 kali 3

4 Bidan Desa

Jumlah kunjungan rumah/home visit (Askeb) jumlah per bulan 3 - 4 kali 2

4 Bidan Desa

Jumlah kunjungan rumah/home visit (Askeb) jumlah per bulan

1 - 2 kali 1

4 Bidan Desa

Melakukan jaga malam di UGD / DTP / PONED (jumlah per bulan) setiap kali jaga o z

4 Bidan Desa

Melakukan jaga sore di UGD / DTP / PONED (jumlah per bulan) setiap kali jaga 1

4 Bidan Desa

catatan : 1 kali kunjungan untuk 4 rumah

HI KELOMPOK TENAGA KESEHATAN LAINNYA

1 Asisten Apoteker / Pengelola Obat

J u m l a h p e l a k s a n a a n D i s p e n s i n g p a d a p a s i e n ( R a t a - r a t a l e m b a r r e s e p / h a r i )

> 7 9 1 0



6 0 - 7 9 8


J u m l a h p e l a k s a n a a n D i s p e n s i n g p a d a p a s i e n ( R a t a - r a t a l e m b a r r e s e p / h a r i ) 4 0 - 5 9 6



2 0 - 3 9 4


J u m l a h p a s i e n d i b e r i k a n i n f o r m a s i o b a t

> 1 0 8



/ - y O


J u m l a h p a s i e n d i b e r i k a n i n f o r m a s i o b a t 4 - ft i u 4 i



1 - 3 2

1 Asisten Apoteker / Pengelola Obat P e n y u l u h a n p e n y e b a r l u a s a n i n f o r m a s i

k e s e h a t a n d a n a t a u p e n g a b d i a n m a s y a r a k a t d i d a l a m / l u a r g e d u n g ( P e r

B u l a n )

5 k a l i 6 1 Asisten Apoteker / Pengelola Obat P e n y u l u h a n p e n y e b a r l u a s a n i n f o r m a s i


B u l a n )

4 k a l i 4 1 Asisten Apoteker /

Pengelola Obat P e n y u l u h a n p e n y e b a r l u a s a n i n f o r m a s i k e s e h a t a n d a n a t a u p e n g a b d i a n


3 k a l i 3



B u l a n ) 2 k a l i 2



B u l a n ) 1 k a l i 1



> 5 l a p 6



3 - 4 l a p 4


P e n c a t a t a n d a n p e l a p o r a n k e g i a t a n p e n g e l o l a a n p e r b e k a l a n k e f a r m a s i a n 2 l a p 3



I l a p 2

2 Sanitarian

J u m l a h p a s i e n d i l a y a n i d i K l i n i k s a n i t a s i ( j u m l a h p e r b u l a n )

> 5 0 k u n j 1 0

2 Sanitarian


3 0 - 4 0 k u n j 8

2 Sanitarian


2 0 - 2 9 k u n j 6

2 Sanitarian


1 0 - 1 9 k u n j 4

2 Sanitarian


1 - 9 k u n j 2

2 Sanitarian

J u m l a h I S u n t u k T T U , T P M , I n d u s t r i p e r b u l a n

> 1 5 k u n j 5

2 Sanitarian


1 0 - 1 5 k u n j 3

2 Sanitarian


1 - 9 k u n j 2

2 Sanitarian J u m l a h r u m a h y a n g d i - I S ( j u m l a h p e r

b u l a n )

> 5 0 r m h 1 0 2 Sanitarian J u m l a h r u m a h y a n g d i - I S ( j u m l a h p e r

b u l a n ) 4 0 - 4 9 r m h 7


b u l a n ) 3 0 - 3 9 r m h 5


b u l a n )

2 0 - 2 9 r m h 3

2 Sanitarian

J u m l a h p e n y u l u h a n k e l o m p o k d i d a l a m d a n d i l u a r g e d u n g ( j u m l a h

p e r b u l a n )

> 5 k a l i 5

2 Sanitarian


p e r b u l a n )

4 k a l i 4

2 Sanitarian


p e r b u l a n ) 3 k a l i 3

2 Sanitarian


p e r b u l a n ) 2 k a l i 2

2 Sanitarian


p e r b u l a n )

1 k a l i 1

3 Analis Kesehatan

J u m l a h p e m e r i k s a a n s p e s i m e n l a b u m u m ( j u m l a h p e r b u l a n )

> 5 0 1 0

3 Analis Kesehatan


3 1 - 5 0 8

3 Analis Kesehatan


2 1 - 3 0 6

3 Analis Kesehatan


1 1 - 2 0 4

3 Analis Kesehatan


1 - 1 0 2

3 Analis Kesehatan

J u m l a h p e n g a m b i l a n s p e s i m e n l a b ( j u m l a h p e r b u l a n )

> 2 5 6

3 Analis Kesehatan


1 1 - 2 5 4

3 Analis Kesehatan


1 - 1 0 2

3 Analis Kesehatan

P e m e l i h a r a a n a l a t d a n s a r a n a p r a s a r a n a

A d a d a f t a r c e k l i s t p e m e r i k s a a n a l a t d a n d i i s i

l e n g k a p 5

3 Analis Kesehatan


A d a d a f t a r c e k l i s t p e m e r i k s a a n a l a t d a n

t i d a k d i i s i l e n g k a p 2 3 Analis Kesehatan


T i d a k a d a 0

3 Analis Kesehatan

P e m b u a t a n r e n c a n a k e r j a d a n l a p o r a n ( h a r i a n , b u l a n a n d a n t a h u n a n ) .

L e n g k a p & t e p a t w a k t u 5

3 Analis Kesehatan


L e n g k a p , t i d a k t e p a t w a k t u 2

3 Analis Kesehatan


T i d a k l e n g k a p d a n a t a u t d k t e p a t w a k t u

0

3 Analis Kesehatan

F r e k u e n s i p e l a y a n a n d i l u a r g e d u n g ( j u m l a h p e r b u l a n )

2 4 k a l i 4

3 Analis Kesehatan


3 k a l i 3

3 Analis Kesehatan

F r e k u e n s i p e l a y a n a n d i l u a r g e d u n g ( j u m l a h p e r b u l a n ) 2 k a l i 2

3 Analis Kesehatan


1 k a l i 1

J u m l a h P e n y u l u h a n d a l a m G e d u n g

8 k a l i 5


5 - 7 k a l i 3

J u m l a h P e n y u l u h a n d a l a m G e d u n g 3 - 6 k a l i 2 J u m l a h P e n y u l u h a n d a l a m G e d u n g

1 - 2 k a l i 1


0 0

> 1 0 k a l i 4

7 O 1M»1> t - y K a n

7 J

J u m l a h P e n y u l u h a n L u a r G e d u n g J - O K a l i 2

1 - 2 K a l i i 1

( J U

> 2 0 K a l i 5

1 5 - 1 9 k a l i 7 3

K 1 P / K 1 1 1/1 1 I t 1 1 - 1 4 k a l i 2

5 - 1 0 k a l i I 1 - 4 k a l i o

K u n j u n g a n r u m a h 1 k a l i k u n j u n g a n > 1 0 k a l i 2

u n t u k 4 r u m a h I U K a i l i i •a V J

4 Tenaga Penyuluh / Promkes P e m b u a t a n M e d i a I n f o r m a s i ^ 4 z Tenaga Penyuluh / Promkes P e m b u a t a n M e d i a I n f o r m a s i 1 - 2 1

0 0

M e l a k s a n a k a n K e g i a t a n P H B S m u l a i d a r i D i b u a t d a n d i l a k s a n a k a n 5

p e n d a t a a n , a n a l i s i s s i t u a s i , p e n e n t u a n m a s a l a h , p e n e n t u a n k e g i a t a n , i n t e r v e n s i

D i b u a t T i d a k d i l a k s a n a k a n

3

d a n e v a l u a s i T i d a k D i l a k s a n a k a n 0

M e l a k s a n a k a n K e g i a t a n D e s a S i a g a S e s u a i d e n g a n 8 i n d i k a t o r d e s a s i a g a

M e l a k s a n a k a n p e m b i n a a n s e l u r u h i n d i k a t o r

3

M e l a k s a n a k a n K e g i a t a n D e s a S i a g a S e s u a i d e n g a n 8 i n d i k a t o r d e s a s i a g a M e l a k s a n a k a n 4 i n d i k a t o r 2

T i d a k m e l a k s a n a k a n 0

» K 1 1 A J A * A J 1 .

M e l a k s a n a k a n a d v o k a s i k e p a d a p e m b u a t k e b i j a k a n d i w i l a y a h k e r j a p u s k e s m a s

AHa r i p i C i l I T , p n

d i l a k s a n a k a n 0 » K 1 1 A J A * A J 1 .

M e l a k s a n a k a n a d v o k a s i k e p a d a p e m b u a t k e b i j a k a n d i w i l a y a h k e r j a p u s k e s m a s

A d a D o k u m e n t i d a k d i l a k s a n a k a n

u

T i d a k D i l a k s a n a k a n 0

P e m b i n a a n U K B M ( p o s y a n d u , p o s y a n d u r e m a j a , p o s k e s t r e n , S B H ,

P o s b i n d u , P o s k e s d e s , d l l )

> 1 0 3 P e m b i n a a n U K B M ( p o s y a n d u ,

p o s y a n d u r e m a j a , p o s k e s t r e n , S B H , P o s b i n d u , P o s k e s d e s , d l l )

5 - 1 0 2 P e m b i n a a n U K B M ( p o s y a n d u ,

p o s y a n d u r e m a j a , p o s k e s t r e n , S B H , P o s b i n d u , P o s k e s d e s , d l l )

1 - 5 1

P e m b i n a a n U K B M ( p o s y a n d u , p o s y a n d u r e m a j a , p o s k e s t r e n , S B H ,

P o s b i n d u , P o s k e s d e s , d l l ) 0 0

T> O H I n i n i a o

J u m l a h p a s i e n y a n g d i l a y a n i ( k o n s e l i n g ) 1 o _ 1 Q l n ] n j A U

d i K l i n i k G i z i ( j u m l a h p e r b u l a n ) 7 — 1 9 I m n i / — I Z x v U I l J 4 7

A I n 1 n i i - D K U I I J 9 z

-> OA I n i n i Z\J K U I I J a o

A s u h a n g i z i p a d a b a l i t a g i z i b u r u k / g i z i 1 o i n l n m i l O iX7 KU . I1J A VJ

k u r a n g / b u m i l K E K ( j u m l a h p e r b u l a n ) 7 — 1 9 I n i n i / — LZ K U X I J 4 7

1 - o K u n j 9 z

^ i o p y u a o M e l a k u k a n p e m a n t a u a n d a n p e m b i n a a n

p e l a y a n a n g i z i d i p o s y a n d u ( j u m l a h p e r b u l a n )

Q 1 9 rwml v - i z p y c i

A o

5 Nutrisionis/ Petugas Gizi

M e l a k u k a n p e m a n t a u a n d a n p e m b i n a a n p e l a y a n a n g i z i d i p o s y a n d u ( j u m l a h

p e r b u l a n ) 5 - 8 p y d 4

M e l a k u k a n p e m a n t a u a n d a n p e m b i n a a n p e l a y a n a n g i z i d i p o s y a n d u ( j u m l a h

p e r b u l a n )

1 - 4 p y d 2

M e m b u a t d a f t a r m e n u , m e l a k u k a n T l p m h i t i f l f l T i fXnn t i P F t a T m p i i n p i f i w f i Y i U v U l l / U l u u l l , U u l l U V l U U l C C U l l K I Q n Q U

t e r h a d a p k e g i a t a n d a p u r d i P u s k e s m a s D T P / P O N E D

D i b u a t d a n d i l a k s a n a k a n o M e m b u a t d a f t a r m e n u , m e l a k u k a n T l p m h i t i f l f l T i fXnn t i P F t a T m p i i n p i f i w f i Y i U v U l l / U l u u l l , U u l l U V l U U l C C U l l K I Q n Q U

t e r h a d a p k e g i a t a n d a p u r d i P u s k e s m a s D T P / P O N E D

D i b u a t , t i d a k d i l a k s a n a k a n

3

M e m b u a t d a f t a r m e n u , m e l a k u k a n T l p m h i t i f l f l T i fXnn t i P F t a T m p i i n p i f i w f i Y i U v U l l / U l u u l l , U u l l U V l U U l C C U l l K I Q n Q U

t e r h a d a p k e g i a t a n d a p u r d i P u s k e s m a s D T P / P O N E D T i d a k d i b u a t 0

> 6 k l 6

P . I n i l i l l i l i m . i \r 1 , \ i~w r \ , 1 i ^ o t a m . 1 „ , 1 , r C I l y U IU I l c l I 1 K.C l U I I i p U K U l U G U U I I I U d l l U l l l i a t " f i p n i i n i r l i i i i Y i l o h r i p . l u d j g c u u n g y u i u i c t i i p e l

b u l a n )

5 k a l i 5 P . I n i l i l l i l i m . i \r 1 , \ i~w r \ , 1 i ^ o t a m . 1 „ , 1 , r C I l y U IU I l c l I 1 K.C l U I I i p U K U l U G U U I I I U d l l U l l l i a t " f i p n i i n i r l i i i i Y i l o h r i p . l u d j g c u u n g y u i u i c t i i p e l

b u l a n )

4 k a l i 4 P . I n i l i l l i l i m . i \r 1 , \ i~w r \ , 1 i ^ o t a m . 1 „ , 1 , r C I l y U IU I l c l I 1 K.C l U I I i p U K U l U G U U I I I U d l l U l

l l i a t " f i p n i i n i r l i i i i Y i l o h r i p . l u d j g c u u n g y u i u i c t i i p e l

b u l a n ) T I r a l i 7 O

P . I n i l i l l i l i m . i \r 1 , \ i~w r \ , 1 i ^ o t a m . 1 „ , 1 , r C I l y U IU I l c l I 1 K.C l U I I i p U K U l U G U U I I I U d l l U l l l i a t " f i p n i i n i r l i i i i Y i l o h r i p . l u d j g c u u n g y u i u i c t i i p e l

b u l a n ) 2 k a l i 2

1 k a l i 1

M e m b u a t R e n c a n a K e r j a B u l a n a n ( B e n c a n a , K L B / W a b a h P D 3 I , K e r a - c u n a n

p a n g a n , P e n y e l e n g g a r a a n H a j i )

A d a 1 M e m b u a t R e n c a n a K e r j a B u l a n a n ( B e n c a n a , K L B / W a b a h P D 3 I , K e r a - c u n a n

p a n g a n , P e n y e l e n g g a r a a n H a j i ) T i d a k A d a 0

M e m b u a t S O P ( B e n c a n a , K L B / W a b a h P D 3 I , K e r a c u n a n p a n g a n ,

P e n y e l e n g g a r a a n H a j i )

A d a 1 M e m b u a t S O P ( B e n c a n a , K L B / W a b a h P D 3 I , K e r a c u n a n p a n g a n ,

P e n y e l e n g g a r a a n H a j i ) T i d a k A d a 0

M e l a k s a n a k a n P e n y e l i d i k a n E p i d e - m i o l o g i s e r t a m e m b u a t l a p o r a n s e t i a p k e j a d i a n

p e n i n g k a t a n k a s u s / K L B / w a b a h p e n y a k i t

A d a 2 M e l a k s a n a k a n P e n y e l i d i k a n E p i d e - m i o l o g i s e r t a m e m b u a t l a p o r a n s e t i a p k e j a d i a n

p e n i n g k a t a n k a s u s / K L B / w a b a h p e n y a k i t T i d a k A d a 0

M e m b u a t d a n m e l a p o r k a n W 2 A d a 6 m i n g g u a n ( s m s g a t e w a y ) T i d a k A d a 0

D p n p m i m n C o o n o A C D I M n n Dnt ln l A d a 2

6 EPIDEMIOLOG

T i d a k A d a 0

6 EPIDEMIOLOG P e n e m u a n K a s u s S u s p e c k

C a m p a k / R u b e l l a

A d a 2

6 EPIDEMIOLOG P e n e m u a n K a s u s S u s p e c k

C a m p a k / R u b e l l a T i d a k A d a 0 6 EPIDEMIOLOG M e m b u a t d a n m e l a p o r k a n S u r v e i l a n s

T e r p a d u P e n y a k i t ( S T P ) , C I c a m p a k s e t i a p B u l a n

A d a 6

6 EPIDEMIOLOG M e m b u a t d a n m e l a p o r k a n S u r v e i l a n s

T e r p a d u P e n y a k i t ( S T P ) , C I c a m p a k s e t i a p B u l a n T i d a k a d a 0

6 EPIDEMIOLOG

M e l a k s a n a k a n S u r v e i l a n s A k t i f R u m a h S a k i t ( S A R S ) / k l i n i k s w a s t a / F a s y a n k e s

A d a 3

6 EPIDEMIOLOG

M e l a k s a n a k a n S u r v e i l a n s A k t i f R u m a h S a k i t ( S A R S ) / k l i n i k s w a s t a / F a s y a n k e s T i d a k a d a 0

6 EPIDEMIOLOG

M e l a k s a n a k a n d a n m e l a p o r k a n k e j a d i a n b e n c a n a / p e n i n g k a t a n k a s u s / K L B / w a b a h

A d a 3

6 EPIDEMIOLOG

M e l a k s a n a k a n d a n m e l a p o r k a n k e j a d i a n b e n c a n a / p e n i n g k a t a n k a s u s / K L B / w a b a h T i d a k a d a 0

6 EPIDEMIOLOG

P e l a c a k a n K 3 J H d a n p e n g i n p u t a n S i s t e m K o m p u t e r i s a s i H a j i T e r p a d u b i d a n g

K e s e h a t a n ( S i s k o h a t k e s )

A d a 2

6 EPIDEMIOLOG

P e l a c a k a n K 3 J H d a n p e n g i n p u t a n S i s t e m K o m p u t e r i s a s i H a j i T e r p a d u b i d a n g

K e s e h a t a n ( S i s k o h a t k e s ) T i d a k a d a 0

6 EPIDEMIOLOG

M e m b u a t V i s u a h s a s i d a n a n a h s i s d a t a E W A R S b u l a n a n

A d a 2

6 EPIDEMIOLOG

M e m b u a t V i s u a h s a s i d a n a n a h s i s d a t a E W A R S b u l a n a n T i d a k a d a 0

IV KELOMPOK ADMINISTRASI

1 K a Sub Bag T U

M e n g e l o l a P c r c n . c 3 i i a . a r i d a n p c l a p o r a n ( l a k i p , l a p t a h , R U K , R P K , P K P , S K M ,

P r o f i l )

D i k e r j a k a n s e m u a 2

1 K a Sub Bag T U


P r o f i l ) d i k e r j a k a n 3 - 6 1

1 K a Sub Bag T U


P r o f i l ) < 3 0

1 K a Sub Bag T U

M e n g e l o l a K e p e g a w a i a n ( a n j a b / A B K , e -f o r m a s i , P e n j a g a a n k e n a i k a n p a n g k a t d a n

b e r k a l a , u p d a t i n g D U K , M e n g u s u l k a n N a k e s T e l a d a n / p r e s t a s i )

D i k e r j a k a n s e m u a 2

1 K a Sub Bag T U


b e r k a l a , u p d a t i n g D U K , M e n g u s u l k a n N a k e s T e l a d a n / p r e s t a s i )

d i k e r j a k a n 3 - 5 1

1 K a Sub Bag T U


b e r k a l a , u p d a t i n g D U K , M e n g u s u l k a n N a k e s T e l a d a n / p r e s t a s i ) < 3 0

1 K a Sub Bag T U

M e n g e l o l a T a t a U s a h a K e u a n g a n ( j a s p e l , i n s e n t i f , m a m i n , p e n g a d a a n , b e l a n j a

o p e r a s i o n a l p u s k e s m a s , v e r i f i k a s i d a n r e k o m e n d a s i k e u a n g a n , p e n g e s a h a n s p j ,

l a p o r a n k e u a n g a n )

D i k e r j a k a n s e m u a 1 0

1 K a Sub Bag T U




u i x c e i j c U v c u i o / 7

1 K a Sub Bag T U




d i k e r j a k a n 2 - 5 3 1 K a Sub Bag T U



l a p o r a n k e u a n g a n ) < 2 0

1 K a Sub Bag T U

M e n g e l o l a a d m i n i s t r a s i u m u m ( a r s i p , s u r a t m e n y u r a t , p e n o m o r a n s u r a t , p e n g e n d a l i a n d o k u m e n , a b s e n s i ,

m e n g e l o l a b u k u t a m u , n o t u l e n r a p a t )

D i k e r j a k a n s e m u a 1 0

1 K a Sub Bag T U


m e n g e l o l a b u k u t a m u , n o t u l e n r a p a t )

d i k e r j a k a n 4 - 6 7

1 K a Sub Bag T U


m e n g e l o l a b u k u t a m u , n o t u l e n r a p a t ) d i k e r j a k a n 2 - 4 3

1 K a Sub Bag T U


m e n g e l o l a b u k u t a m u , n o t u l e n r a p a t ) < 2 0

1 K a Sub Bag T U

M e n g e l o l a A s e t ( p e n g a d a a n b a r j a s , p e n g a d a a n m o d a l , p e n a t a u s a h a a n a s e t ,

d i k e r j a k a n s e m u a 6

1 K a Sub Bag T U

M e n g e l o l a A s e t ( p e n g a d a a n b a r j a s , p e n g a d a a n m o d a l , p e n a t a u s a h a a n a s e t , d i k e r j a k a n 2 - 3 3

1 K a Sub Bag T U

x~\A*TO nrn/H m i r\ \ ott-o c i o n ri nl/t i m o n n o n i r o n o o n i pcllgeKJ.IIllIll.oUI HBUul U . U K U . I I 1 C I 1 pCI lga t iad l l / < 2 0

2 Bendahara Penerimaan BLUD

M e l a k u k a n r e k a p i t u l a s i p e n d a p a t a n h a r i a n

A d a d a n l e n g k a p 6



A d a t i d a k l e n g k a p 3



T i d a k a d a 0


i v i c i c u t u K c i n p e n y e i o r u n

S e t i a p h a r i b u k a b a n k 6


i v i c i c u t u K c i n p e n y e i o r u n T i d a k s e t i a p h a r i O


i v i c i c u t u K c i n p e n y e i o r u n

S e b u l a n s e k a l i 0


M e l a k u k a n R e k a p i t u l a s i b u l a n a n d a n i n p u t S T S




A d a t i d a k l e n i f k a n 3



T i d a k a d a 0 2 Bendahara Penerimaan

BLUD

P e n a t a u s a h a a n p e n e r i m a a n ( B K U , B u k u K a s T u n a i , B u k u B a n k , R e g i s t e r

p e n u t u p a n k a s , B e r i t a a c a r a p e n u t u p a n k a s )




p e n u t u p a n k a s , B e r i t a a c a r a p e n u t u p a n k a s )

A d a t i d a k l e n g k a p 3



p e n u t u p a n k a s , B e r i t a a c a r a p e n u t u p a n k a s ) T i d a k a d a 0


P e n y u s u n a n l a p o r a n ( R i n c i a n o b j e k p e n e r i m a a n , p e r t a n g g u n g j a w a b a n

p e n e r i m a a n d a n f u n g s i o n a l

A d a 8 s l e n g k a p 6



p e n e r i m a a n d a n f u n g s i o n a l A d a t d k l e n g k a p 3



p e n e r i m a a n d a n f u n g s i o n a l T i d a k a d a 0

3 Bendahara Pengeluaran

R e k a p i t u l a s i N o t a D i n a s , P e n g a a j u a a n p e n c a i r a n d a n a ( P e m b u a t a n S P P , S P M ,

S P 2 D )

A d a , l e n g k a p d a n t e p a t w a k t u

5



S P 2 D ) A d a , t d k l e n g k a p . 3



S P 2 D )

T i d a k a d a 0


M e l a k s a n a k a n P e n e r i m a a n d a n P e n g e l u a r a n D a n a

L e n g k a p d a n t e p a t w a k t u 5


M e l a k s a n a k a n P e n e r i m a a n d a n P e n g e l u a r a n D a n a

T i d a k l e n g k a p . 0

3 Bendahara Pengeluaran M e l a k s a n a k a n P e n a t a u s a h a a n A d a , l e n g k a p d a n t e p a t

w a k t u 1 0

http://Pcrcn.c3iia.ari



http://pcllgeKJ.IIllIll.oUI

BLUD k e u a a n g a n ( B K U P e n g e l u a r a n , B u k u K a s T u n a i , B u k u B a n k , B u k u P a j a k , d l l )

A d a , t d k l e n g k a p . 5 BLUD k e u a a n g a n ( B K U P e n g e l u a r a n , B u k u K a s T u n a i , B u k u B a n k , B u k u P a j a k , d l l )

T i d a k a d a 0

BLUD

M e n g e l o l a p e r t a n g g u n g j a w a b a n p e m a n f a a t a n k e u a n g a n .

S P J a d a , l e n g k a p d a n t e p a t w a k t u .

5

BLUD

M e n g e l o l a p e r t a n g g u n g j a w a b a n p e m a n f a a t a n k e u a n g a n . S P J a d a t i d a k l e n g k a p 3

BLUD

M e n g e l o l a p e r t a n g g u n g j a w a b a n p e m a n f a a t a n k e u a n g a n .

T i d a k a d a 0

BLUD

iVlClIJ.UU.cLL bdpUl d l l IvCTctlloctol IYCU.eu.lgeU.1 b u l a n a n / s e m e s t e r / t a h u n a n


5

BLUD

iVlClIJ.UU.cLL bdpUl d l l IvCTctlloctol IYCU.eu.lgeU.1 b u l a n a n / s e m e s t e r / t a h u n a n A d a , t d k l e n g k a p 3

BLUD

iVlClIJ.UU.cLL bdpUl d l l IvCTctlloctol IYCU.eu.lgeU.1 b u l a n a n / s e m e s t e r / t a h u n a n

T i d a k a d a 0

4 Bendahara Pembantu Pengeluaran Puskesmas

M e n g e l o l a a n g g a r a n B i a y a O p e r a s i o n a l P u s k e s m a s b a i k d a n a A P B D a t a u p u n

A P B N ( B K U , B u k u K a s T u n a i , B u k u B a n k , B u k u P a j a k , d l l )


1 0



A P B N ( B K U , B u k u K a s T u n a i , B u k u B a n k , B u k u P a j a k , d l l )

A d a , t d k l e n g k a p 5



A P B N ( B K U , B u k u K a s T u n a i , B u k u B a n k , B u k u P a j a k , d l l ) T i d a k a d a 0


M e n g e l o l a p e r t a n g g u n g j a w a b a n p e m a n f a a t a n k e u a n g a n b e r s u m b e r d a n a

A P B D

S P J a d a , l e n g k a p d a n t e p a t w a k t u .

5



A P B D S P J a d a t i d a k l e n g k a p 3



A P B D T i d a k a d a 0


L a p o r a n R e a l i s a s i K e u a n g a n ( b u l a n a n & t a h u n a n )




A d a , t d k l e n g k a p 3



T i d a k a d a 0

5 Bendahara Barang / Aset

M e n e r i m a , m e n y i m p a n , m e n d i s t r i b u s i k a n A A A4- A A-A T» A HA A AHA AAA AH AHA A1 /A TPTH' T ) I T I }

a s e t d a n b a r a n g o p e r a s i o n a l ( A l K , H H P , O b a t , b e l a n j a m o d a l )

K I B A - D , K I R , b e r i t a a c a r a s e r a h t e r i m a b a r a n g a d a

d a n l e n g k a p .

1 D

1 0




A d a , t i d a k l e n g k a p 5




T i d a k a d a 0

5 Bendahara Barang / Aset M e n d o k u m e n t a s i S B B K ( s e t i a p m e n e r i m a

b a r a n g )

B u k u P e n e r i m a a n & P e n g e l u a r a n B a r a n g , a d a

f lan l pn or I/" a n 1 0 5 Bendahara Barang / Aset

M e n d o k u m e n t a s i S B B K ( s e t i a p m e n e r i m a b a r a n g )


5 Bendahara Barang / Aset M e n d o k u m e n t a s i S B B K ( s e t i a p m e n e r i m a

b a r a n g )

T i d a k a d a 0


M e m b u a t L a p o r a n ( S t o c k o p n a m e , K o n d i s i B a r a n g , b u l a n a n , s e m e s t e r ,

t a h u n a n )

A d a d a n l e n g k a p 1 0



t a h u n a n ) A d a , t i d a k l e n g k a p 5



t a h u n a n ) T i d a k a d a 0

6 Akuntan

M e l a k u k a n r e k o n s i l i a s i d e n g a n b e n d a h a r a p e n e r i m a a n B L U D

M e l a k u k a n , l e n g k a p , t e p a t w a k t u

5

6 Akuntan

M e l a k u k a n r e k o n s i l i a s i d e n g a n b e n d a h a r a p e n e r i m a a n B L U D M e l a k u k a n , t i d a k l e n g k a p 3

6 Akuntan

M e l a k u k a n r e k o n s i l i a s i d e n g a n b e n d a h a r a p e n e r i m a a n B L U D

T i d a k m e l a k u k a n 0

6 Akuntan

M e l a k u k a n r e k o n s i l i a s i d e n g a n b e n d a h a r a p e n g e l u a r a n B L U D


5

6 Akuntan

M e l a k u k a n r e k o n s i l i a s i d e n g a n b e n d a h a r a p e n g e l u a r a n B L U D M e l a k u k a n , t i d a k l e n g k a p 3

6 Akuntan

M e l a k u k a n r e k o n s i l i a s i d e n g a n b e n d a h a r a p e n g e l u a r a n B L U D


6 Akuntan

M e m b u a t j u r n a l

M e m b u a t , l e n g k a p , t e p a t w a k t u

5

6 Akuntan

M e m b u a t j u r n a l M e m b u a t , t i d a k l e n g k a p 3

6 Akuntan

M e m b u a t j u r n a l

T i d a k m e l a k u k a n 0 6 Akuntan

M e l a k u k a n r e k o n s i l i a s i d e n n a n

p e n g e l o l a k e u a n g a n D i n k e s


5

6 Akuntan


p e n g e l o l a k e u a n g a n D i n k e s M e l a k u k a n , t i d a k l e n g k a p 3

6 Akuntan


p e n g e l o l a k e u a n g a n D i n k e s


6 Akuntan

M e m b u a t p e n g e s a h a n p e n d a p a t a n d a n b e l a n j a ( S P 3 B )

M e m b u a t , l e n g k a p , t e p a t w a k t u 5

6 Akuntan

M e m b u a t p e n g e s a h a n p e n d a p a t a n d a n b e l a n j a ( S P 3 B ) M e m b u a t , t i d a k l e n g k a p 3

6 Akuntan

M e m b u a t p e n g e s a h a n p e n d a p a t a n d a n b e l a n j a ( S P 3 B )


6 Akuntan

M e m b u a t L a p o r a n K e u a n g a n

M e m b u a t , l e n g k a p , t e p a t w a k t u

5

6 Akuntan

M e m b u a t L a p o r a n K e u a n g a n M e m b u a t , t i d a k l e n g k a p 3

6 Akuntan

M e m b u a t L a p o r a n K e u a n g a n


M e l a k u k a n , l e n g k a p , t e p a t w a k t u 3

http://iVlClIJ.UU.cLL



7 Administrasi Keuangan dan

M e m b a n t u p e n a t a u s a h a a n k e u a n g a n M e l a k u k a n , t i d a k l e n g k a p 1


M e m b a n t u p e n a t a u s a h a a n k e u a n g a n



M e m b a n t u m e n g e l o l a p e r a t n g g u n g j a w a b a n p e m a n f a t a a n d a n a


3


M e m b a n t u m e n g e l o l a p e r a t n g g u n g j a w a b a n p e m a n f a t a a n d a n a M e l a k u k a n , t i d a k l e n g k a p 1


M e m b a n t u m e n g e l o l a p e r a t n g g u n g j a w a b a n p e m a n f a t a a n d a n a

T i r i a l r m p l a W i i k s m J . l u a j v m t l e u v u r v d i i

o


M e m b a n t u p e n c a t a a n b a r a n g m i l i k H s a p m t i v n n B H i t e r i m s i I f f H f l l f i m U c l C ) a l l y c X i i K U l 11.1 1111 c l JV_. U C U C U i i

b u k u / k a r t u b a r a n g


3



b u k u / k a r t u b a r a n g M e l a k u k a n , t i d a k l e n g k a p 1



b u k u / k a r t u b a r a n g



M e m b a n t u p e n c a t a t a n p e r s e d i a a n b a r a n g


3


M e m b a n t u p e n c a t a t a n p e r s e d i a a n b a r a n g M e l a k u k a n , t i d a k l e n g k a p 1


M e m b a n t u p e n c a t a t a n p e r s e d i a a n b a r a n g



M e m b a n t u m e n y i a p k a n R e n c a n a B i s m s A n g g a r a n ( R B A )


3


M e m b a n t u m e n y i a p k a n R e n c a n a B i s m s A n g g a r a n ( R B A ) M e l a k u k a n , t i d a k l e n g k a p 1


M e m b a n t u m e n y i a p k a n R e n c a n a B i s m s A n g g a r a n ( R B A )

T i d a k m e l a k u k a n 0 7 Aset

M e m b a n t u m e n g e l o l a a r s i p b e r k a s a d m i n i s t r a s i p e g a w a i s e s u a i d e n g a n

p r o s e d u r d a n k e t e n t u a n y a n g b e r l a k u


3 7 Aset

M e m b a n t u m e n g e l o l a a r s i p b e r k a s a d m i n i s t r a s i p e g a w a i s e s u a i d e n g a n

p r o s e d u r d a n k e t e n t u a n y a n g b e r l a k u M e l a k u k a n , t i d a k l e n g k a p 1

7 Aset M e m b a n t u m e n g e l o l a a r s i p b e r k a s

a d m i n i s t r a s i p e g a w a i s e s u a i d e n g a n p r o s e d u r d a n k e t e n t u a n y a n g b e r l a k u

T i d a k m e l a k u k a n U

7 Aset

M e m b a n t u m e n g e l o l a s u r a t m e n y u r a t p u s k e s m a s s e s u a i d e n g a n p r o s e d u r d a n

k e t e n t u a n y a n g b e r l a k u


o o

7 Aset


k e t e n t u a n y a n g b e r l a k u M e l a k u k a n , t i d a k l e n g k a p 1

7 Aset


k e t e n t u a n y a n g b e r l a k u


7 Aset

M e m b a n t u m e n c a t a t s e c a r a t e r t i b d a n t e r a t u r p e n e r i m a a n b a r a n g , p e n g e l u a r a n b a r a n g , d a n k e a d a a n p e r s e d i a a n b a r a n g

k e d a l a m b u k u / k a r t u b a r a n g m e n u r u t j e n i s n y a


3

7 Aset


k e d a l a m b u k u / k a r t u b a r a n g m e n u r u t j e n i s n y a

M e l a k u k a n , t i d a k l e n g k a p 1

7 Aset


k e d a l a m b u k u / k a r t u b a r a n g m e n u r u t j e n i s n y a T i d a k m e l a k u k a n 0

7 Aset

M e m b a n t u m e m b u k u k a n S B B K / T a n d a t e r i m a b a r a n g / B e r i t a A c a r a S e r a h T e r i m a

B a r a n g


3

7 Aset


B a r a n g M e l a k u k a n , t i d a k l e n g k a p 1

7 Aset


B a r a n g


7 Aset

M e m b a n t u m e m b u a t l a p o r a n m e n g e n a i b a r a n g y a n g d i u r u s n y a b e r d a s a r k a n

T C a r t n P e r s p H i f l a n R a r a r i p 1 \ ( U L U ' V 1 O V U l O C U l 1,111 (111CI


3

7 Aset



M e l a k u k a n , t i d a k l e n g k a p 1

7 Aset




8

K o o r d i n a t o r P r o g r a m t e r d i r i d a r i : K o o r d i n a t o r U K P , K o o r d i n a t o r U K M

e s e n s i a l , K o o r d i n a t o r U K M p e n g e m b a n g a n , K o o r d i n a t o r

j a r i n g a n d a n J e j a r i n g P u s k e s m a s , P e n g e l o l a K e s . I b u , P e n g e l o l a K e s .

A n a k , P e n g e l o l a K B , P e n g e l o l a P r o m k e s , P e n g e l o l a G i z i ( s e l a i n N u t r i s i o n i s ) , P e n g e l o l a S a n i t a s i

( s e l a i n S a n i t a r i a n ) , P e n g e l o l a I m u n i s a s i , P e n g e l o l a T B , P e n g e l o l a

P A L , P e n g e l o l a S u r v e i l a n s , P e n g e l o l a K u s t a , P e n g e l o l a I S P A ,

P e n g e l o l a D i a r e , P e n g e l o l a H I V / A I D S , P e n g e l o l a U K S ,

P e n g e l o l a P T M , P e n g e l o l a P r o l a n i s , P e n g e l o l a M a t a , P e n g e l o l a

T H T , P e n g e l o l a J i w a , P e n g e l o l a K e s j a , P e n g e l o l a L a n s i a , P e n g e l o l a

M T B S / S D I D T K , P e n g e l o l a U K G S / U K G M D , P e n g e l o l a B P ,

M e m b u a t p e r e n c a n a a n t a h u n a n

A d a D o k u m e n P e r e n c a n a a n

4

8











M e m b u a t p e r e n c a n a a n t a h u n a n

T i d a k a d a 0

8











M e m b u a t P O A b u l a n a n

A d a D o k u m e n P O A 4

8











M e m b u a t P O A b u l a n a n

T i d a k a d a 0

8











M e m b u a t l a p o r a n b u l a n a n

A d a d o k u m e n L a p o r a n H a s i l K e g i a t a n 4

8











M e m b u a t l a p o r a n b u l a n a n

T i d a k a d a 0

8











M e m b u a t l a p o r a n t a h u n a n

A d a d o k u m e n L a p o r a n T a h u n a n 4

8











M e m b u a t l a p o r a n t a h u n a n

T i d a k a d a 0

P e n g e l o l a B P G i g i , P e n g e l o l a U G D , P e n g e l o l a K e s o r g a , P e n g e l o l a

K e s p r o , d l l M e m b u a t v i s u a l i s a s i d a t a b u l a n a n d a n t a h u n a n .

A d a V i s u a l i s a s i D a t a 4

P e n g e l o l a B P G i g i , P e n g e l o l a U G D , P e n g e l o l a K e s o r g a , P e n g e l o l a

K e s p r o , d l l M e m b u a t v i s u a l i s a s i d a t a b u l a n a n d a n t a h u n a n .

T i d a k a d a 0

9 Koordinator Unit Perawatan (DTP/PONED)

M e n g a t u r & m e m b u a t j a d w a l p i k e t A d a J a d w a l 8 s L e n g k a p 1 0


M e n g a t u r & m e m b u a t j a d w a l p i k e t

T i d a k a d a 0


M e m b u a t l a p o r a n B O R p e r b u l a n n y a A d a D o k u m e n L a p . 2


M e m b u a t l a p o r a n B O R p e r b u l a n n y a T i d a k a d a 0


M e n g e l o l a A S K E P / A S K E B i n d i v i d u A d a d o k u m e n 3


M e n g e l o l a A S K E P / A S K E B i n d i v i d u T i H n l r a H n

1 l U c U l . e l U c t o


M e m b u a t l a p o r a n 1 0 b e s a r p e n y a k i t r a w a t I n a p p e r b u l a n .

A d a D o k u m e n L a p o r a n c D


M e m b u a t l a p o r a n 1 0 b e s a r p e n y a k i t r a w a t I n a p p e r b u l a n .

T i d a k a d a 0 9 Koordinator Unit Perawatan (DTP/PONED)

M e n g e l o l a k e t e r s e d i a a n s a r a n a 8 s p r a s a r a n a p e n u n j a n g p e l a y a n a n

k e s e h a t a n .

A d a d a f t a r c e k l i s i n v e n t a r i s o b a t 8 s B H P

r u a n g p e r a w a t a n d a n d i i s i l e n g k a p

1 0



k e s e h a t a n .

A d a d a f t a r c e k l i s i n v e n t a r i s o b a t 8 s B H P r u a n g p e r a w a t a n d a n

t i d a k d i i s i l e n g k a p

5



k e s e h a t a n .

T i d a k a d a 0

10 Pendaftaran/ Rekam Medis

J u m l a h p a s i e n y a n g d i l a y a n i d e n g a n k e l e n g k a p a n m e d r e k r a t a - r a t a p e r

h a r i .

> 1 0 0 8



h a r i . 5 0 - 9 9 7



h a r i . 3 0 - 4 9 6


J m l n a s i e n d i l a v a n i d i m 1 b i n 2 0 - 2 9 5




E n t r y d a t a p a s i e n k e S i m p u s d a n P -c a r e .

> 1 0 0 1 0



5 0 - 9 9 8



3 0 - 4 9 6

10 Pendaftaran/ Rekam Medis J m l d a t a v g d i e n t r v d i m 1 b i n 2 0 - 2 9 4

10 Pendaftaran/ Rekam Medis j u m l a h h a r i k e r j a 1 - 1 9 2 10 Pendaftaran/ Rekam Medis M e l a k s a n a k a n d i s t r i b u s i d a n

p e n y i m p a n a n k e m b a l i b e r k a s r e k a m U I C U J J Y

> 1 0 0 7

10 Pendaftaran/ Rekam Medis M e l a k s a n a k a n d i s t r i b u s i d a n

p e n y i m p a n a n k e m b a l i b e r k a s r e k a m U I C U J J Y

5 0 - 9 9 6

10 Pendaftaran/ Rekam Medis M e l a k s a n a k a n d i s t r i b u s i d a n

p e n y i m p a n a n k e m b a l i b e r k a s r e k a m U I C U J J Y 3 0 - 4 9 5


J m l m e d r e k v g d i k e l o l a d i m 1 b i n Z U 4 7




M e l a k s a n a k a n p e m e r i k s a a a n k e t i d a k l e n g k a p a n p e n g i s i a n c a t a t a n m e d i s

( K L P C M )

d i p e r i k s a s e l u r u h n y a 5



( K L P C M ) d i p e r i k s a s e b a g i a n 3



( K L P C M ) T i d a k d i l a k s a n a k a n 0

11 Pengelola SP3

M e n g e l o l a l a p o r a n h a s i l k e g i a t a n p r o g r a m ( L B 1 , L B 3 d a n L B 4 )

A l i o t P T i n V o n t p a a t . , , c l f t " i i r \ t i a , i e i l gK .dp , I c p d l W c u X I U c o

11 Pengelola SP3


A d a . l e n g k a p . t d k t e p a t w a k t u

3

11 Pengelola SP3



11 Pengelola SP3


T i d a k a d a 0

11 Pengelola SP3

M e m b u a t l a p o r a n p o l a p e n y a k i t R a w a t J a l a n 8 s r a w a t i n a p h a r i a n


D

11 Pengelola SP3


A d a . l e n g k a p . t d k t e p a t w a k t u

3

11 Pengelola SP3


A d a , t i d a k l e n g k a p 1 11 Pengelola SP3


T i d a k a d a 0

11 Pengelola SP3

M e m b u a t l a p o r a n p o l a p e n y a k i t R a w a t J a l a n 8 s R a w a t I n a p b u l a n a n d a n t a h u n a n

d a n v i s u a l i s a s i d a t a k u n j u n g a n


5

11 Pengelola SP3



A d a . l e n g k a p . t d k t e p a t w a k t u 3

11 Pengelola SP3


d a n v i s u a l i s a s i d a t a k u n j u n g a n A d a , t i d a k l e n g k a p 1

11 Pengelola SP3



T i d a k a d a 0

11 Pengelola SP3

M e n g k o o r d i n i r v i s u a l i s a s i d a t a b u l a n a n d a n t a h u n a n p r o g r a m

D i l a k s a n a k a n IT o

11 Pengelola SP3

M e n g k o o r d i n i r v i s u a l i s a s i d a t a b u l a n a n d a n t a h u n a n p r o g r a m T i d a k d i l a k s a n a k a n 0

12 Staf TU / Petugas Administrasi umum

M e l a k s a n a k a n a d m i n i s t r a s i p e l a y a n a n d i P u s k e s m a s ( s u r a t k e t e r a n g a n s e h a t , s u r a t

r u j u k a n , k w i t a n s i , p e n g a n t a r s u r a t , d a n f o r m a t - f o r m a t l a i n n y a )

D i k e r j a k a n 1 0




d i k e r j a k a n 5 0 % 5




T i d a k d i k e r j a k a n 0


M e l a k s a n a k a n a b s e n s i ( t e r m a s u k d a f t a r h a d i r a p e l )

D i k e r j a k a n 5


M e l a k s a n a k a n a b s e n s i ( t e r m a s u k d a f t a r h a d i r a p e l ) T i d a k d i k e r j a k a n 0 12 Staf TU / Petugas

Administrasi umum M e n g e l o l a b u k u t a m u , n o t u l e n r a p a t ,

s u r a t k e l u a r m a s u k

D i k e r j a k a n 5


M e n g e l o l a b u k u t a m u , n o t u l e n r a p a t , s u r a t k e l u a r m a s u k T i d a k d i k e r j a k a n 0


M e m e l i h a r a d a n m e n a t a k e a r s i p a n ( t e r m a s u k b u k u - b u k u p e d o m a n , m o d u l

k e g i a t a n , m a j a l a h , d l l )

D i k e r j a k a n 1 0



k e g i a t a n , m a j a l a h , d l l ) d i k e r j a k a n 5 0 % 5



k e g i a t a n , m a j a l a h , d l l ) T i d a k d i k e r j a k a n 0

V KELOMPOK PENUNJANG

1 J u r u Cuc i

M e n c u c i , m e m b e r s i h k a n d a n m e n y e t r i k a l i n e n y a n g a d a d i p e r a w a t a n ( P u s k . D T P 8 s

P O N E D ) s e t i a p h a r i .

D i l a k s a n a k a n t i a p h a r i 1 0

1 J u r u Cuc i


P O N E D ) s e t i a p h a r i .

D i l a k s a n a k a n , t i d a k h a p h a r i

5

1 J u r u Cuc i


P O N E D ) s e t i a p h a r i . T i d a k d i l a k s a n a k a n 0 1 J u r u Cuc i

M e n g i n v e n t a r i s a s i d a n m e m e l i h a r a s a r a n a p r a s a r a n a n l i n e n

D i l a k s a n a k a n 5

1 J u r u Cuc i

M e n g i n v e n t a r i s a s i d a n m e m e l i h a r a s a r a n a p r a s a r a n a n l i n e n T i d a k d i l a k s a n a k a n 0

2 J u r u Masak

M e m b e r s i h k a n d a p u r D i l a k s a n a k a n 2 , 5

2 J u r u Masak

M e m b e r s i h k a n d a p u r T i d a k d i l a k s a n a k a n 0

2 J u r u Masak

M e m b e r s i h k a n a l a t m a s a k

D i l a k s a n a k a n , r a p i h d a n b e r s i h

2 , 5

2 J u r u Masak

M e m b e r s i h k a n a l a t m a s a k T i d a k d i l a k s a n a k a n 0

2 J u r u Masak

M e m b e r s i h k a n a l a t m a k a n ( p i l i n g , s e n d o k 8 s g a r p u )

DilalfN^analfaTi r a n i H a n 1 l l l f l l l . . . l l l l l l l l l l l , l .11.1 111111

b e r s i h 2 , 5

2 J u r u Masak

M e m b e r s i h k a n a l a t m a k a n ( p i l i n g , s e n d o k 8 s g a r p u )

T i d a k d i l a k s a n a k a n 0 2 J u r u Masak

M e m a s a k m a k a n a n p a s i e n 3 k a l i s e h a r i ( p a g i , s i a n g 8 s s o r e )

D i l a k s a n a k a n 2 , 5

2 J u r u Masak

M e m a s a k m a k a n a n p a s i e n 3 k a l i s e h a r i ( p a g i , s i a n g 8 s s o r e ) T i d a k d i l a k s a n a k a n 0

2 J u r u Masak

M e n d i s t r i b u s i k a n m a k a n a n k e r u a n g a n p a s i e n .


2 J u r u Masak

M e n d i s t r i b u s i k a n m a k a n a n k e r u a n g a n p a s i e n . T i d a k d i l a k s a n a k a n 0

2 J u r u Masak

M e n g i n v e n t a r i s a s i d a n m e m e l i h a r a s a r a n a p r a s a r a n a n l i n e n


2 J u r u Masak

M e n g i n v e n t a r i s a s i d a n m e m e l i h a r a s a r a n a p r a s a r a n a n l i n e n T i d a k d i l a k s a n a k a n 0

3 Supir

B e r t a n g g u n g j a w a b m e r a w a t d a n m e m b e r s i h k a n m o b i l s e t i a p h a r i


3 Supir

B e r t a n g g u n g j a w a b m e r a w a t d a n m e m b e r s i h k a n m o b i l s e t i a p h a r i T i d a k d i l a k s a n a k a n 0

3 Supir

M e n g a n t a r p a s i e n y a n g a k a n d i r u j u k k e R S r u j u k a n d a n m e m i n t a b u k t i m e r u j u k

d a r i R S


3 Supir

M e n g a n t a r p a s i e n y a n g a k a n d i r u j u k k e R S r u j u k a n d a n m e m i n t a b u k t i m e r u j u k

d a r i R S T i d a k d i l a k s a n a k a n 0

3 Supir M e n g a n t a r d a n m e n j e m p u t k a r y a w a n P u s k e s m a s d a l a m k e g i a t a n l a p a n g a n

( P u s k e l )

D i l a k s a n a k a n c D 3 Supir M e n g a n t a r d a n m e n j e m p u t k a r y a w a n P u s k e s m a s d a l a m k e g i a t a n l a p a n g a n

( P u s k e l ) T i d a k d i l a k s a n a k a n 0

3 Supir

M e l a k s a n a k a n s e r v i c e d a n g a n t i o l i s e t i a p 3 b u l a n s e k a l i


3 Supir

M e l a k s a n a k a n s e r v i c e d a n g a n t i o l i s e t i a p 3 b u l a n s e k a l i T i d a k d i l a k s a n a k a n 0

3 Supir

M e m b a y a r k a n p a j a k k e n d a r a a n / S T N K D i l a k s a n a k a n 2 , 5

3 Supir

M e m b a y a r k a n p a j a k k e n d a r a a n / S T N K T i d a k d i l a k s a n a k a n 0

4 Petugas Kebersihan

M e n y a p u d a n m e n g e p e l l a n t a i 2 k a l i s e h a r i

D i l a k s a n a k a n , r a p i d a n b e r s i h s e r t a w a n g i 3


M e n y a p u d a n m e n g e p e l l a n t a i 2 k a l i s e h a r i

T i d a k d i l a k s a n a k a n 0


M e m b e r s i h k a n r u a n g a n , m e j a , l e m a r i , k a c a j e n d e l a d a n p i n t u s e t i a p h a r i .

D i l a k s a n a k a n , r a p i d a n b e r s i h 3


M e m b e r s i h k a n r u a n g a n , m e j a , l e m a r i , k a c a j e n d e l a d a n p i n t u s e t i a p h a r i .


4 Petugas Kebersihan M e m b e r s i h k a n k a m a r m a n d i / W C s e t i a p h a r i


4 Petugas Kebersihan M e m b e r s i h k a n k a m a r m a n d i / W C s e t i a p h a r i



M e n j a g a k e b e r s i h a n h a l a m a n s e t i a p h a r i .



M e n j a g a k e b e r s i h a n h a l a m a n s e t i a p h a r i .


M e n g i n v e n t a r i s a s i d a n m e m e l i h a r a a l a t a l a t k e b e r s i h a n

D i l a k s a n a k a n 3 M e n g i n v e n t a r i s a s i d a n m e m e l i h a r a a l a t a l a t k e b e r s i h a n T i d a k d i l a k s a n a k a n 0

5 Petugas keamanan

M e n y e l e n g g a r a k a n k e a m a n a n d a n k e t e r t i b a n d i l i n g k u n g a n P u s k e s m a s .


5 Petugas keamanan

M e n y e l e n g g a r a k a n k e a m a n a n d a n k e t e r t i b a n d i l i n g k u n g a n P u s k e s m a s . T i c l o l c AilcAfCOT,olfon n

V

5 Petugas keamanan

M e n y e l e n g g a r a k a n k e t e r t i b a n k e n d a r a a n b e r m o t o r d i h a l a m a n P u s k e s m a s ( l a h a n

n a r i r i r i

D i l a k s a n a k a n c o

5 Petugas keamanan

M e n y e l e n g g a r a k a n k e t e r t i b a n k e n d a r a a n b e r m o t o r d i h a l a m a n P u s k e s m a s ( l a h a n

n a r i r i r i ' | 'i A ft If A t 1 ft If c ft ft ft If ft rt n

5 Petugas keamanan M e m b u a t d a n m e n g i s i d a f t a r h a d i r d a n b u k u l a p o r a n j a g a ,

D i l a k s a n a k a n o o 5 Petugas keamanan M e m b u a t d a n m e n g i s i d a f t a r h a d i r d a n

b u k u l a p o r a n j a g a , l l u R K ( l l l B K S a i l c L K t i l l n u 5 Petugas keamanan

M e l a k u k a n p e m e r i k s a a n t e r h a d a p t a m u y a n g d a t a n g k e U P T D / P u s k e s m a s

( i d e n t i t a s . k e n e r l u a n . d l h

Di laksanakan 9 5

5 Petugas keamanan M e l a k u k a n p e m e r i k s a a n t e r h a d a p t a m u

y a n g d a t a n g k e U P T D / P u s k e s m a s ( i d e n t i t a s . k e n e r l u a n . d l h

l u n r\\r riilolzociti o b a r i 1 lUc l i v U l i d K o c L t l c U X c t l l n u

5 Petugas keamanan

M e m e r i k s a k e l u a r m a s u k n y a m o b i l d i l i n g k u n g a n U P T D / P u s k e s m a s

D i l a k s a n a k a n 2 .5

5 Petugas keamanan

M e m e r i k s a k e l u a r m a s u k n y a m o b i l d i l i n g k u n g a n U P T D / P u s k e s m a s T i d a k d i l a k s a n a k a n 0

6 POS (Pembantu Orang Saklt)

M e m b a n t u p e r a w a t d a l a m m e r a w a t p a s i e n d i P u s k e s m a s D T P d i l u a r

t i n d a k a n m e d i s

D i l a k s a n a k a n d e n g a n b a i k b a i k

K d


M e m b a n t u p e r a w a t d a l a m m e r a w a t p a s i e n d i P u s k e s m a s D T P d i l u a r

t i n d a k a n m e d i s T N H Q I C A i l sale c a n n l f at", l l U c u l U11 d H C d l l a R . a l i o


M e m b a n t u a d m i n i s t r a s i p a s i e n r a w a t i n a p d i P u s k e s m a s D T P


5 6 POS (Pembantu Orang Saklt)

M e m b a n t u a d m i n i s t r a s i p a s i e n r a w a t i n a p d i P u s k e s m a s D T P



B e r t a n g g u n g j a w a b a t a s k e b e r s i h a n r u a n g d i P u s k e s m a s D T P


5


B e r t a n g g u n g j a w a b a t a s k e b e r s i h a n r u a n g d i P u s k e s m a s D T P


C a t a t a n

c.

S e t i a p p o i n t p a d a u n s u r k i n e r j a y a n g d i p e r o l e h m a s i n g - m a s i n g j e n i s t e n a g a p a d a s e t i a p b u l a n t e r c a t a t d a l a m f o r m a t S a s a r a n K e r j a P e g a w a i ( S K P ) / b u k u c a t a t a n k e g i a t a n d i s e r t a i d e n g a n b u k t i p e l a k s a n a a n k e g i a t a n .

S e t i a p p e t u g a s m a k s i m a l m e m e g a n g 2 p r o g r a m / t u g a s t a m b a h a n d i l u a r p r o f e s i n y a u n t u k m e n d a p a t p o i n t j a s a

p e l a y a n a n .

T e n a g a p r o f e s i y a n g d i b e r i t u g a s t a m b a h a n ( a d m i n i s t r a s i a t a u p r o g r a m ) k e d u a , m e n d a p a t p o i n t t a m b a h a n s e b e s a r 5 0 % d a r i p o i n t k i n e r j a p r o g r a m / t u g a s t a m b a h a n t e r s e b u t y a n g d i p e r o l e h d a l a m s a t u b u l a n .

T u g a s t a m b a h a n d i t e t a p k a n b e r d a s a r k a n S u r a t T u g a s d a r i K e p a l a P u s k e s m a s

Variabel Penambah

T a m b a h a n p o i n d i b e r i k a n a p a b i l a t e n a g a t e r s e b u t m e m p u n y a i j a b a t a n t u g a s s e b a g a i :

1 .

2 .

4 . 5 . 6 . 7 . 8 .

0

2 5

1 5

K e p a l a P u s k e s m a s d i b e r i n i l a i p e j a b a t t e k n i s ( U K M e s e n s i a l , U K M p e n g e m b a n g a n , U K P , J a r i n g a n d a n j e j a r i n g ) s e s u a i S K B u p a t i P e n g e l o l a P r o g r a m , K e t u a T i m M u t u , K e t u a t i m P P I , K e t u a t i m P M K P ( s e s u a i S K K e p a l a P u s k e s m a s )

B e n d a h a r a P e n e r i m a a n B L U D ( s e s u a i S K . B u p a t i ) B e n d a h a r a P e n g e l u a r a n B L U D ( s e s u a i S K . B u p a t i ) B e n d a h a r a B a r a n g / A s e t ( s e s u a i S K . B u p a t i ) B e n d a h a r a p e n g e l u a r a n p e m b a n t u p u s k e s m a s S e s u a i S k B u p a t i ) P e n g e l o l a B O K ( s e s u a i S K K e p a l a D i n a s ) B e n d a h a r a y a n g s u d a h m e n d a p a t k a n h o n o r d a r i s u a t u p e l a k s a n a a n k e g i a t a n t i d a k m e n d a p a t

n i l a i t a m b a h a n .

1 0

1 0 1 5 1 5 1 0 1 0

d. Variabel Pengurang

NO KELOMPOK / J E N I S SDM UNSUR VARIABEL PENGURANG D I K U R A N G I N ILA I

1 D o k t e r / D o k t e r G i g i / T i d a k p e r n a h m e n g i s i b u k u r e k a m m e d i s , S I M P U S & a t a u P - c a r e 5

2 D o k t e r / P e r a w a t / B i d a n T i d a k m a u m e l a k s a n a k a n t u g a s j a g a s o r e / m a l a m d i U G D / D T P / P O N E D 1 0

3 P e r a w a t / P e r a w a t G i g i / B i d a n T i d a k p e r n a h m e n g i s i b u k u r e k a m m e d i s , S I M P U S & P -c a r e 5

4 P e r a w a t / P e r a w a t G i g i T i d a k p e r n a h m e m b u a t A s u h a n K e p e r a w a t a n 5

5 B i d a n T i d a k p e r n a h m e m b u a t A s u h a n K e b i d a n a n 5

6 B i d a n T i d a k m e m b u a t K o h o r t 1 0

7 B i d a n D e s a T i d a k t i n g g a l d i t e m p a t 1 0

8 P e n g e l o l a P r o g r a m T i d a k m e m b u a t l a p o r a n b u l a n a n 3 b u l a n b e r t u r u t i n r u t 5

Semua tenaga kesehatan yang hams memiliki S T R dan/ atau SIP 5 0 % d a r i t o t a l s c o r e

Kehadiran Pegawai Non PNS

P e n i l a i a n k e h a d i r a n m e m p e r h i t u n g k a n j u m l a h k e h a d i r a n d i b a g i h a r i k e r j a

T e r l a m b a t d a t a n g / P u l a n g c e p a t / m e n i n g g a l k a n t u g a s d i a k u m u l a s i s a m p a i d e n g a n 7 j a m , d i k u r a n g i 1 h a r i

D A D A N G M N A S E R

L A M P I R A N I I P E R A T U R A N B U P A T I B A N D U N G N O M O R 2 2 T A H U N 2 0 1 9 T E N T A N G P E T U N J U K T E K N I S P E N G G U N A A N J A S A P E L A Y A N A N B A G I P E G A W A I P U S K E S M A S Y A N G M E N E R A P K A N P O L A P E N G E L O L A A N K E U A N G A N B A D A N L A Y A N A N U M U M D A E R A H D I K A B U P A T E N B A N D U N G

DAFTAR PERHITUNGAN JASA PELAYANAN PUSKESMAS - DINAS KESEHATAN KABUPATEN BANDUNG

BULAN 3019

Jumlah Pendapatan : Jasa Pelayanan ( %) Biaya Umum (10 %) : Jaepel yang dibagikan :

NO NAMA NIP GOL / RUANG PENDIDIKAN STATUS

PEGAWAI

JENIS KETENAGAA

H

JABATAN (POIN

PENAMBA H)

JUMLAH POIN

VARIABEL KETENAGA

AN

KINERJA TOTAL POIN

NON PNS

SKOR AKHIR POIN

PENGURAN O

POIN TANG DIDAPAT

JASA PELAYANAN

JASA PELAYANAN YANG OITERIMA

TARDA TANG AN NO NAMA NIP GOL /

RUANG PENDIDIKAN STATUS PEGAWAI

JENIS KETENAGAA

H

JABATAN (POIN

PENAMBA H)

JUMLAH POIN

VARIABEL KETENAGA

AN

KINERJA TOTAL POIN

POIN TAMBAHA

N

TOTAL POIN NON

PNB

KEHADIRAN SKOR AKHIR

POIN PENGURAN

O

POIN TANG DIDAPAT

JASA PELAYANAN


TARDA TANG AN NO NAMA NIP GOL /

RUANG PENDIDIKAN STATUS PEGAWAI

JENIS KETENAGAA

H

JABATAN (POIN

PENAMBA H)

JUMLAH POIN

VARIABEL KETENAGA

AN

KINERJA TOTAL POIN

POIN TAMBAHA

N

TOTAL POIN NON

PNB

JUMLAH MASUK HARI

KERJA

JUMLAH HARI

KERJA

% KEHADIRAN

SKOR AKHIR POIN

PENGURAN O

POIN TANG DIDAPAT

JASA PELAYANAN


TARDA TANG AN

1 3 3 4 S 6 7 8 9 (7*8) 10 11 [9*I0| 13 13|11 .13) 14 IS • (14/18 X 10O

17 ( NOR PNS • 13

X 16 PNS -11)

IS 19 (17-18

ATAU 17 X !•>

30 31 (19 X 30 / TOTAL 19) 33

1

2

3

4

5

6

7

8

9

10

11

12

13 dat

Kepala Puskesmas .

L A M P I R A N I I I P E R A T U R A N B U P A T I B A N D U N G N O M O R 2 2 T A H U N 2 0 1 9 T E N T A N G P E T U N J U K T E K N I S P E N G G U N A A N J A S A P E L A Y A N A N B A G I P E G A W A I P U S K E S M A S Y A N G M E N E R A P K A N P O L A P E N G E L O L A A N K E U A N G A N B A D A N L A Y A N A N U M U M D A E R A H D I K A B U P A T E N B A N D U N G

K O P B L U D P U S K E S M A S

BERITA ACARA REKONSILIASI DATA REALISASI PENDAPATAN BLUD PUSKESMAS

BULAN TAHUN ANGGARAN 2019

Pada hari ini Tanggal Bu lan tahun D u a Ribu Sembilan Belas, diselenggarakan Rekonsil iasi laporan Realisasi Anggaran Periode Bulan D u a Ribu Sembilan Belas antara B L U D Puskesmas dengan Dinas Kesehatan Kabupaten Bandung .

N a m a J a b a t a n U r u s a n P e m e r i n t a h a n U n i t k e r j a Sub U n i t Organ isdas i

B e n d a h a r a n P e n e r i m a a n BLUD P u s k e s m a s 1 .02. K e s e h a t a n 4 . 1 . 2 . 0 1 . 0 1 D inas K e s e h a t a n

BLUD Puskesmas . .

T e l a h m e l a k s a n a k a n Rekons i l i as i D a t a Real isas i p e n d a p a t a n b u l a n T a h u n A n g g a r a n D u a R i b u S e m b i l a n Beias d e n g a n Dinas K e s e h a t a n K a b u p a t e n B a n d u n g Cq. Subag K e u a n g a n , d e n g a n d a t a sebagai b e r i k u t :

Kode Rekening Uraian Realisasi

4 PENDAPATAN 4 . 1 PENDAPATAN ASLI DAERAH 4 . 1 . 4 Lain Lain P A D y a n g Sah

4 . 1 . 4 . 1 6 . 0 1 P e n d a p a t a n Jasa L a y a n a n U m u m BLUD

LAIN LAIN PAD YANG SAH

4 . 1 . 4 . 1 6 . 0 5 Kapitas i

4 . 1 . 4 . 1 6 . 0 6 Bunga R e k e n i n g

J u m l a h Real isasi p e n d a p a t a n Rp . . . t e r b i l a n g . ,

J u m l a h Real isasi p e n d a p a t a n t e r s e b u t di a t a s t e l a h sesua i d e n g a n d a t a rea l i sas i y a n g ada d i D inas K e s e h a t a n K a b u p a t e n B a n d u n g ( R inc ian A P B D T e r l a m p i r )

B a n d u n g , 2 0 1 9

Kepala PPK BLUD Puskesmas

NIP NIP Bendahara Penerimaan Dinkes Kepala Dinas Kesehatan

Kabupaten Bandung

NIP NIP Kepala Sub Bagian Keuangan Dinkes

NIP 1

1 D U N G

d ) A N G M N A S E R

L A M P I R A N I V P E R A T U R A N B U P A T I B A N D U N G N O M O R O 2 T A H U N 2 0 1 9 T E N T A N G P E T U N J U K T E K N I S P E N G G U N A A N J A S A P E L A Y A N A N B A G I P E G A W A I P U S K E S M A S Y A N G M E N E R A P K A N P O L A P E N G E L O L A A N K E U A N G A N B A D A N L A Y A N A N U M U M D A E R A H D I K A B U P A T E N B A N D U N G

D A F T A R P E N E R I M A A N J A S A P E L A Y A N A N

Jumlah Jaapel yang dibagikan Jumlah Total Poin Nilai 1 Poin / Skoring

NO RAMA HIP QOL / RUAR

Q

JUMLA H

POIR

NILAI 1 POIN

JUMLAH JARPBL PAJAK JUMLAH JARPBL

YG DITER1MA RO. REKENING BRI TARDA TAROAH

1 a 3 4 5 6 7 ( 5 X 6 ) S 9 (7 - 8) io 11

1 Rp

2 Rp

a Rp

4 Rp

5 Rp

6 Rp

7 Rp

8 Rp

9 Rp

10 Rp

11 dst Rp

Rp

JUMLAH " P

Kepala Puskesmas

BUPATI BANDUNG PROVINSI JAWA BARAT PERATURAN BUPATI …

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