---
title: "IPD Admission"
description: "How to admit a patient to IPD via Quick Actions — creating an in-patient encounter, form fields, and what happens after admission."
date: 2026-07-19
lastModified: 2026-10-21
category: "ipd"
author: "Dr. Umesh Bilagi"
beta: false
---

## Overview

IPD admission creates an in-patient encounter for a patient, marking the start of an inpatient stay. The admission form is a modal opened from the patient dashboard. Bed assignment, clinical charting, and billing are handled separately after the encounter is created.

Admission is not available on Lab or Clinic plans.

## Access

### From Patient Dashboard (Quick Actions)

1. Open the patient's record from patient management.
2. In the **Quick Actions** strip at the top, click **New IPD Visit**.
3. The admission form opens in a modal.

### Direct URL

You can also navigate directly to `/admin/patient/encounter/ipd/create/{patientId}`.

## Admission Form Fields

The admission form is a shared encounter component used for both OPD and IPD visits. When the type is "Admit," the form pre-configures certain fields for inpatient use.

| Field | Required | Default | Description |
|-------|----------|---------|-------------|
| **MLC** | Yes | FALSE | Whether this is a Medico-Legal Case. Options: FALSE (Not Medico legal case) or TRUE (Medico legal case). |
| **Status** | Yes | in-progress | Encounter status. Options: finished, in-progress, cancelled, entered-in-error, planned. For new admissions, leave as "in-progress." |
| **Class** | Yes | in-patient | Fixed to "in-patient" for IPD admissions. Not editable. |
| **Date Of Admission** | Yes | Current date/time | When the admission starts. Adjust if backdating or scheduling. |
| **Payor** | Yes | Self | Who is paying. "Self" for direct patient payment, or select from the organization's PAYOR accounts (e.g., insurance companies, corporate accounts). |
| **Tariff Name** | Yes | Default | The billing tariff to apply. Select from the organization's configured tariff names. |
| **Policy Id** | No | — | Insurance policy number, if applicable. Free-text field. |
| **Department** | Yes | General | The clinical department responsible for the admission. Select from configured departments, or leave it on General. The choice is saved with the encounter and appears in the MIS beta reports (Month wise and Daily collection), where it can be filtered. |
| **Participants** | Yes | — | Multi-select of treating doctors (practitioners with "On Panel" or "Visiting" status). At least one participant is required — the form will not submit without one. |

### Referral Management

Below the main form, the **Referral Management** section allows you to:

| Field | Description |
|-------|-------------|
| **Referral Doctor** | Single-select from the organization's referring doctors list. |
| **Unlisted Requester** | Opens a modal to type a free-text name for a referring doctor not in the list. |
| **Network Requests** | "Based On" button — placeholder for future use. |

### Estimated Discharge Date

The system automatically sets an estimated discharge date **3 days** from the admission date. This is not shown on the form but is stored in the encounter and can be used for bed planning.

## Open Encounter Warning

If the patient already has an open encounter (in-progress), the form shows a warning:

> "This patient has an open encounter in progress."

A checkbox appears: **Close existing encounters and proceed**. Check it to finish the existing encounter(s) and create the new admission. Without this, the API returns an error and the admission is blocked.

## What the API Does

When the form is submitted to `POST /api/admin/ndhm/native/encounter/create`:

1. Checks for open encounters. If found and `closeExisting=true`, finishes them. If found and not closing, returns an error.
2. Auto-increments the organization's IPD counter (`ipdMaxId`) and assigns the next IPD number.
3. Creates the encounter in the FHIR store.
4. For facilities with ABDM integration, handles patient notification if the patient has a PHR address.

Note: unlike OPD visits, IPD admissions do **not** create doctor tokens — the token queue system is only for outpatient visits.

## IPD Console

Admitted patients appear in the **IPD Console** — a table of all in-progress inpatients accessible from the sidebar:

**Sidebar → Patient → Services → IPD Console** (`/admin/mis-reports/patient-stats/?onlyinpatientinprogress=true`)

The console shows these columns for each admitted patient:

| Column | Description |
|--------|-------------|
| **ID (MRN)** | Clickable patient ID that opens the Patient Dashboard |
| **Facility ID** | Organization-specific facility identifier |
| **Name** | Patient's full name |
| **IPD No** | Auto-assigned IPD admission number |
| **Payor** | Self, insurance company, or corporate account |
| **Mobile** | Patient's registered mobile number |
| **Consultants** | Assigned treating doctors |
| **Date of Admission** | When the encounter was created |
| **Date of Discharge** | When the encounter ended (empty for in-progress patients) |
| **Bed** | Currently allotted bed, if assigned |
| **Invoice** | Total invoiced amount during the stay |
| **Collection** | Total amount collected so far |
| **Balance** | Outstanding amount (Invoice minus Collection) |
| **Estimated Discharge Date** | Color-coded: green (3+ days away), blue (1–3 days), orange (< 1 day), red (overdue) |

Clicking a patient's MRN in the console opens the **Patient Dashboard**, which is the hub for all per-patient IPD actions.

## Cancelling an Admission

NICE HMS has **no delete for an admission** — an encounter is never hard-deleted. To undo an admission, edit the encounter's **Status**:

1. Open the patient's **Search Edit Encounter** page (`/admin/patient/encounter/search/{patientId}`).
2. Open the admission encounter.
3. Set **Status** to one of:
   - **`cancelled`** — the admission was made in error or the patient did not stay. Use this to cancel it.
   - **`entered-in-error`** — the record itself is invalid (for example, created for the wrong patient). Use this to flag it as not to be used.
4. Save.

**Who can do this:** encounter editing is available to **Admin, Director, Receptionist, and Receptionist Accountant**. Only an **Admin** can edit an encounter that is already `finished`.

> **Editing is blocked while another open encounter exists.** If the patient has a *different* in-progress encounter, the save is rejected with *"There are already open encounters kindly use them or finish them before editing encounter"*. Finish the other encounter first.

### Cancel vs. discharge vs. delete

| Action | What it does |
|--------|--------------|
| **Cancel** (`Status = cancelled`) | Marks the encounter cancelled and removes the patient from the in-progress **IPD Console**. The record is **kept**. |
| **Discharge** (`Status = finished`) | Ends the stay normally and **releases the allotted bed**. See [IPD Discharge](/docs/ipd-discharge). |
| **Entered-in-error** (`Status = entered-in-error`) | Marks the encounter record invalid; the record is kept. |
| **Delete** | **Not available for an admission.** Only a whole patient record can be deleted — you cannot delete a single encounter. |

### What cancelling does *not* do

- **It does not release an allotted bed.** The bed is freed when the stay is completed by **Discharge** (`finished`). If a bed was allotted, discharge the patient (or transfer the bed out via [IPD Bed Transfer](/docs/ipd-bed-transfer)) rather than merely cancelling.
- **It does not reverse billing.** Charges already raised against the encounter remain; void or adjust them separately in Billing (see [Bill Transaction](/docs/bill-transaction)).
- **It does not delete linked documents.** Clinical documents and notes attached to the encounter are not removed.

## Next Steps After Admission

The admission form only creates the encounter. These are separate actions from the Patient Dashboard:

| Step | Where |
|------|-------|
| **Bed Allotment** | Patient Details → **Allot Bed**. See [Bed Management](/docs/bed-management). |
| **Initial Assessment** | Documents & Encounters → **Initial Assessment**. Clinical notes, vitals, and examination findings. |
| **Billing** | Quick Actions → **Billing**. See [Bill Transaction](/docs/bill-transaction). |

The patient's encounter also appears in **Search Edit Encounter** (`/admin/patient/encounter/search/{patientId}`) where it can be viewed and edited.

## FAQ

**Q: Can I delete an IPD admission?**
A: No — an admission (encounter) cannot be deleted. To undo one, open it in **Search Edit Encounter** and set its **Status** to `cancelled` (made in error) or `entered-in-error` (invalid record). Cancelling removes it from the in-progress IPD Console but does not release the bed or reverse billing — **discharge** the patient to free the bed, and adjust the bill separately. Only an Admin can edit a `finished` encounter.

**Q: Can I change the bed after admission?**
A: Yes. Use the bed transfer feature. See [IPD Bed Transfer](/docs/ipd-bed-transfer).

**Q: How is the IPD number generated?**
A: Each organization has an auto-incrementing IPD counter. The number is unique per organization and assigned sequentially at admission.

**Q: What is an MLC admission?**
A: Medico-Legal Case — flagged for cases requiring police or legal documentation (accidents, assaults, etc.). Set MLC to TRUE on the admission form.

**Q: Can I admit a patient who already has an open encounter?**
A: Yes. Check the "Close existing encounters and proceed" checkbox. The open encounter will be marked as finished before the new admission is created.

**Q: Why is the "New IPD Visit" button not showing?**
A: IPD admission is not available on Lab or Clinic plans. If your plan includes IPD, verify your role has patient management permissions.

**Q: Can I backdate an admission?**
A: Yes. Change the Date Of Admission field to the desired date and time before submitting.