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458 lines
24 KiB
458 lines
24 KiB
2 years ago
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<?php
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/**
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* facility_admin.php
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*
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* @package OpenEMR
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* @link http://www.open-emr.org
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* @author Brady Miller <brady.g.miller@gmail.com>
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* @copyright Copyright (c) 2019 Brady Miller <brady.g.miller@gmail.com>
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* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
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*/
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require_once("../globals.php");
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require_once("$srcdir/options.inc.php");
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require_once("$srcdir/erx_javascript.inc.php");
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use OpenEMR\Common\Csrf\CsrfUtils;
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use OpenEMR\Core\Header;
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use OpenEMR\Services\FacilityService;
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$facilityService = new FacilityService();
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if (isset($_GET["fid"])) {
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$my_fid = $_GET["fid"];
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}
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?>
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<html>
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<head>
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<?php Header::setupHeader(['opener']); ?>
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<script src="../main/calendar/modules/PostCalendar/pnincludes/AnchorPosition.js"></script>
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<script src="../main/calendar/modules/PostCalendar/pnincludes/PopupWindow.js"></script>
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<script src="../main/calendar/modules/PostCalendar/pnincludes/ColorPicker2.js"></script>
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<!-- validation library -->
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<!--//Not lbf forms use the new validation, please make sure you have the corresponding values in the list Page validation-->
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<?php $use_validate_js = 1; ?>
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<?php require_once($GLOBALS['srcdir'] . "/validation/validation_script.js.php"); ?>
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<?php
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//Gets validation rules from Page Validation list.
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//Note that for technical reasons, we are bypassing the standard validateUsingPageRules() call.
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$collectthis = collectValidationPageRules("/interface/usergroup/facility_admin.php");
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if (empty($collectthis)) {
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$collectthis = "undefined";
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} else {
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$collectthis = json_sanitize($collectthis["facility-form"]["rules"]);
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}
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?>
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<script>
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/*
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* validation on the form with new client side validation (using validate.js).
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* this enable to add new rules for this form in the pageValidation list.
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* */
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var collectvalidation = <?php echo $collectthis; ?>;
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function submitform() {
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var valid = submitme(1, undefined, 'facility-form', collectvalidation);
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if (!valid) return;
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<?php if ($GLOBALS['erx_enable']) { ?>
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alertMsg = '';
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f = document.forms[0];
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for (i = 0; i < f.length; i++) {
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if (f[i].type == 'text' && f[i].value) {
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if (f[i].name == 'facility' || f[i].name == 'Washington') {
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alertMsg += checkLength(f[i].name, f[i].value, 35);
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alertMsg += checkFacilityName(f[i].name, f[i].value);
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} else if (f[i].name == 'street') {
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alertMsg += checkLength(f[i].name, f[i].value, 35);
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alertMsg += checkAlphaNumeric(f[i].name, f[i].value);
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} else if (f[i].name == 'phone' || f[i].name == 'fax') {
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alertMsg += checkPhone(f[i].name, f[i].value);
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} else if (f[i].name == 'federal_ein') {
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alertMsg += checkLength(f[i].name, f[i].value, 10);
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alertMsg += checkFederalEin(f[i].name, f[i].value);
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}
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}
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}
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if (alertMsg) {
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alert(alertMsg);
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return false;
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}
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<?php } ?>
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top.restoreSession();
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let post_url = $("#facility-form").attr("action");
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let request_method = $("#facility-form").attr("method");
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let form_data = $("#facility-form").serialize();
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$.ajax({
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url: post_url,
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type: request_method,
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data: form_data
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}).done(function (r) { //
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dlgclose('refreshme', false);
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});
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return false;
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}
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$(function () {
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/**
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* add required/star sign to required form fields
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*/
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for (var prop in collectvalidation) {
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//if (collectvalidation[prop].requiredSign)
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if (collectvalidation[prop].presence)
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$("label[for='" + prop + "']").append('*');
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}
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});
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var cp = new ColorPicker('window');
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// Runs when a color is clicked
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function pickColor(color) {
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document.getElementById('ncolor').value = color;
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}
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var field;
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function pick(anchorname, target) {
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var cp = new ColorPicker('window');
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field = target;
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cp.show(anchorname);
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}
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function displayAlert() {
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if (document.getElementById('primary_business_entity').checked == false)
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alert(<?php echo xlj('Primary Business Entity tax id is used as the account id for NewCrop ePrescription.'); ?>);
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else if (document.getElementById('primary_business_entity').checked == true)
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alert(<?php echo xlj('Once the Primary Business Facility is set, changing the facility id will affect NewCrop ePrescription.'); ?>);
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}
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</script>
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</head>
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<body class="body_top">
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<div class="container-fluid">
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<h5 class="title"><?php echo xlt('Edit Facility'); ?></h5>
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<div class="py-3">
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<a class="btn btn-primary" name='form_save' id='form_save' onclick='submitform();' href='#'><?php echo xlt('Save'); ?></a>
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<a class="btn btn-secondary" id='cancel' onclick='dlgclose();' href='#'><?php echo xlt('Cancel'); ?></a>
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</div>
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<form name='facility-form' id="facility-form" method='post' action="facilities.php">
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<input type="hidden" name="csrf_token_form" value="<?php echo attr(CsrfUtils::collectCsrfToken()); ?>" />
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<input type=hidden name='mode' value="facility" />
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<input type=hidden name='newmode' value="admin_facility" />
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<!-- diffrentiate Admin and add post backs !-->
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<input type=hidden name=fid value="<?php echo attr($my_fid); ?>" />
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<?php $facility = $facilityService->getById($my_fid); ?>
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<div class="row">
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<div class="col-6">
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<div class="form-row my-2">
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<div class="col-2">
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<label for='facility' class='col-form-label col-form-label-sm'><?php echo xlt('Name'); ?>:</label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' name='facility' size='20' value='<?php echo attr($facility['name']); ?>' />
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='street' class='col-form-label col-form-label-sm'><?php echo xlt('Address'); ?>: </label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' size='20' name="street" value="<?php echo attr($facility["street"]); ?>" />
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='city' class='col-form-label col-form-label-sm'><?php echo xlt('City'); ?>: </label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' size='20' name='city' value="<?php echo attr($facility["city"]); ?>" />
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='state' class='col-form-label col-form-label-sm'><?php echo xlt('State'); ?>:</label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' size='20' name='state' value="<?php echo attr($facility["state"]); ?>" />
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='country_code' class='col-form-label col-form-label-sm'><?php echo xlt('Country'); ?>:</label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' size='20' name='country_code' value="<?php echo attr($facility["country_code"]); ?>" />
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='website' class='col-form-label col-form-label-sm'><?php echo xlt('Website'); ?>:</label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' size='20' name='website' value="<?php echo attr($facility["website"]); ?>" />
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='iban' class='col-form-label col-form-label-sm'><?php echo xlt('IBAN'); ?>: </label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' size='20' name='iban' value="<?php echo attr($facility["iban"]); ?>" />
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</div>
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</div>
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<div class="form-row custom-control custom-switch my-2">
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<div class="col">
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<input type='checkbox' class='custom-control-input' name='billing_location' id='billing_location' value='1' <?php echo ($facility['billing_location'] != 0) ? 'checked' : ''; ?> />
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<label for='billing_location' class='custom-control-label'><?php echo xlt('Billing Location'); ?></label>
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</div>
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</div>
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<div class="form-row custom-control custom-switch my-2">
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<div class="col">
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<input type='checkbox' class='custom-control-input' name='accepts_assignment' id='accepts_assignment' value='1' <?php if ($facility['accepts_assignment'] == 1) {
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echo 'checked="checked"';
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}; ?> />
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<label for='accepts_assignment' class='custom-control-label'><?php echo xlt('Accepts Assignment'); ?></label>
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</div>
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<div class="col">
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<small class="form-text text-muted mt-0">(<?php echo xlt('only if billing location'); ?>)</small>
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</div>
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</div>
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<div class="form-row custom-control custom-switch my-2">
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<div class="col">
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<input type='checkbox' class='custom-control-input' name='service_location' id='service_location' value='1' <?php echo ($facility['service_location'] == 1) ? 'checked' : ''; ?> />
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<label for='service_location' class='custom-control-label'><?php echo xlt('Service Location'); ?></label>
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</div>
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</div>
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<div class="form-row custom-control custom-switch my-2">
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<div class="col">
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<?php
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$disabled = '';
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$resPBE = $facilityService->getPrimaryBusinessEntity(array("excludedId" => $my_fid));
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if ($resPBE) {
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$disabled = 'disabled';
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}
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?>
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<input type='checkbox' class='custom-control-input' name='primary_business_entity' id='primary_business_entity' value='1' <?php echo ($facility['primary_business_entity'] == 1) ? 'checked' : ''; ?> <?php if ($GLOBALS['erx_enable']) {
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?> onchange='return displayAlert()' <?php } ?> <?php echo $disabled; ?> />
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<label for='primary_business_entity' class='custom-control-label'><?php echo xlt('Primary Business Entity'); ?></label>
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='ncolor' class='col-form-label col-form-label-sm'><?php echo xlt('Color'); ?>:</label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' name='ncolor' id='ncolor' size='20' value="<?php echo attr($facility["color"]); ?>" />
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</div>
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<div class="col">
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[<a href="javascript:void(0);" onClick="pick('pick','newcolor'); return false;" NAME="pick" ID="pick"><?php echo xlt('Pick'); ?></a>]
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</div>
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</div>
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<div class="form-row my-2 d-flex align-items-center">
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<div class="col-2">
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<label for='pos_code' class='col-form-label col-form-label-sm'><?php echo xlt('POS Code'); ?>:</label>
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</div>
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<div class="col">
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<select name="pos_code" class="form-control form-control-sm">
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<?php
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$pc = new POSRef();
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foreach ($pc->get_pos_ref() as $pos) {
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echo "<option value=\"" . attr($pos["code"]) . "\" ";
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if ($facility['pos_code'] == $pos['code']) {
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echo "selected";
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}
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echo ">" . text($pos['code']) . ": " . text($pos['title']);
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echo "</option>\n";
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}
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?>
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</select>
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</div>
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</div>
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<div class="form-row my-2 d-flex align-items-center">
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<div class="col-2">
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<label for="domain_identifier" class="col-form-label col-form-label-sm"><?php echo xlt('CLIA Number'); ?>:</label>
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</div>
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<div class="col">
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<input type="text" class="form-control form-control-sm" name="domain_identifier" size="45" value="<?php echo attr($facility['domain_identifier']); ?>" />
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</div>
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</div>
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</div>
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<div class="col-6">
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<div class="form-row my-2">
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<div class="col-2">
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<label for='phone' class='col-form-label col-form-label-sm'><?php echo xlt('Phone'); ?></label>
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</div>
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<div class="col">
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<input type='text' class='form-control form-control-sm' name='phone' size='20' value='<?php echo attr($facility['phone']); ?>' />
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<small class="form-text text-muted"><?php echo xlt('as'); ?> (000) 000-0000</small>
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</div>
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</div>
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<div class="form-row my-2">
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<div class="col-2">
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<label for='fax' class='col-form-label col-form-label-sm'><?php echo xlt('Fax'); ?>:</label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' name="fax" size='20' value='<?php echo attr($facility['fax']); ?>' />
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<small class="form-text text-muted"><?php echo xlt('as'); ?> (000) 000-0000</small>
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</div>
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</div>
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<div class="form-row my-2 d-flex align-items-center">
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<div class="col-2">
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<label for='postal_code' class='col-form-label col-form-label-sm'><?php echo xlt('Zip Code'); ?>:</label>
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</div>
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<div class="col">
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<input type='entry' class='form-control form-control-sm' size='20' name='postal_code' value="<?php echo attr($facility["postal_code"]); ?>" />
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</div>
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</div>
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|
<div class="form-row my-2">
|
||
|
|
<?php
|
||
|
|
$ssn = '';
|
||
|
|
$ein = '';
|
||
|
|
if ($facility['tax_id_type'] == 'SY') {
|
||
|
|
$ssn = 'selected';
|
||
|
|
} else {
|
||
|
|
$ein = 'selected';
|
||
|
|
}
|
||
|
|
?>
|
||
|
|
<div class="col-2">
|
||
|
|
<label for='federal_ein' class='col-form-label col-form-label-sm'><?php echo xlt('Tax ID'); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col-3">
|
||
|
|
<select name='tax_id_type' class='form-control form-control-sm'>
|
||
|
|
<option value="EI" <?php echo $ein; ?>><?php echo xlt('EIN'); ?></option>
|
||
|
|
<option value="SY" <?php echo $ssn; ?>><?php echo xlt('SSN'); ?></option>
|
||
|
|
</select>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type='entry' class='form-control form-control-sm' size='11' name='federal_ein' value="<?php echo attr($facility["federal_ein"]); ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-row my-2 d-flex align-items-center">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for='facility_npi' class='col-form-label col-form-label-sm'><?php echo($GLOBALS['simplified_demographics'] ? xlt('Facility Code') : xlt('Facility NPI')); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type='entry' class='form-control form-control-sm' size='20' name='facility_npi' value="<?php echo attr($facility["facility_npi"]); ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-row my-2 d-flex align-items-center">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for='facility_taxonomy' class='col-form-label col-form-label-sm'><?php echo xlt('Facility Taxonomy'); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type='entry' class='form-control form-control-sm' size='20' name='facility_taxonomy' value="<?php echo attr($facility["facility_taxonomy"]); ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for='email' class='col-form-label col-form-label-sm'><?php echo xlt('Email'); ?>: </label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type='entry' class='form-control form-control-sm' size='20' name='email' value="<?php echo attr($facility["email"]); ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-row my-2 d-flex align-items-center">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="attn" class="col-form-label col-form-label-sm"><?php echo xlt('Billing Attn'); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" name="attn" size="45" value="<?php echo attr($facility['attn']); ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-row my-2 d-flex align-items-center">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="facility_id" class="col-form-label col-form-label-sm"><?php echo xlt('Facility ID'); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" name="facility_id" size="45" value="<?php echo attr($facility['facility_code']); ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="oid" class="col-form-label col-form-label-sm"><?php echo xlt('OID'); ?>: </label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" size="20" name="oid" value="<?php echo attr($facility["oid"]) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<hr />
|
||
|
|
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="mail_street" class="col-form-label col-form-label-sm"><?php echo xlt('Mailing Address'); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" size="20" name="mail_street" value="<?php echo attr($facility["mail_street"]) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="mail_street2" class="col-form-label col-form-label-sm"><?php echo xlt('Suite'); ?>: </label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" size="20" name="mail_street2" value="<?php echo attr($facility["mail_street2"]) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="mail_city" class="col-form-label col-form-label-sm"><?php echo xlt('City'); ?>: </label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" size="20" name="mail_city" value="<?php echo attr($facility["mail_city"]) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="mail_state" class="col-form-label col-form-label-sm"><?php echo xlt('State'); ?>: </label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" size="20" name="mail_state" value="<?php echo attr($facility["mail_state"]) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="mail_zip" class="col-form-label col-form-label-sm"><?php echo xlt('Zip'); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<input type="text" class="form-control form-control-sm" size="20" name="mail_zip" value="<?php echo attr($facility["mail_zip"]) ?>" />
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<div class="form-row my-2">
|
||
|
|
<div class="col-2">
|
||
|
|
<label for="info" class="col-form-label col-form-label-sm"><?php echo xlt('Info'); ?>:</label>
|
||
|
|
</div>
|
||
|
|
<div class="col">
|
||
|
|
<textarea class="form-control form-control-sm" size="20" name="info"><?php echo attr($facility["info"]) ?></textarea>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
|
||
|
|
<p class="text"><span class="mandatory">*</span> <?php echo xlt('Required'); ?></p>
|
||
|
|
</form>
|
||
|
|
<div class="py-3">
|
||
|
|
<a class="btn btn-primary" name='form_save' id='form_save' onclick='submitform();' href='#'><?php echo xlt('Save'); ?></a>
|
||
|
|
<a class="btn btn-secondary" id='cancel' onclick='dlgclose();' href='#'><?php echo xlt('Cancel'); ?></a>
|
||
|
|
</div>
|
||
|
|
</div>
|
||
|
|
</body>
|
||
|
|
</html>
|