Agency Schedule Detail

Authorization Number : 440-0477

Agency Series No. : 16-04-R

Status : Active

Agency Web Link :

Agency : DOH

Confidential Description : N/A-Load

Division :

Vital Description :

Section :

Record Title : Medicare Certification Applications

Revision : 0

Record Description : This record series pertains to Medicare certification applications submitted by prospective providers/suppliers of the Medicare program (ie. Skilled nursing facilities, home health agencies, ambulatory surgical centers, etc.) but did not result in Medicare certification (ie. Withdrawl of application, failure to produce complete application by specified timeframe).

Retention Period	Retention Justification	Media Code	Method of Disposal
Nonparticipating Facilities: retain materials for one year following the year in which the last certification contact was made. This schedule pertains only to applications that did not result in Medicare certification (ie., withdrawal of application, incomplete application whereby applicant failed to produce requested forms and paperwork by specified deadline)	State Operations Manual (HCFA Publication 7) 4801 Provider Certification Records - Nonparticipating Facilities	Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Transfer User	Records Viewer	5/2/2001 12:00:00 AM

Notes

Date	Reason	User