Agency Schedule Detail

Authorization Number : 440-0286

Agency Series No. : 11-01

Status : Active

Agency Web Link :

Agency : DOH

Confidential Description :

Division : DOH3013

Vital Description : N/A-Load

Section :

Record Title : HFR Medicare/Medicaid Certification Surv

Revision : 1

Record Description : Provides information regarding the certification status of various health care facilities. Included are applications to become a provider, disclosure of ownership and control interest statements, certification & transmittal forms, statements of deficienc

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain exit interview tapes for 5 years then erase, provided that no legal action is to be taken against the facility and all appeals have been resolve	HB 822 requires the tape, however, no retention period is specified. Therefore, the paper/hardcopy retention period will be utilized	Electronic	Erase
Retain in office for 3 years after the year in which the record was prepared. Store for 2 years offsite, then destroy provided that no legal actions is to be taken against the facility and all appeals have been resolved	State Operations Manual Sec. #4801 Interagency agreement between the Ohioi Department of Health and the Ohio Department of Human Services	Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Transfer User	Records Viewer	3/14/1994 12:00:00 AM

Notes

Date	Reason	User