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Agency Schedule Detail

Authorization Number :  50750061
Agency Series No. :  404-67-03
Status :  Active
Agency Web Link : 
Agency :  ODM
Confidential Description :   
Division :  ODMPOLI
Vital Description : 
Section :  ODMPOLI
Record Title :  Hospital Interim/Final Settlement Audit Packages
Revision :  1
Record Description :  Interim/ final audit settlements of services provided at Community Alternative Funding System (CAFS), hospitals, passport program and public developmental centers. File contains but is not limited to cost report forms (alpha by provider name) and audit work papers and reports (numeric by provider number). May also contain the following forms: ODHS 2930, 2918, 2919, 2920, 2921, 2934, 2935, 2936, 2937, 2938, 2939, and 2220. All information pertaining to Hospital Franchise Fees will also be filled due to links cost reports.
Retention Period Retention Justification Media Code Method of Disposal
In office and/ or in Storage Retain in office until adjudicated and in records center 5 years, then destroy provided audits are completed, reports are released and all discrepancies are resolved. OAC 2913.4D Paper Shred

Approvals

Status Name Title Date
Approved Dennis Hawk Records Coordinator 2/5/2019 3:16:00 PM
Approved Lisa Stafford Records Officer 2/5/2019 3:41:00 PM
Approved Terri Dittmar Record Administrator 2/6/2019 7:48:00 AM
Approved Fred Previts State Archivist 2/11/2019 10:51:00 AM
Approved Martin Meeks State Auditor 2/15/2019 2:32:00 PM

Notes

Date Reason User

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