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Kansas Records Retention Schedules

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Agency Code: 039 (Department for Aging and Disability Services)

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Agency Number: 039-008
Department for Aging and Disability Services
State Hospitals and Institutions

Operation and oversight of state hospitals and related facilities was transferred to KDADS at the beginning of FY2012.


SERIES ID 0322-629 
TITLE Insurance Notebooks 
DESCRIPTION Insurance claim forms for patient hospitalization billing filed in notebooks for convenience of reference. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0533-629 
TITLE Intermediate Care Facilities Files 
DESCRIPTION Records related to inspections and certifications required by the federal Health Care Financing Administration: reports, regulations, correspondence, etc. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0120-629 
TITLE Intermediate Care Facilities for Mentally Retarded Surveys 
DESCRIPTION Surveys made by the Department of Health and Environment to monitor programs and services which cite any deficiencies and the agency's plan of corrections to ensure compliance with federal standards. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0243-629 
TITLE Intermediate Care Facilities for the Mentally Retarded Financial Records 
DESCRIPTION Financial and statistical records required by all Intermediate Care Facilities for the Mentally Retarded providers to ensure the accountability to the federal government including cost reports. 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0314-629 
TITLE Inventory Database 
DESCRIPTION Computer database used to manage capital property inventory. 
RETENTION See Comments 
COMMENTS Retain data until updated, then delete. Data is also printed in reports scheduled as part of other series. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0531-629 
TITLE Inventory Property Number Registers 
DESCRIPTION Lists of agency non-expendable property on inventory: dates of acquisitions, types of property, descriptions, and property numbers assigned. 
RETENTION See Comments 
COMMENTS Retain until no longer in effect plus 3 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0320-629 
TITLE Inventory Records - Library Materials 
DESCRIPTION Records related to inventory management of library materials. 
RETENTION See Comments 
COMMENTS Retain until superseded by new inventory plus 3 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0530-629 
TITLE Inventory Transaction Register 
DESCRIPTION Hand completed forms listing all purchases of capital equipment - maintained in conjunction with copies of DAM013 reports. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0500-629 
TITLE Invoice Files 
DESCRIPTION Accounts payable records consisting of invoices from vendors and contractors along with some supporting documents. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-13
K.A.R. NUMBER 53-2-075 

SERIES ID 0227-629 
TITLE Job Training and Partnership Act Employees Files 
DESCRIPTION Documents associated with employment of specific personnel under the Job Training and Partnership Act: employment contract, time sheets, evaluations, and other personnel materials. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) & 39-709b 
APPROVED 1993-04-15  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-096 

SERIES ID 0325-629 
TITLE Key Deposit Receipt Books 
DESCRIPTION Receipt books indicating which employee has paid a deposit on a facility key and when the key was returned. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0270-629 
TITLE Key Security Log 
DESCRIPTION Log relating to the control and issuing of facility security key sets. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0466-629 
TITLE Key and Combination Control Files 
DESCRIPTION Documents listing the combinations to locks and to whom key is assigned. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-087 

SERIES ID 0253-629 
TITLE Laboratory Request Slips 
DESCRIPTION Internal forms used to keep track of requests from physicians for various types of laboratory work to be completed on residents including type of work needed, resident's name, date of birth, etc. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0186-629 
TITLE Laboratory Specimen Log 
DESCRIPTION Specimen log used to record the completion of laboratory work for residents. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0327-629 
TITLE Laundry Production Costs Records 
DESCRIPTION Laundry production costs summary data compiled for budgetary purposes. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0104-629 
TITLE Leisure Activities Evaluation Forms 
DESCRIPTION Forms used to evaluate the effectiveness of large group leisure activities for the residents at the facilities. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-13
K.A.R. NUMBER 53-2-093 

SERIES ID 0132-629 
TITLE Linen Delivery Records 
DESCRIPTION Documents used to record the amount of linen delivered to each unit daily. 
RETENTION 001 fisc yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-093 

SERIES ID 0488-629 
TITLE Lists of Outstanding Obligations 
DESCRIPTION DA forms 118 and associated materials used to document funds encumbered from previous fiscal year which are yet to be disbursed. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-075 

SERIES ID 0463-629 
TITLE Maps of Utility Locations 
DESCRIPTION Maps required for maintenance of water lines, sewer lines, telephone cables and other utilities. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0487-629 
TITLE Meal Tickets 
DESCRIPTION Tickets for meals sold to employees and other non-residents. 
RETENTION 001 fisc yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0251-629 
TITLE Mealtime Management Files 
DESCRIPTION Documents relating to the unit feeding committees to assess at-risk residents and their progress. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0351-629 
TITLE Medicaid and Medicare Logs 
DESCRIPTION Logs used in conjunction with cost report data which monitor the charges and payments for billing each patient. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) & 39-709(b) 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0456-629 
TITLE Medical Record - Child or Adolescent 
DESCRIPTION Documents of individual patient care including: medical, psychiatric, social, and legal information, as well as correspondence, progress notes, and response to treatment. 
RETENTION See Comments 
COMMENTS Retain 1 yr beyond the date that patient reaches majority, or 10 years after last discharge date, whichever is longer. Every 100th file transfer to archives. 
DISPOSITION See Comments 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0449-629 
TITLE Medical Staff Bylaws 
DESCRIPTION Original bylaws and updates which physicians must agree to abide by while practicing at the State Hospitals. 
RETENTION See Comments 
COMMENTS Retain until superseded or no longer in effect, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0457-629 
TITLE Medical and Service Records -- SRS Hospitals and Facilities 
DESCRIPTION Documents concerning individual patient care including: medical, psychiatric, social, and legal information, as well as correspondence, progress notes, and response to treatment. 
RETENTION See Comments 
COMMENTS Retain for 10 years after the date of last discharge. According to SRS legal counsel, 45 CFR Section 164.530(j)(2) states "all patient records must be retained for 6 years from the date of the patient's discharge, transfer or death", & 42 CFR Section 482.24(b)(1) states "Medical records must be retained in their original or legally reproduced form for a period of at least 5 years". 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 2011-04-28  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-167 

SERIES ID 0349-629 
TITLE Medicare Remittance Advice 
DESCRIPTION Medicare payment history maintained on patients and used for billing purposes. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-099 

SERIES ID 0696-629 
TITLE Medication Alert/El Dorado Medication Error Tool Form 
DESCRIPTION Forms describing medication errors which occurred during the treatment of patients which are used as a monitoring tool to ensure that quality standards are met and maintained. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-04-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-100 

SERIES ID 0142-629 
TITLE Medication and Supply Requisitions 
DESCRIPTION Internal requisitions received from all areas to the central supply for medication and supplies including area requesting items, date, items requested, quantity, price, person requesting item, etc. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0348-629 
TITLE Menu Files 
DESCRIPTION Documents relating to the preparation of patient dietary needs. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0153-629 
TITLE Midnight Movement Reports 
DESCRIPTION Reports from residence units regarding patient movements in and out of the units - information summarized in Client Census Reports (q.v.). 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1989-04-27  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-079 

SERIES ID 0733-629 
TITLE Minutes - Treatment Teams 
DESCRIPTION Minutes of unit treatment teams which meet to review individual patient activities and treatment. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(3) & KSA 65-5602 
APPROVED 2001-01-11  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-125 

SERIES ID 0408-629 
TITLE Monitoring Information 
DESCRIPTION Documents related to monitoring of patient care and staff clinical performance which includes: protocols, monitoring and quarterly reports related to quality assurance functions for accreditation. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0336-629 
TITLE Monthly Fire Prevention Reports 
DESCRIPTION Reports made on a variety of fire related activities including building, fire and safety inspections, reported hazards, fire drills, reported fires, fire extinguisher inspections, etc. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0345-629 
TITLE Monthly Inspection List 
DESCRIPTION Check list assigning the security officers to the various types of inspections made at the facility for health and safety reasons. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0354-629 
TITLE Monthly Room Inspection Reports 
DESCRIPTION Fire and safety inspection reports made of individual living quarters to ensure the welfare of the patients. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0343-629 
TITLE Music Therapy Activity Files 
DESCRIPTION Documents relating to the planning and implementation of music therapy activities scheduled for the patients. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0342-629 
TITLE Music Therapy Professional Files 
DESCRIPTION Documents relating to the function and operation of the music therapy program. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0311-629 
TITLE Neighborhood Youth Corps Health Records 
DESCRIPTION Minimal health examination records maintained on participants in the NYC (summer job) program: nursing assessments, TB test results, and injury reports. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-076 

SERIES ID 0107-629 
TITLE Nursing Administration Records 
DESCRIPTION Wide variety of documents used in the administration of the nursing services at the facilities. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS Portions may be restricted 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0123-629 
TITLE Nursing Staff Records 
DESCRIPTION Daily staffing sheets used to schedule nurses in the wards to ensure adequate coverage. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0468-629 
TITLE Nutritional Interview 
DESCRIPTION Data gathered and updated regarding patients' nutritional status, including anthropometric, possible food/drug interaction, obvious clinical signs of malnutrition, food habits, food allergies, etc. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0484-629 
TITLE Object Code Ledger Books 
DESCRIPTION Handwritten record of all agency expenditures arranged by object codes: object codes, dates, vendors, voucher numbers, estimated costs, dates paid, and fund balances. 
RETENTION 010 fisc yrs 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0252-629 
TITLE Off Campus Appointment Records 
DESCRIPTION Internal forms used to schedule all appointments made for the residents with consulting physicians not at the facilities. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0341-629 
TITLE Office Machine Repair Files 
DESCRIPTION Documents relating to the service work done on equipment to maintain a repair history and monitor contract maintenance agreements on typewriter and copier machines. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0448-629 
TITLE On-Duty Books 
DESCRIPTION Documents relating to the events during the time a physician covers for off-duty medical staff, namely calls from courts or community officials, as well as problems encountered. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then contact the archives for appraisal, if not accepted, destroy. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0483-629 
TITLE Organization Files 
DESCRIPTION Miscellaneous records related to interaction with other organizations, including local, state, and federal agencies: correspondence, reports, notes, etc. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0339-629 
TITLE Outing Log 
DESCRIPTION Log used to monitor the location and number of trips which patients and accompanying staff take from the facility. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0113-629 
TITLE Outpatient Resident Index Cards 
DESCRIPTION Background documentation filled out on index cards about residents for possible admission to the facility on an outpatient basis. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 76-12(b)(11) & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0437-629 
TITLE Pathology Laboratory Reports - Monthly 
DESCRIPTION Lists of procedures done in the laboratory for patients. 
RETENTION 010 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0225-629 
TITLE Patient Account Management Records 
DESCRIPTION Database records, reports, vouchers and other documents related to collection of payments from clients maintained in hard copy and electronic format. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(1)(3) 
APPROVED 1993-04-15  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-096 

SERIES ID 0337-629 
TITLE Patient Attendance Records 
DESCRIPTION Reports relating to patient attendance in activity therapy groups maintained to provide documentation for any possible investigations or audits. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0258-629 
TITLE Patient Benefit Fund Records 
DESCRIPTION Documents concerning the financial accounting of the patient benefit fund: ledgers, receipts, bank statements, invoices, check ledgers. 
RETENTION 003 fisc yrs 
DISPOSITION Archives 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-099 

SERIES ID 0636-629 
TITLE Patient Billing Files 
DESCRIPTION Patient billing files for hospitalization services including statements, claim forms, copy of insurance cards, insurance authorization, computer printouts, financial packets, etc. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0453-629 
TITLE Patient Card Files 
DESCRIPTION Individual cards for each patient with information including dates, diagnosis, number of admissions of each patient. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0736-629 
TITLE Patient Charge Files 
DESCRIPTION Documents used to prepare patient billing including doctor orders, patient billing statements, physicians charge sheets, census records and pharmacy charges. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0738-629 
TITLE Patient Contact Reports 
DESCRIPTION Monthly statistical reports documenting the number of patient contact hours which are used to provide feedback to the treatment team as well as the summaries used for accreditation surveys. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0447-629 
TITLE Patient Death - Thanatology Reports 
DESCRIPTION Reviews completed by ad hoc committees and submitted to the Clinical Director with recommendations regarding problems noted. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0469-629 
TITLE Patient Grievances 
DESCRIPTION Grievance form letters written to the ombudsman by patients as part of a Patient Advocacy/Complaint Resolution service. 
RETENTION See Comments 
COMMENTS Retain 5 years after resolution of grievance and transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0754-629 
TITLE Patient Log 
DESCRIPTION Log listing pertinent patient information which is used to generate assessments on a timely basis and to review the patient's current status. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0753-629 
TITLE Patient Nutritional Files 
DESCRIPTION Documents relating to patient nutritional needs maintained to ensure that the proper dietary care is provided by the staff. 
RETENTION See Comments 
COMMENTS Retain until superseded, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0455-629 
TITLE Patient Registers 
DESCRIPTION Bound registers of patients admitted. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-087 

SERIES ID 0476-629 
TITLE Payment Journal - Patient Reimbursement 
DESCRIPTION Record of payments credited to patients reimbursement accounts: dates, patient identification, source code, amounts, description of payment, name of parent or guardian, trust fund. 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0474-629 
TITLE Personnel Administration Files 
DESCRIPTION Wide variety of documents used to administer personnel at agency: correspondence, reports, statistics, policies, procedures, studies, notes, etc. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0315-629 
TITLE Personnel and Payroll Database System 
DESCRIPTION Inter-related computer databases used to manage agency personnel and payroll. 
RETENTION See Comments 
COMMENTS All information in database duplicates that found in paper records series schedule elsewhere. Retain data until updated or until no longer useful, then delete. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0459-629 
TITLE Pharmacy - Daily/Monthly Prescription Records 
DESCRIPTION Documents used to keep track of the number of prescriptions issued on a daily basis to patients. 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0433-629 
TITLE Pharmacy Billing Journals 
DESCRIPTION Records of charges to an individual patient and sent to reimbursement for collection purposes to the hospital. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0740-629 
TITLE Photocopier Log 
DESCRIPTION Daily log kept to monitor the number of photocopies made on a monthly basis and to generate a summary report. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0446-629 
TITLE Physicians' Continuing Medical Education Files 
DESCRIPTION Master list of on-grounds continuing medical education files, along with hours completed for each physician. 
RETENTION See Comments 
COMMENTS Retain until termination of physician, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0461-629 
TITLE Prescription Journal for Patients 
DESCRIPTION Journal of prescriptions issued to individual patients. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0303-629 
TITLE Prescriptions 
DESCRIPTION Physicians' prescriptions for various medications to be issued to clients. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-076 

SERIES ID 0413-629 
TITLE Primary Client Service Files 
DESCRIPTION Follow-up sheet made on patients to check the progress of patients. 
RETENTION See Comments 
COMMENTS Retain 10 years after the discharge date. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0473-629 
TITLE Printing Requisitions 
DESCRIPTION Copies of DA forms 104 used to order and pay for work by the State Printer, and supporting materials. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0650-629 
TITLE Private Review Organizations Files 
DESCRIPTION Documents relating to private organizations and reviewed for payment approval to the hospital. 
RETENTION 007 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & KSA 65-5602 
APPROVED 2001-01-11  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-125 

SERIES ID 0511-629 
TITLE Property Disposition Records - Non-Expendable 
DESCRIPTION Copies of DA forms 110 and supporting documents used to remove capital equipment from the agency inventory. 
RETENTION 003 fisc yrs 
COMMENTS A.k.a. "Condemnation Records." 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0117-629 
TITLE Property Relocation Requests 
DESCRIPTION Documents used to keep track of property locations and any possible relocation within the facility. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0110-629 
TITLE Protection from Harm Files 
DESCRIPTION Documents relating to investigations by the Risk Management Division of resident abuse cases which are used to take measures to protect the residents from any further harm. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0724-629 
TITLE Psychiatric Admission/Release Reports 
DESCRIPTION Reports listing the number of admissions and discharges which are used to determine the necessary services in the community to provide placement for patients. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0127-629 
TITLE Psychological Test Kits 
DESCRIPTION Standard psychological tests completed on residents to determine their intelligence level. 
RETENTION See Comments 
COMMENTS Retain test protocols until no longer useful, then destroy. Retain test protocol summaries in respective "Client Records" and retain accordingly. 
DISPOSITION See Comments 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0737-629 
TITLE Psychology Department Clinical Monitoring Plans 
DESCRIPTION Plans developed to monitor the quality and the appropriateness of the care and treatment of individuals who are provided psychological services. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0193-629 
TITLE Psychology Files 
DESCRIPTION Documents relating to the profile and progress or regression in the individual resident's program. 
RETENTION See Comments 
COMMENTS Retain until tenure of resident, then transfer to the resident's file. 
DISPOSITION See Comments 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0758-629 
TITLE Psychotherapy Notes 
DESCRIPTION Notes recorded in any medium by a mental health professional documenting or analyzing the contents of a conversation during a private counseling session or a group, joint, or family counseling session that is maintained separate from the rest of the patient's medical record. 
RETENTION 010 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS K.S.A. 65-5602 & 45-221(a)(3) 
APPROVED 2006-01-13  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-146 

SERIES ID 0506-629 
TITLE Purchase Requisition Control Log 
DESCRIPTION Register of all purchase requisitions generated. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0479-629 
TITLE Purchasing Records - General 
DESCRIPTION Wide variety of documents (largely copies) related to operation of purchasing unit: correspondence, reports, invoices, procedures, publications, etc. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0396-629 
TITLE Quality Assurance Plans 
DESCRIPTION A wide variety of documents relating to the Quality Assurance Program required to meet accreditation standards. 
RETENTION 010 cldr yrs 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0731-629 
TITLE Quality Assurance/Risk Management Activities Files 
DESCRIPTION Documents used to assess the quality assurance and risk management activities at the facility. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0730-629 
TITLE Quality Assurance/Risk Management Supplemental Files 
DESCRIPTION Documents used to supplement the primary documentation, excluding that contained in the incident report files, of specific issues addressed by and activities of the Quality Assurance Committee. 
RETENTION See Comments 
COMMENTS Retain in conjunction with Quality Assurance/Risk Management Activities Files. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0424-629 
TITLE Quality Control Files 
DESCRIPTION Documents relating case analyses made on patients to check on the services provided. 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0729-629 
TITLE Quality Improvement Plans 
DESCRIPTION Documents used to monitor the quality assurance/continuous quality improvement plans and activities at the facility. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0728-629 
TITLE Quality Improvement Supplemental Files 
DESCRIPTION Documents used to supplement the primary documentation of hospital-wide and departmental quality assurance/improvement plans and activities. 
RETENTION See Comments 
COMMENTS Retain in conjunction with Quality Improvement Plans. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0412-629 
TITLE Questionnaires/Survey Forms 
DESCRIPTION Copies of forms completed by the hospital staff as responses to agencies or research programs which have requested data. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0128-629 
TITLE Reach Program Index Cards 
DESCRIPTION Index cards relating to the screening of preschool children with learning disabilities to determine their level and needs for the Reach program which helps prepare them for school. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0727-629 
TITLE Receiving Reports 
DESCRIPTION Reports made regarding the receipt of merchandise or services which are submitted to the accounting section for use in validating invoices. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0502-629 
TITLE Reconciliation of Change Fund (Petty Cash) Records 
DESCRIPTION DA form 75 used to account for petty cash. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0129-629 
TITLE Recreation and Leisure Records 
DESCRIPTION Documents related to the residents' related recreational and leisure activities including assessments data sheets, forms, meeting notes, etc. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS Portions may be restricted 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0442-629 
TITLE Refill Sheets Regarding Controlled Drugs 
DESCRIPTION Requests from wards for refills of prescriptions of controlled drugs. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-01-17  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-087 

SERIES ID 0496-629 
TITLE Reimbursement Statements 
DESCRIPTION Copies of billings sent to guardians and/or parents of patients for care and board of those patients. 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0726-629 
TITLE Release Form 
DESCRIPTION Form listing the length of stay and subsequent release of patients from the facility. 
RETENTION See Comments 
COMMENTS Retain in conjunction with individual patient file. 
DISPOSITION See Comments 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0725-629 
TITLE Release of Information Log 
DESCRIPTION Log listing the nature and purpose of information requested. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0486-629 
TITLE Reports - Miscellaneous 
DESCRIPTION Collection of special reports on a variety of topics related to the agency mission. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 
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