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Kansas Records Retention Schedules

Results of Query:

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

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Agency Number: 039-000
Department for Aging and Disability Services
All Divisions

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0003-039 
TITLE Area Agencies on Aging - Permanent Files 
DESCRIPTION Copies of documents maintained by the Dept. on Aging that establish policies for area agencies on aging: articles of incorporation, by-laws, policy manuals, affirmative action plans, sample contracts. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0004-039 
TITLE Area Plans 
DESCRIPTION Plans submitted by area agencies on aging, used as the basis for grant funding decisions, that contain information on aging program characteristics, objectives, coordination, and service levels. 
RETENTION See Comments 
COMMENTS Retain in office 2 fiscal years after the end of the grant period, transfer to the records center for 3 fiscal years, then transfer to the archives for purging. Supersedes general schedule retention requirements for "Grant Files." 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0005-039 
TITLE Assessment Reports - Federal Administration on Aging 
DESCRIPTION Reports and correspondence related to the Dept. of Health and Human Services' Administration on Aging's evaluations of the services provided by the Kansas Department on Aging. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0006-039 
TITLE Assessments - Area Agencies on Aging 
DESCRIPTION Assessment reports, correspondence, and other documents relating to the Department on Aging's periodic evaluations of the effectiveness of each area agency on aging. 
RETENTION 003 fisc yrs 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0008-039 
TITLE Audit Reports - Area Agencies on Aging 
DESCRIPTION Results of audits of area agencies on aging or other contractors conducted by independent auditors. 
RETENTION 005 fisc yrs 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0036-039 
TITLE Correspondence - Constituent Concerns 
DESCRIPTION Correspondence and other documents pertaining to concerns expressed by individuals on aging related issues and the agency's responses to the complaints. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. Supersedes general schedule retention requirements for "Correspondence." Such correspondence may be filed with program or grant records; if so, it should not be purged but should be transferred to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(14) 
APPROVED 2011-10-13 
K.A.R. NUMBER 53-2-169 

SERIES ID 0019-039 
TITLE Governor's Conference on Aging Files 
DESCRIPTION Variety of documents pertaining to the planning of a biennial educational conference held for Kansas seniors and professionals involved in the field of aging. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0026-039 
TITLE Program Reports - Older Americans Act Grants 
DESCRIPTION Interim and final reports submitted to the Department on Aging by area agencies on aging used to monitor the progress of federally funded grant projects to provide services for the elderly. 
RETENTION See Comments 
COMMENTS Retain in office 2 fiscal years after the end of the grant period, transfer to the records center for 3 fiscal years, then transfer to the archives for purging. Supersedes general schedule retention requirements for "Grant Files." 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0001-039 
TITLE Rules and Regulations Working files 
DESCRIPTION Notes, staff suggestions, copies of regulations, and other documents relating to the process of revising the agency's administrative regulations.  
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2011-10-13 
K.A.R. NUMBER 53-2-169 

SERIES ID 0029-039 
TITLE State Plan on Aging Files 
DESCRIPTION Documents relating to the formulation of the State Plan on Aging submitted to the federal Administration on Aging as required by Title III of the Older Americans Act. 
RETENTION See Comments 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 3 fiscal years, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0030-039 
TITLE State Program Reports - Title III Older Americans Act 
DESCRIPTION Annual report submitted by the Dept. on Aging to the federal Administration on Aging providing aggregate statistical data on services provided to older Kansans under OAA Title III. 
RETENTION See comments 
COMMENTS Retain working files for five calendar years, then destroy. Send copy of final State Plan to archives. 
DISPOSITION See comments 
RESTRICTIONS None 
APPROVED 2011-10-13 
K.A.R. NUMBER 53-2-168 

SERIES ID 0035-039 
TITLE Training/Meeting/Field Reports 
DESCRIPTION Reports prepared by staff members summarizing the content of meetings attended, training sessions conducted, or field work performed and maintained to monitor staff activities. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

Agency Number: 039-001
Department for Aging and Disability Services
Office of the Secretary

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0154-039 
TITLE Assessments - Working Files 
DESCRIPTION Correspondence, notes, drafts, etc. relating to the preparation of the reports on the periodic evaluation of the effectiveness of each agency on aging. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2000-01-13 
K.A.R. NUMBER 53-2-122 

SERIES ID 0350-629 
TITLE Cost Report Data 
DESCRIPTION Statistical and financial data accumulated by the staff and used to prepare the annual Cost Reports. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) & 39-709(b) 
APPROVED 2015-09-24  ; Revised 2015-09-24
K.A.R. NUMBER 53-2-099 

SERIES ID 0037-039 
TITLE Employee Grievance Files 
DESCRIPTION Variety of documents related to grievances filed by employees against the agency under state civil service and civil rights protection statutes. These are not EEO grievance files. 
RETENTION See Comments 
COMMENTS Retain 5 years after grievance is settled, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(11)(25) 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0042-039 
TITLE Subject Files - Administrative Assistant to the Secretary 
DESCRIPTION Correspondence, reports, notes, publications, and other documents relating to the activities and interests of the agency secretary. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0043-039 
TITLE Subject Files - Secretary 
DESCRIPTION Variety of documents relating to the administration and operation of the agency. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS Portions per KSA 45-221(a)(4) 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0044-039 
TITLE Working Files - Personnel 
DESCRIPTION Variety of documents relating to personnel administration in the Department on Aging. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

Agency Number: 039-001
Department for Aging and Disability Services
Office of the Secretary
Accounting Unit

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0157-039 
TITLE Cost Allocations - Health and Human Services 
DESCRIPTION Applications and supporting documentation submitted to state or federal grantor agencies to support the department's plan for allocating costs for administering its programs. 
RETENTION 007 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 5 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2002-01-10 
K.A.R. NUMBER 53-2-129 

Agency Number: 039-001
Department for Aging and Disability Services
Office of the Secretary
Nursing Facility Program

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0046-039 
TITLE Nursing Facility Program Files 
DESCRIPTION Application, correspondence, provider agreement, certification and transmittals, etc. relating to nursing care facilities' eligibility to participate in the Medicare & Medicaid reimbursement program. 
RETENTION 010 cldr yrs 
COMMENTS Retain in office 3 calendar years, transfer to the records center for 7 calendar years, then destroy. The provider agreement is the only original document, the remainder are copies received from KDHE. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

Agency Number: 039-003
Department for Aging and Disability Services
Operations

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0049-039 
TITLE Grant Administration Files 
DESCRIPTION Notices of grant awards, financial status reports, correspondence, and other documents relating to the administration of grant funds distributed by the agency to area agencies on aging. 
RETENTION See Comments 
COMMENTS Retain in office 2 fiscal years after the end of the grant period, transfer to the records center for 3 fiscal years, then transfer to the archives for purging. Supersedes general schedule retention requirements for "Grant Files." 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0051-039 
TITLE Grant Payment Vouchers 
DESCRIPTION Documents relating to agency disbursement of grant funds to area agencies on aging including DA 120 forms and advance cash request forms. 
RETENTION See Comments 
COMMENTS Retain in office 2 fiscal years after the end of the grant period, transfer to the records center for 3 fiscal years, then destroy. Supersedes general schedule retention requirements for "Grant Files." 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0059-039 
TITLE Purchasing Records 
DESCRIPTION Documents related to the purchase of goods and services: correspondence, vouchers, invoices, ledger books and cards, requisitions, etc. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0065-039 
TITLE Vehicle Operation Records 
DESCRIPTION Documents related to the use of state-owned motor vehicles: MP forms 1a, 2c, 3a, 3b, 10, 20, and internal agency forms. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

Agency Number: 039-003
Department for Aging and Disability Services
Operations
Community Based Services

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0159-039 
TITLE Home and Community Based Cost Cap Exception Files 
DESCRIPTION Application and supporting documentation relating to older Kansans applying for Medicaid assistance above the normal cost of regular planning care. 
RETENTION See Comments 
COMMENTS Retain in office until case is closed, transfer to the records center for 5 years, then destroy 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 2001-04-12 
K.A.R. NUMBER 53-2-126 

Agency Number: 039-004
Department for Aging and Disability Services
Advocacy and Legislation

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0172-039 
TITLE Correspondence - Partnership Loan Program 
DESCRIPTION Incoming and outgoing letters and memoranda relating to the Partnership Loan Program. 
RETENTION 005 cldr yrs 
COMMENTS Retain in office 2 years, transfer to the records center for 3 years, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2003-01-09 
K.A.R. NUMBER 53-2-133 

SERIES ID 0170-039 
TITLE Partnership Loan Program Application Files - Denied 
DESCRIPTION Application and supporting documentation relating to the denial of loans to submitting nursing facilities. 
RETENTION See Comments 
COMMENTS Retain in office for 2 years after the date of final disposition, transfer to the records center for 3 years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2003-01-09 
K.A.R. NUMBER 53-2-133 

SERIES ID 0169-039 
TITLE Partnership Loan Program Files - Approved 
DESCRIPTION Application and supporting documentation relating to nursing facilities applying and receiving loans to support expansion of services and housing alternatives for senior Kansans. 
RETENTION See Comments 
COMMENTS Retain in office for 3 years, transfer to the records center until 7 years after the end date of the loan, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2003-01-09 
K.A.R. NUMBER 53-2-133 

SERIES ID 0168-039 
TITLE Program for All-inclusive Care for the Elderly (PACE) Files 
DESCRIPTION Registration form, monthly financial statements, service utilization reports, outcome based efficiency reports, payment reports, etc. relating to a program designed to provide comprehensive medical and social services managed care benefits for the frail elderly. 
RETENTION 005 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 3 fiscal years, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS 42 CFR Part 460 
APPROVED 2003-01-09 
K.A.R. NUMBER 53-2-133 

SERIES ID 0070-039 
TITLE Silver Haired Legislature Files 
DESCRIPTION Correspondence, copies of testimony, copies of proceedings, and other documents related to the Silver Haired Legislature which offers recommendations to the legislature and governor on aging issues. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

Agency Number: 039-004
Department for Aging and Disability Services
Advocacy and Legislation
Home and Community Based Services

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0166-039 
TITLE Home and Community Based Services Resident Status Review Files 
DESCRIPTION Level of care score reviews conducted upon residents in nursing facilities to determine whether their needs could be served within the community. 
RETENTION 005 fisc yrs 
COMMENTS Retain in office 1 fiscal year, transfer to the records center for 4 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2003-01-09 
K.A.R. NUMBER 53-2-133 

SERIES ID 0165-039 
TITLE Home and Community Based Services Resident Status Review Training Materials 
DESCRIPTION Manuals, forms, handouts, etc. relating to the preparation of Resident Status Review training. 
RETENTION See Comments 
COMMENTS Retain until training program is obsolete, then transfer one copy of each manual, syllabus, textbook and/or handouts to the archives. Destroy the remainder. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2003-01-09 
K.A.R. NUMBER 53-2-133 

Agency Number: 039-004
Department for Aging and Disability Services
Advocacy and Legislation
Public Health Educator

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0099-039 
TITLE Publications - Public Health Education 
DESCRIPTION Publications produced and distributed by the Department on Aging on health issues affecting older Kansans. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer two copies of each publication to the archives, destroy the remainder. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

Agency Number: 039-004
Department for Aging and Disability Services
Advocacy and Legislation
Senior Care Act Coordinator

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0106-039 
TITLE Senior Care Act Program Evaluations 
DESCRIPTION Independent studies of the Senior Care Act program produced to evaluate the effectiveness of the program that provides state grant funds for in-home services for older Kansans. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

SERIES ID 0107-039 
TITLE Senior Care Act Program Files 
DESCRIPTION Variety of documents related to the establishment and implementation of the Senior Care Act program that provides in-house assistance to the elderly. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

Agency Number: 039-005
Department for Aging and Disability Services
Client, Assessment and Referral Program

Starting at the beginning of FY2013, the Department on Aging changed its name under governor executive order to the Department for Aging and Disability Services (KDADS). The KDOA had been formed in 1977 out of the Services for Aging Section of the Kansas Department of Social and Rehabilitation Services (SRS).


SERIES ID 0111-039 
TITLE Annual Report Drafts 
DESCRIPTION Working files compiled and used to produce the agency annual report. 
RETENTION 002 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1999-01-13 
K.A.R. NUMBER 53-2-118 

SERIES ID 0114-039 
TITLE CARE Level I Monthly Billing and CARE Reports 
DESCRIPTION Monthly billing reports submitted by Area Agencies on Aging to the Department on Aging for reimbursement to nursing home facilities operating at CARE Level I. 
RETENTION 007 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 5 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2000-04-13 
K.A.R. NUMBER 53-2-123 

SERIES ID 0116-039 
TITLE CARE Level II Monthly Billing and CARE Reports 
DESCRIPTION Monthly billing reports submitted by Area Agencies on Aging to the Department on Aging for reimbursement to nursing home facilities operating at CARE Level II. 
RETENTION 007 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 5 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2000-04-13 
K.A.R. NUMBER 53-2-123 

SERIES ID 0119-039 
TITLE End of Year Data 
DESCRIPTION Statistical data compiled as required for Health Care Finance Administration reporting. 
RETENTION 007 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 5 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1999-01-13 
K.A.R. NUMBER 53-2-118 

SERIES ID 0123-039 
TITLE Preadmission Screenings and Annual Resident Reviews (PASARR) 
DESCRIPTION Correspondence, medical records, assessments, etc. made on individuals diagnosed with either a mental illness or mental retardation to determine the level of care. 
RETENTION 80 fisc yrs 
COMMENTS Retain in office 10 fiscal years, transfer to the records center for 70 years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1999-04-15 
K.A.R. NUMBER 53-2-119 

SERIES ID 0153-039 
TITLE Procedures Manuals 
DESCRIPTION Original copies of agency procedures issued in a collective manual. 
RETENTION See Comments 
COMMENTS Retain until superseded or no longer in effect, then transfer 1 copy to the archives, destroy the remainder. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1999-01-13 
K.A.R. NUMBER 53-2-118 

Agency Number: 039-006
Department for Aging and Disability Services
Budget, Finance, and Analysis

SERIES ID 0128-039 
TITLE Payments for Frail and Elderly Services 
DESCRIPTION Documents relating to the reconciliation of Blue Cross, STARS, and SRS payments made under the Frail and Elderly Waiver. 
RETENTION 007 fisc yrs 
COMMENTS Retain in office 1 fiscal year, transfer to the records center for 6 fiscal years, then destroy. Meets Health Care Finance Administration requirements. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1999-01-13 
K.A.R. NUMBER 53-2-118 

SERIES ID 0129-039 
TITLE Population Statistics 
DESCRIPTION Census statistics gathered to determine minority population percentages in each planning and service area and used to calculate target minority participation rates for aging programs. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-04-14 
K.A.R. NUMBER 53-2-100 

Agency Number: 039-006
Department for Aging and Disability Services
Budget, Finance, and Analysis
Accounting and Financial Management

SERIES ID 0163-039 
TITLE Revisions of Financial Reports 
DESCRIPTION Correspondence, reports, work papers, etc. relating to the carryover of state and federal funds as computed by the agency based upon corrections of errors in calculating the Project Income Match. 
RETENTION 007 fisc yrs 
COMMENTS Retain in office 1 fiscal year, transfer to the records center for 6 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12 
K.A.R. NUMBER 53-2-126 

Agency Number: 039-006
Department for Aging and Disability Services
Budget, Finance, and Analysis
Audit

SERIES ID 0132-039 
TITLE Nursing Facilities Central Office Files 
DESCRIPTION Documents relating to the distribution of costs among multiple nursing care facilities owned by a corporation as calculated by its central office. 
RETENTION 005 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 3 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0133-039 
TITLE Nursing Facility Audit Reports 
DESCRIPTION Audit reports, supporting documentation and copies of nursing facility program files reviewed both within the agency and by the Health Care Finance Administration to ensure accountability. 
RETENTION See Comments 
COMMENTS Retain in office 2 years, purge files and transfer audit reports and supporting documentation to the records center for 3 years, then destroy. Retain ownership papers until closure plus 5 years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

Agency Number: 039-006
Department for Aging and Disability Services
Budget, Finance, and Analysis
Reimbursement

SERIES ID 0134-039 
TITLE Appeals Files 
DESCRIPTION Documents relating to nursing care providers that appeal reimbursement actions established by the Department on Aging. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. SRS Fair Hearings Section retains the originals. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(25) 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0137-039 
TITLE Case Mix Project Files 
DESCRIPTION Documents relating to the reimbursement proportion established for nursing care providers based upon the case mix. 
RETENTION 005 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 3 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0140-039 
TITLE Litigation Case Files - Reimbursement 
DESCRIPTION Copies of documents relating to lawsuits filed in state and federal courts which usually involve but are not limited to reimbursement and audit actions. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(29) 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0141-039 
TITLE Nursing Facility Finding Files 
DESCRIPTION Documents used to establish reimbursement rates allowed by the Health Care Finance Administration to nursing care providers. 
RETENTION 006 fisc yrs 
COMMENTS Retain in office 3 fiscal years, transfer to the records center for 3 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0142-039 
TITLE Nursing Facility Reimbursement Files 
DESCRIPTION Cost reports and copies of the nursing facility program file which the reimbursement division reviews and uses to establish reimbursement rates for nursing care providers. 
RETENTION 010 fisc yrs 
COMMENTS Retain in office 3 fiscal years, transfer to the records center for 7 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0144-039 
TITLE Post-Payment Reports 
DESCRIPTION Monthly computer printouts generated by EDS or Blue Cross listing claim payment data from nursing care providers. 
RETENTION 007 fisc yrs 
COMMENTS Retain in office 2 fiscal years, transfer to the records center for 5 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0146-039 
TITLE Quality Indicator Profile Reports 
DESCRIPTION Computer report detailing the aggregate data on case distribution in each nursing facility which is used to determine reimbursement rates. 
RETENTION 005 fisc yrs 
COMMENTS Retain in office 1 fiscal year, transfer to the records center for 4 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0147-039 
TITLE Rate Schedules - Book Copy 
DESCRIPTION Compilation of computer printouts generated summarizing cost report data which is used to determine reimbursement rates for nursing care providers and maintained for convenience of reference. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0149-039 
TITLE Resident Listing Report 
DESCRIPTION Quarterly computer printout listing the residents living in each nursing facility. 
RETENTION 005 fisc yrs 
COMMENTS Retain in office 1 fiscal year, transfer to the records center for 4 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

SERIES ID 0150-039 
TITLE State Plan Files 
DESCRIPTION Comprehensive plan developed in conjunction with the Health Care Finance Administration to establish methods, standards, and reimbursement rates for nursing care providers. 
RETENTION 013 cldr yrs 
COMMENTS Retain in office 10 calendar years, transfer to the records center for 3 calendar years, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1998-07-14 
K.A.R. NUMBER 53-2-116 

Agency Number: 039-007
Department for Aging and Disability Services
Senior Health Insurance Counseling for Kansas

SERIES ID 0174-039 
TITLE Senior Health Insurance Counseling (SHICK) Files 
DESCRIPTION Documents relating to assistance provided by community volunteers to seniors regarding Medicare and other health care insurance issues. 
RETENTION 002 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS K.S.A. 45-221(a)(3) 
APPROVED 2006-10-12 
K.A.R. NUMBER 53-2-149 

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 0583-629 
TITLE AWOL/Missing Persons Reports 
DESCRIPTION Copies of forms completed by Security Department officers indicating that a patient's location is unknown and used to notify the proper authorities and personnel to begin search procedures. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 
APPROVED 1997-04-10  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-111 

SERIES ID 0309-629 
TITLE Accountable Medication Records 
DESCRIPTION Documents used to maintain inventories of controlled substances in the residential units - indicates all issuances, to whom issued, and running balances. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-074 

SERIES ID 0382-629 
TITLE Accounts Receivable Ledgers - Patients 
DESCRIPTION Documents related to the collection of payments due the facility for Medicare, Medicaid, and insurance billing purposes. 
RETENTION 003 fisc yrs 
COMMENTS See also Vouchers - Receipts. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0360-629 
TITLE Accounts Receivable Records 
DESCRIPTION Documents related to the collection of payments due the agency: copies of invoices, correspondence, DA forms 32, etc. 
RETENTION 003 fisc yrs 
COMMENTS See also Vouchers - Receipts. 
DISPOSITION Destroy 
RESTRICTIONS Portions may be restricted per KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0216-629 
TITLE Activity Descriptions 
DESCRIPTION Descriptions made and reviewed by the staff of various recreational activities planned for the residents which are used to determine the feasibility of such activities. 
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 0359-629 
TITLE Activity Therapy Monthly Reports 
DESCRIPTION Monthly reports monitoring patient participation in scheduled activities. 
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 0358-629 
TITLE Activity Therapy Patient Program Files 
DESCRIPTION Wide variety of documents relating to the activity therapy programs offered to patients to help with their progress. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
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 0357-629 
TITLE Activity Therapy Quality Assurance Monitors Files 
DESCRIPTION Semi-annual staff performance evaluations produced to ensure the quality and appropriateness of activity therapy programs and activities. 
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 0148-629 
TITLE Admission Application Files - Not Accepted 
DESCRIPTION Documents regarding applications for admission to the Institute which were not approved: correspondence, reports, application forms, and supporting materials. 
RETENTION 010 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 0356-629 
TITLE Admissions Log 
DESCRIPTION Log compiled on all patients admitted to the state hospitals which is used for reimbursement purposes. 
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 0222-629 
TITLE Agency Financial Reports 
DESCRIPTION Daily, monthly, and annual computer printouts listing by object code all funds budgeted, expended, encumbered, and the balance. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. These are not CASK or STARS reports. Previously titled "Agency Monthly Reports." 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1993-04-15  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-096 

SERIES ID 0187-629 
TITLE Agency Monthly Reports 
DESCRIPTION Monthly computer reports listing by object code all funds budgeted, expended, encumbered, and the balance. 
RETENTION See Comments 
COMMENTS These are not CASK or STARS reports. Previously titled "Summary of Expenditures by Object Code Reports." 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0435-629 
TITLE Antibiotic Daily Reports 
DESCRIPTION Reports of antibiotics issued on a daily basis to patients. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0472-629 
TITLE Applicants Register 
DESCRIPTION Computer reports listing names and addresses of applicants for employment. 
RETENTION 003 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-075 

SERIES ID 0755-629 
TITLE Asbestos Removal Reports 
DESCRIPTION Documents relating to the removal of asbestos from buildings on the state hospital grounds. 
RETENTION 005 cldr yrs 
COMMENTS Retain in office 5 calendar years, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2003-01-09  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-133 

SERIES ID 0444-629 
TITLE Audiometric Screening Test Results 
DESCRIPTION Requisitions for hearing tests and test results for patients. 
RETENTION See Comments 
COMMENTS Retain for 10 years after the date of last discharge or one year beyond the date that patients who are minors reach their majority, whichever is longer. 
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 0179-629 
TITLE Augmentative Files 
DESCRIPTION Documents concerning the use and operation of the augmentative equipment which provides alternative ways to communicate with 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 0395-629 
TITLE Authorized Purchase Order Listings 
DESCRIPTION Handwritten journals of expenditures encumbered and allowed by funding codes. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-075 

SERIES ID 0452-629 
TITLE Bank Statements and Cancelled Checks 
DESCRIPTION Banking documents related to a variety of fund accounts. 
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 0384-629 
TITLE Banking Records 
DESCRIPTION Bank statements, deposit books and slips, check registers, and canceled checks. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0125-629 
TITLE Biennial Reports 
DESCRIPTION Biennial reports containing information relating to the activities of the state hospitals. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer one copy to the archives and destroy the remainder. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1993-04-15  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-096 

SERIES ID 0524-629 
TITLE Boiler Operation Log 
DESCRIPTION Record of essential data on power plant boiler operation: temperature, pressure, etc. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0523-629 
TITLE Budget Preparation Files - Annual 
DESCRIPTION Documents used in the preparation of annual agency budget: correspondence, draft budget requests, computer reports, notes, and other miscellaneous materials. 
RETENTION 005 fisc yrs 
COMMENTS Portions and/or duplicates of this series is also maintained in the business office - duplicate materials may be discarded prior to transfer to the archive or purged once transferred. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0521-629 
TITLE Building Construction Files 
DESCRIPTION Records related to building construction projects: correspondence, drawings, contracts, specifications, bid information and awards, etc. 
RETENTION Permanent 
COMMENTS Retain permanently in office or transfer to archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0520-629 
TITLE Building Maintenance Files 
DESCRIPTION Records related to building maintenance projects: correspondence, drawings, bids, publications, notes, etc. 
RETENTION 010 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14 
K.A.R. NUMBER 53-2-075 

SERIES ID 0597-629 
TITLE Building Security Violation Report 
DESCRIPTION Form completed by Security Department officers during their assigned routine inspections to ensure that any lapses in security procedures are corrected. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1997-04-10  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-111 

SERIES ID 0405-629 
TITLE Bylaws 
DESCRIPTION Formal policy statements regarding the administrative and organizational structure of the hospital and the responsibilities of individuals and committees. 
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 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0166-629 
TITLE CETA Files 
DESCRIPTION Records concerning work performance and training of individuals employed under the CETA program: copies of certificates and diplomas, applications, transcripts, time sheets, agreements, etc. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 1988-10-13  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-076 

SERIES ID 0250-629 
TITLE Cancelled Forms List 
DESCRIPTION List of all the cancelled forms which is kept for reference in the event a discontinued form needs to be used again. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-093 

SERIES ID 0389-629 
TITLE Canteen Fund Records 
DESCRIPTION Documents concerning the financial accounting of the canteen fund: ledgers, receipts, bank statements, invoices, check ledgers. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0518-629 
TITLE Capital Improvement Projects Cost Statistics 
DESCRIPTION Documents related to building construction costs: vouchers, ledger sheets, correspondence, 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 0451-629 
TITLE Card File of Patients 
DESCRIPTION Documents relating to patients' medical history and current status. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer one copy to the archives, the remainder destroy. 
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 0387-629 
TITLE Carpet Care Records 
DESCRIPTION Documents recording the frequency of carpet care to ensure proper maintenance. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0397-629 
TITLE Case Files of Employees 
DESCRIPTION Documents relating to investigations of employee conduct including: court orders, reports to courts, correspondence and personal notes of attorneys, investigative reports, and grievances. 
RETENTION See Comments 
COMMENTS Retain 5 years after case is closed, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0460-629 
TITLE Case Files of Patients 
DESCRIPTION Documents relating to investigations of patient conduct including: court orders, reports to courts, correspondence and personal notes of attorneys, investigative reports, grievances. 
RETENTION See Comments 
COMMENTS Retain 5 years after case is closed, 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 0425-629 
TITLE Caseload Sampling 
DESCRIPTION Samplings made of case loads to compare against certain standards and how the patient was being supported. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
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 0465-629 
TITLE Cemetery Records - Patients and Stillborn Infants 
DESCRIPTION Documents related to the graves in the hospital cemetery. 
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 0386-629 
TITLE Census Reports 
DESCRIPTION Electronic and manual census reports of patients compiled to monitor the patient population and used for billing purposes. 
RETENTION 005 cldr yrs 
COMMENTS Formerly titled Computer Census Reports. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0241-629 
TITLE Center Forms List 
DESCRIPTION List of all the forms created for the facilities which is used to keep track of any revisions, cancellations, or new forms. 
RETENTION See Comments 
COMMENTS Retain until superseded, then place in "Cancelled Forms List." 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0394-629 
TITLE Central Nursing Daily Reports 
DESCRIPTION Daily reports of nursing concerns related to patient care or medical conditions including illnesses and behaviors that required special control. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
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 0374-629 
TITLE Chaplainry Services Monthly Reports 
DESCRIPTION Monthly reports relating to the various types of chaplainry services provided 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 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0385-629 
TITLE Chaplainry Services Quality Assurance Monitors Files 
DESCRIPTION Documents used to monitor the quality and appropriateness of chaplainry services to ensure quality assurance standards are met. 
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 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0490-629 
TITLE Check Registers and Stubs 
DESCRIPTION Records of bank transactions related to reimbursement operations. 
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 0672-629 
TITLE Child/Adult Abuse Hotline Report 
DESCRIPTION Copies of reports summarizing the content of calls received on the child and adult abuse and neglect hotline which are maintained to verify that proper action was taken in the event of a lawsuit. 
RETENTION See Comments 
COMMENTS Retain in office 2 calendar years, transfer to the records center for 19 years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 38-1507 and 39-1404 
APPROVED 1994-04-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-100 

SERIES ID 0682-629 
TITLE Children Hospitalization Report 
DESCRIPTION Documents relating to the hospitalization of children who are ready for placement in the community. 
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 0516-629 
TITLE Client Abuse Records 
DESCRIPTION Records related to allegations, charges, and investigations of abuse of clients by staff members: correspondence, reports, photographs, legal documents, etc. 
RETENTION See Comments 
COMMENTS Retain until case is closed plus 3 calendar years, then transfer to archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0482-629 
TITLE Client Account Ledger Cards 
DESCRIPTION Record of expenditures for individual client's care and board, of reimbursement received thereof, and subsequent credit/debit balances. 
RETENTION See Comments 
COMMENTS Two subseries: 1. Care and Maintenance and 2. Trust Fund (obsolete). 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0471-629 
TITLE Client Accounts Worksheets 
DESCRIPTION Ledger style spread sheets used in accounting for client costs & reimbursements thereof. 
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 0161-629 
TITLE Client Admission and Discharge Register 
DESCRIPTION Log of all patients admitted and discharged - includes date of admission, patient number, county of admission, number of admissions and re-admissions for each client, and client's date of birth. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives. Contains three sub-series: residents, out-patients, and discharges. 
DISPOSITION Archives 
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 0313-629 
TITLE Client Benefit Fund Database System 
DESCRIPTION Inter-related computer databases used to manage Client Benefit Fund. 
RETENTION See Comments 
COMMENTS Print data in report monthly and maintain with Client Benefit Fund General Accounting Records, then delete data from hard disk. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0480-629 
TITLE Client Benefit Fund General Accounting Files 
DESCRIPTION Documents related to the administration of and accounting for the Client Benefit Fund: receipt books, worksheets, memoranda of withdrawals, computer reports, check stubs and books, etc. 
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 0154-629 
TITLE Client Card File - Master 
DESCRIPTION Abstracts of client records maintained on 5x7 cards: name, number, parents or guardians, vital statistics, admission and discharged information, personal information, diagnoses, records of leaves. 
RETENTION See Comments 
COMMENTS Retain until client deceased or discharged plus 25 years, then transfer to archives. 
DISPOSITION Archives 
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 0170-629 
TITLE Client Census Reports 
DESCRIPTION Daily and monthly summaries of client movement statistics (admissions, discharges, etc.) - includes short entries regarding individual clients moved. 
RETENTION 005 cldr yrs 
DISPOSITION Archives 
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 0157-629 
TITLE Client Census Working Files 
DESCRIPTION Records documenting the compilation of the Client Census Reports (q.v.): notes, completed forms, worksheets, etc. 
RETENTION 003 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 0497-629 
TITLE Client Files 
DESCRIPTION Records of financial conditions of clients' guardians or parents maintained for purposes of assigning reimbursement charges for care and board of those patients. 
RETENTION See Comments 
COMMENTS Retain until after death or discharge of client plus 20 calendar years, then transfer to archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 65-5602 & 45-221(a)(1)(3) 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0298-629 
TITLE Client Prescription Profiles 
DESCRIPTION Records of prescriptions for individual clients - duplicate maintained in Client Files (q.v.) at medical records center. 
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 0162-629 
TITLE Client Records 
DESCRIPTION Records on all aspects of clients' diagnoses and treatment: medical, psychological, social, educational, speech and audiology, dental, unit filings, crisis files, etc. Includes outpatient & transfer. 
RETENTION See Comments 
COMMENTS Retain 10 years after client deceased or discharged, or one year beyond date minor client reaches age 18, whichever is greater, then transfer every 100th file to archives - destroy remainder. 
DISPOSITION See Comments 
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 0289-629 
TITLE Client Trust Fund Database System 
DESCRIPTION Inter-related computer databases used to manage the Client Trust Fund and containing information regarding receipts, expenditures, balances, and individual patients' financial situations. 
RETENTION See Comments 
COMMENTS Transfer data to floppy disks yearly and delete from hard disk - retain floppy disks for 3 additional fiscal years, then erase. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0489-629 
TITLE Client Trust Fund General Accounting Records 
DESCRIPTION Records related to administration of and accounting for the Client Trust Fund: receipts, withdrawal slips, bank books and statements, etc. 
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 0478-629 
TITLE Client Trust Fund Monthly Transaction Lists 
DESCRIPTION Monthly computer report of all activities in the Client Trust Fund. 
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 0503-629 
TITLE Client Trust Fund Receipts and Sales Slips 
DESCRIPTION Records of purchases for and/or by clients using trust fund monies. 
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 0477-629 
TITLE Client Trust Fund Vouchers 
DESCRIPTION Internal form used to document purchases by resident using trust fund monies. 
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 0383-629 
TITLE Clinical Director's Files 
DESCRIPTION Documents relating to the administration and management of the clinical director's office. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0404-629 
TITLE Clinical Privileges 
DESCRIPTION Documents relating to the granting of clinical privileges for persons in various departments. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0393-629 
TITLE Clinical Privileges Review Panel Files 
DESCRIPTION Minutes and other documents relating to the review process for granting clinical privileges to staff in various departments. 
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 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0299-629 
TITLE Clothing Inventory Records 
DESCRIPTION Documents used to keep track of the clothing and personal property of residents. 
RETENTION See Comments 
DISPOSITION Destroy 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-093 

SERIES ID 0255-629 
TITLE Community Services Client Files 
DESCRIPTION Documents maintained on clients outside the facility which contains behavioral consults, testing, and recommendations by the staff for them. 
RETENTION Permanent 
DISPOSITION Permanent 
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 0268-629 
TITLE Community Services Files 
DESCRIPTION Documents relating to community services projects completed by the staff including logs, hours, trips, evaluation reports, and test results. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
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 0275-629 
TITLE Compliance Reports 
DESCRIPTION Reports created to help plan, monitor and review the various programs within the facility to ensure compliance with federal and state regulations. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0515-629 
TITLE Condition Reports 
DESCRIPTION Completed forms used to survey and report on conditions for specific units of the physical plant. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-075 

SERIES ID 0135-629 
TITLE Consent Form Files 
DESCRIPTION Consent forms signed by the individual resident's guardian for a variety of reasons including medication consents, photo releases, release of information forms, authorizations for off-campus. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then place in respective 'Client Records.' 
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 0430-629 
TITLE Continuing Education Units 
DESCRIPTION Documents relating to the accumulation of continuing education units granted to maintain licensure of the professional staff. 
RETENTION See Comments 
COMMENTS Retain until expiration of license, plus 1 year, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0434-629 
TITLE Controlled Drugs Records 
DESCRIPTION Documents listing controlled drugs prescribed and dispensed by physicians and used as a tracking mechanism and required by the Drug Enforcement Act. 
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 0380-629 
TITLE Correspondence 
DESCRIPTION Incoming and outgoing letters and memoranda. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then contact the archives for appraisal - if not accepted for transfer to the archives, then destroy. 
DISPOSITION See Comments 
RESTRICTIONS Portions may be restricted per KSA 65-5602 & 45-221(a)(3) 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0428-629 
TITLE County Masterfile Error Listing 
DESCRIPTION Lists of case errors that workers made in entering amounts to be paid by clients. 
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 0144-629 
TITLE Courier Log 
DESCRIPTION Log used to record all packages delivered to the switchboard by the courier companies. 
RETENTION 001 fisc yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0379-629 
TITLE Craft Ideas and Samples Files 
DESCRIPTION Documents relating to the planning and implementation of patient recreational activities. 
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 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0378-629 
TITLE Credential Files 
DESCRIPTION Documents relating to the credentialing of the staff, including correspondence, evaluations, and credentials added during time of employment. 
RETENTION See Comments 
COMMENTS Retain 5 years after termination of employee, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0307-629 
TITLE Daily Activity Journals - Pharmacy 
DESCRIPTION Daily logs of prescription medication issued, to whom, by whom, and quantity issued. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-074 

SERIES ID 0377-629 
TITLE Daily Activity Log 
DESCRIPTION Daily log listing patient activities used for convenience of reference. 
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 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0458-629 
TITLE Daily Bulletins 
DESCRIPTION Daily census reports indicating names, legal status, and county of origin, as well as daily patient movement within the grounds. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
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 0376-629 
TITLE Daily Fund Balances 
DESCRIPTION Final balances on all funds calculated on a daily basis to ensure accountability for all financial transactions. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0757-629 
TITLE Daily Infection Report 
DESCRIPTION Reports submitted daily by each unit to the health clinic indicating the types of infections and treatments for patients. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 2003-07-17  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-135 

SERIES ID 0346-629 
TITLE Daily Movement Log 
DESCRIPTION Daily log used to monitor the movement of the patient population. 
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 0392-629 
TITLE Dedication of All Faith Chapel File 
DESCRIPTION Documents relating to the dedication of the All Faith Chapel at Larned State Hospital. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0443-629 
TITLE Dental Clinic Patients' Charts 
DESCRIPTION Documents relating to an individual patient's dental work. 
RETENTION See Comments 
COMMENTS Retain for 10 years after the date of last discharge or one year beyond the date that patients who are minors reach their majority, whichever is longer. 
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 0432-629 
TITLE Dental Procedures - Monitors 
DESCRIPTION Documents relating to the monitors used as a check on dental procedures and completed to meet accreditation requirements. 
RETENTION 003 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-087 

SERIES ID 0248-629 
TITLE Departmental Internal Cost Reports 
DESCRIPTION Monthly expenditures of selected objects by the service department and unit compared to allocated amounts including internal reports by department and object. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0300-629 
TITLE Diet Database System 
DESCRIPTION Inter-related databases regarding dietary requirements of individual clients - duplicates information maintained in Client Records. 
RETENTION See Comments 
COMMENTS Retain data until superseded or until death or discharge of client, then delete. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1988-10-13  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-076 

SERIES ID 0141-629 
TITLE Diet Requests 
DESCRIPTION Documents related to special dietary requirements for some residents. 
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 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0301-629 
TITLE Dietary Staff Scheduling Database 
DESCRIPTION Computer database used to generate work schedules and sign-out sheets for the Dietary Department staff on a monthly basis. 
RETENTION See Comments 
COMMENTS Retain until updated and no longer useful, then delete. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-076 

SERIES ID 0302-629 
TITLE Direct Care Staff Scheduling Database 
DESCRIPTION Computer database used to print monthly work schedules and sign-in sheets for the direct care staff. 
RETENTION See Comments 
COMMENTS Retain until updated and no longer useful, then delete. 
DISPOSITION Delete 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-076 

SERIES ID 0363-629 
TITLE Direct Service Reports 
DESCRIPTION Reports detailing the number of staff hours provided in direct service to Community Mental Health Center patients which are used to justify staff allocation. 
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 2013-05-16
K.A.R. NUMBER 53-2-099 

SERIES ID 0334-629 
TITLE Discharge Log 
DESCRIPTION Log used to monitor the discharge dates of patients released 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 0242-629 
TITLE Dispatch Log 
DESCRIPTION Log used to record all communications with security and any resulting action taken during all the shifts. 
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 0316-629 
TITLE Drug Inspection Reports 
DESCRIPTION Reports of inspection of institution units by pharmacist concerning conditions of drugs storage and other adherence to policies and procedures. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-074 

SERIES ID 0305-629 
TITLE Drug Waste and Returns Records 
DESCRIPTION Records of drugs issued but not used and their dispositions (destroyed or re-issued) thereafter. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-074 

SERIES ID 0304-629 
TITLE Drugs Inventory 
DESCRIPTION Records of periodic inventory of pharmaceuticals on hand. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-074 

SERIES ID 0249-629 
TITLE Dysphagia Consults 
DESCRIPTION Documents related to video swallow consultations for residents who have difficulty in swallowing to the Nutritional Guidance Committee. 
RETENTION See Comments 
COMMENTS Maintain along with individual "Client Records." 
DISPOSITION See Comments 
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 0450-629 
TITLE Electrocardigram Test Results 
DESCRIPTION Results of electrocardigram tests of each patient to check for heart abnormalities. 
RETENTION See Comments 
COMMENTS Retain for 10 years after the date of last discharge or one year beyond the date that patients who are minors reach their majority, whichever is longer. 
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 0441-629 
TITLE Electroencephalogram Card File 
DESCRIPTION Cards pertaining to patient data regarding electroencephalogram tests for handy access. 
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 0420-629 
TITLE Electroencephalogram Test Results 
DESCRIPTION Requisitions and printouts of results for electroencephalogram tests given to patients. Tracings are interpreted by the neurologist and information about abnormalities placed in the medical record. 
RETENTION See Comments 
COMMENTS Retain tracing until interpretation by the neurologist, then destroy. Retain requisitions 10 years after the date of last discharge or patient turns 21. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(3) & 65-5602 
APPROVED 1991-10-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-090 

SERIES ID 0439-629 
TITLE Electroencephalogram and Electrocardigram Technicians' Continuing Education File 
DESCRIPTION Documents pertaining to the educational programs attended by the technicians as required. 
RETENTION See Comments 
COMMENTS Retain for tenure of the technician, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0499-629 
TITLE Electronic Data System Federal Corporation Adjustment Records 
DESCRIPTION Copies of forms used to make adjustments in patients' reimbursement account records at the EDS Federal Corporation. 
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 0333-629 
TITLE Emergency Light Inspections Reports 
DESCRIPTION Monthly and annual emergency light inspection reports made to ensure proper maintenance and functioning at all times. 
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 0280-629 
TITLE Emergency Paging and Announcement Logs 
DESCRIPTION Logs used to record all calls made over the public address system. 
RETENTION 001 fisc yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0538-629 
TITLE Employee Files - Special 
DESCRIPTION Records related to specific employees regarding either their professional credentials or concerning non-routine events such as grievances, disciplinary actions, etc. 
RETENTION See Comments 
COMMENTS Retain during tenure of specific employee plus 5 calendar years, then transfer. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0312-629 
TITLE Employee Health Cards 
DESCRIPTION Card files recording tuberculosis tests, tetanus shots, pinworm medication, hepatitis tests, and other medical tests and treatments administered to employees - a.k.a. "TB Cards." 
RETENTION 010 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 0577-629 
TITLE Employee Health Files 
DESCRIPTION Correspondence, examination sheets, health histories, hepatitis test results, etc. related to individual employee's health as required by KAR 28-34-8. 
RETENTION See Comments 
COMMENTS Retain in office 5 years after employee tenure, then destroy. Retain positives for hepatitis B and HIV permanently. 
DISPOSITION See Comments 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1998-01-08  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-114 

SERIES ID 0277-629 
TITLE Employee Health Records 
DESCRIPTION Documents related to employees' health maintained pursuant to K.A.R. 28-34-8 including examination sheets, health histories, hepatitis test results, correspondence, etc. 
RETENTION See Comments 
COMMENTS Retain 5 years after employee tenure, then destroy. Retain hepatitis B and HIV results permanently. 
DISPOSITION See Comments 
RESTRICTIONS KSA 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0519-629 
TITLE Employee Injury Reports 
DESCRIPTION Completed forms detailing injuries suffered by employees while at work - includes staff physician's diagnosis. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0332-629 
TITLE Employee Personnel Cards 
DESCRIPTION Information abstracted from Employee Personnel Files regarding individual employee's service. 
RETENTION See Comments 
COMMENTS Retain for length of employee's tenure, plus 10 years, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0545-629 
TITLE Employee Personnel Files 
DESCRIPTION Documents associated with employment of specific personnel: employee evaluation forms, applications for employments, INS Residence Status forms, and other personnel materials. 
RETENTION See Comments 
COMMENTS Retain for length of employee's tenure, then transfer vital information to Employee Personnel Cards (q.v.). Retain files additional 5 calendar years and then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0330-629 
TITLE Employee Personnel Files - Office Copies 
DESCRIPTION Copies of documents in agency's Employee Personnel Files associated with the employment of specific personnel (applications, evaluations, etc.) maintained for convenience of reference. 
RETENTION See Comments 
COMMENTS Retain for length of employee's tenure plus 5 calendar years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0470-629 
TITLE Employee Security Clearance Checks 
DESCRIPTION Reports from the Kansas Bureau of Investigation, SRS Youth Services, SRS Adult Services, and court reports regarding individuals seeking employment at the hospital. 
RETENTION See Comments 
COMMENTS Retain for length of employee's tenure plus 20 years in original or abstracted form, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0169-629 
TITLE Employee Training Files 
DESCRIPTION Records related to the training/career development of individual employees: correspondence, course plans, records requests, grades, transcripts, evaluations, copies of certificates and diplomas, etc. 
RETENTION See Comments 
COMMENTS Will require some purging by archives staff. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 1988-10-13  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-076 

SERIES ID 0588-629 
TITLE Employee Vehicle Registration 
DESCRIPTION Form completed by staff to register their vehicle with the Security Department to ensure that no unauthorized vehicles remain on hospital grounds. 
RETENTION See Comments 
COMMENTS Retain until superseded or no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1997-04-10  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-111 

SERIES ID 0541-629 
TITLE Encumbrance Authorization Records 
DESCRIPTION Copies of DA forms 146 and supporting materials authorizing encumbrances of agency funds. 
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 0462-629 
TITLE Equipment Operation Manuals 
DESCRIPTION Documents used for the maintenance and repair of equipment. 
RETENTION See Comments 
COMMENTS Retain for the life of the equipment, then transfer to new owner of equipment or destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0317-629 
TITLE Event Monitoring and Direct Service Form 
DESCRIPTION Form listing the current patients with code numbers and descriptions used to report event monitoring and direct services provided by staff. 
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 0582-629 
TITLE Evidence Custody Receipt 
DESCRIPTION Copies of the Kansas Bureau of Investigation (KBI) form completed by Security Department officers requesting that the KBI examine evidence seized. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(10) 
APPROVED 1997-04-10  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-111 

SERIES ID 0326-629 
TITLE Exit Light Inspections Files 
DESCRIPTION Documents relating to the inspections of all exit lights in every quarter to ensure proper maintenance and functioning at all times. 
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 0540-629 
TITLE Expendable Inventory Reports 
DESCRIPTION Inventory forms listing supplies consumed, unit costs, total costs, and summaries. 
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 0539-629 
TITLE Feedback Sheets 
DESCRIPTION Daily reports from housekeeping staff on their work activities. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-075 

SERIES ID 0335-629 
TITLE Fire Extinguisher Maintenance Checklist 
DESCRIPTION Monthly checklist made on fire extinguishers to ensure proper maintenance and functioning at all times. 
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 0528-629 
TITLE Fire and Safety Records 
DESCRIPTION Records regarding maintenance and inspections of fire and safety equipment, training, and related issues. 
RETENTION See Comments 
COMMENTS Retain 3 calendar years then destroy except for certifications required by regulations to remain on file perpetually - retain these documents until superseded, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0324-629 
TITLE Fire and Safety Reports 
DESCRIPTION Weekly and monthly reports made on fire and safety related issues. 
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 0244-629 
TITLE Foster Grandparent Financial Records 
DESCRIPTION Documents related to the financial accounting of the Foster Grandparent Program. 
RETENTION See Comments 
COMMENTS Retain according to general schedule (KAR 53-3-1) where applicable, otherwise retain 3 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0537-629 
TITLE Foster Grandparents Meal Records 
DESCRIPTION Forms documenting meals served to persons participating in the Foster Grandparents Program. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-075 

SERIES ID 0547-629 
TITLE Funds Review Committee Records 
DESCRIPTION Records regarding activities of committee charged with the oversight of the Patient Benefit and Trust Funds: minutes and financial statements. 
RETENTION 010 cldr yrs 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0403-629 
TITLE Goals and Objectives 
DESCRIPTION Planning documents written each budget year based on the needs of the hospital. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0155-629 
TITLE Guardian Change of Address Card File 
DESCRIPTION Notification received from social workers or postal service pertaining to changes of address by guardians of clients. 
RETENTION See Comments 
COMMENTS Retain until superseded or until associated client has been discharged or deceased, then destroy. 
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 0147-629 
TITLE Guardian Information Files 
DESCRIPTION Documents relating to the individual resident's guardian in the event the facilities need to contact him/her regarding the resident. 
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 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0421-629 
TITLE Hazardous Materials Management Plans 
DESCRIPTION A wide variety of documents relating to the Hazardous Materials Management Plan required to meet accreditation. 
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 0464-629 
TITLE Hazardous Waste Materials Data 
DESCRIPTION Documents relating to the handling of various hazardous materials used. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0111-629 
TITLE Hepatitis B Files 
DESCRIPTION Documents relating to vaccines given to staff to protect them from possible infection by resident Hepatitis B carriers. 
RETENTION See Comments 
COMMENTS Place in respective employee personnel file 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 0409-629 
TITLE Hospital Brochures 
DESCRIPTION Brochures written and published to provide information for visitors, patients, families, hospital staff, and interested persons about programs/current treatment offered. 
RETENTION See Comments 
COMMENTS Transfer one copy to the archives, the remainder destroy when no longer useful. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0165-629 
TITLE In-Service Files 
DESCRIPTION Records related to specific courses taught and the participation of individuals in them: student rosters, attendance records, syllabi, and other miscellaneous documents. 
RETENTION See Comments 
COMMENTS Will require purging by archives staff. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-076 

SERIES ID 0406-629 
TITLE Incident Reports 
DESCRIPTION Reports regarding special incidents regarding patients or staff, including conclusions, recommendations, and results of reviews. 
RETENTION 010 cldr yrs 
DISPOSITION Archives 
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 0578-629 
TITLE Incident Reports 
DESCRIPTION Reports describing any breach of security or other risks which pose a danger to clients. 
RETENTION 010 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602, 65-4915, 65-4291 & 45-221(3) 
APPROVED 1997-07-10  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-112 

SERIES ID 0534-629 
TITLE Incident and Elopement Reports 
DESCRIPTION Narrative reports describing security related incidents and specifically unauthorized absences from institution grounds by residents. 
RETENTION 010 cldr yrs 
DISPOSITION Archives 
RESTRICTIONS KSA 65-5602 & 45-221(a)(1)(3) 
APPROVED 1988-07-14  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-075 

SERIES ID 0323-629 
TITLE Infection Control Annual Reports 
DESCRIPTION Annual reports made concerning the activities of the infection control laboratory. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-099 

SERIES ID 0121-629 
TITLE Infectious Surveillance Records 
DESCRIPTION Documents used to monitor residents' infectious diseases and antibiotic use to prevent further spread. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
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 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 

SERIES ID 0701-629 
TITLE Requisition Control Files 
DESCRIPTION Documents relating to assigning control numbers to requisitions maintained for convenience of reference. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0164-629 
TITLE Research and Reference Files 
DESCRIPTION Documents resulting from research projects and programs conducted: theses, dissertations, papers, publications, and other miscellaneous materials. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-076 

SERIES ID 0669-629 
TITLE Reserve Day Book 
DESCRIPTION Log used to monitor the number of patient therapeutic pass days billed to Medicare and Medicaid. 
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 0445-629 
TITLE Residency Training Program Files 
DESCRIPTION Documents pertaining to the once operative Psychiatric Residency Training Program, including curriculum and class schedules. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, 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 0126-629 
TITLE Resident Activity Attendance Records 
DESCRIPTION Documents relating the attendance of residents participating in leisure activities 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 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0668-629 
TITLE Resident By Age Report 
DESCRIPTION Computer printout and electronic data relating to bed usage at the facility according to the various age groups. 
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 0105-629 
TITLE Resident Care/Behavior Sheets 
DESCRIPTION Reports made by the direct care staff on the units to the nursing staff regarding resident care or behavior incidents. 
RETENTION See Comments 
COMMENTS Retain 7 years after dismissal or death, then destroy. If resident is a minor, retain until majority is reached and/or dismissal plus 7 yrs, then destroy. 
DISPOSITION Destroy 
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 0106-629 
TITLE Resident Check Sheets 
DESCRIPTION Bed check sheets filled out nightly to monitor the residents in the wards. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
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 0254-629 
TITLE Resident I.D. Picture Cards 
DESCRIPTION Photographs taken of residents to use on identification cards which are used by the physicians to help recognize them. 
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 0667-629 
TITLE Resident Ledger Files 
DESCRIPTION Computer printout of patient charges that have been deleted from the computer for various reasons. 
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 0666-629 
TITLE Resident Master Balance Sheets 
DESCRIPTION Ending monthly balances remaining in patient accounts and used for accounting purposes. 
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 0133-629 
TITLE Resident Review Records 
DESCRIPTION Documents relating to the review of the individual resident's current training level to assess the effectiveness of the program plan. 
RETENTION See Comments 
COMMENTS Place in the respective resident's files 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 0495-629 
TITLE Residents Employment Files 
DESCRIPTION Personnel records maintained on residents employed. 
RETENTION See Comments 
COMMENTS Retain during tenure of employee plus 3 calendar years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0136-629 
TITLE Residents by County Records 
DESCRIPTION Index cards listing the number of residents admitted from a specific county which are used for reference purposes. 
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 0145-629 
TITLE Residents' Training Materials 
DESCRIPTION Daily routines and data used to help train residents for a variety of tasks including personal hygiene, speech, etc. 
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 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0257-629 
TITLE Respite Files 
DESCRIPTION Documents maintained for approved respite clients which provides short-term care at the facilities to give some relief for the caregiver of a mentally retarded person. 
RETENTION Permanent 
DISPOSITION Permanent 
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 0109-629 
TITLE Restraint Reports 
DESCRIPTION Reports made on the use of restraints placed on individual residents along with a medical procedure checksheet to ensure the proper use and the well-being of the resident. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09 
K.A.R. NUMBER 53-2-093 

SERIES ID 0756-629 
TITLE Risk Management Files 
DESCRIPTION Incident reports, peer review documents, minutes, correspondence, etc. relating to reportable incidents under KSA 65-4921(f) and investigated by the Risk Management Division. 
RETENTION See Comments 
COMMENTS Retain 2 years after the Final Standard of Care is determined or retain until no longer useful if the case is potentially litigious, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-4925 
APPROVED 2003-01-09  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-133 

SERIES ID 0664-629 
TITLE Risk Management Plans and Minutes 
DESCRIPTION Documents relating to the activities of the Risk Management Committee. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0467-629 
TITLE Roof Moisture Testing Records 
DESCRIPTION Data gathered in the testing for moisture on the various roofs. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0429-629 
TITLE Roster of Attendance at Workshops 
DESCRIPTION Register of attendance for staff members requiring continuing education units for licensure and includes social workers, RNs, LMHTs, and LPNs. 
RETENTION See Comments 
COMMENTS Rosters are maintained as required by the Behavioral Sciences Regulatory Board and the Kansas State Board of Nursing. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0163-629 
TITLE SWEP Files 
DESCRIPTION Records regarding participation of individuals in the Summer Work Employment Program: applications, correspondence, physical examination results, performance ratings, and time sheets. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 1988-10-13  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-076 

SERIES ID 0402-629 
TITLE Safety Program Plans 
DESCRIPTION A wide variety of documents relating to the Safety Program Plans required to meet accreditation. 
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 0158-629 
TITLE Sanitation Checklists 
DESCRIPTION Lists used to monitor monthly sanitation checks of all the units to ensure compliance with federal standards. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0660-629 
TITLE Security Daily Activity Log 
DESCRIPTION Log maintained by the security officers on activities which occurred during each shift. 
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 0662-629 
TITLE Security Daily Reports 
DESCRIPTION Reports made by the security staff detailing daily activities. 
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 0493-629 
TITLE Security Log 
DESCRIPTION Daily narrative record of all security related activities and events. 
RETENTION 010 cldr yrs 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0697-629 
TITLE Security Patient Assistance Reports 
DESCRIPTION Reports prepared by security officers describing the type of assistance security offered to 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 0492-629 
TITLE Security Records 
DESCRIPTION Copies of records maintained by Security Office (see Incident and Elopement Reports). 
RETENTION See Comments 
COMMENTS Reports will be used by archives staff to fill gaps in Incidents and Elopement Reports after transfers. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0512-629 
TITLE Security Report Sheets - Daily 
DESCRIPTION Logs of daily activities by individual security staff members. 
RETENTION 010 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-075 

SERIES ID 0693-629 
TITLE Security Safe Log 
DESCRIPTION Log maintained by the security officers of items going in and out of the security safe. 
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 0691-629 
TITLE Security Schedules 
DESCRIPTION Documents relating to the scheduling of inspections in every quarter to ensure proper maintenance and functioning of equipment at all times. 
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 0585-629 
TITLE Service Rendered Report 
DESCRIPTION Form completed by Security Department officers indicating the nature and type of assistance. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1997-04-10  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-111 

SERIES ID 0175-629 
TITLE Sewing Room Requests 
DESCRIPTION Memos relating to requests for clothing articles to be manufactured or altered by the sewing room staff including item requested, by whom, what area and amount, and a description of said item. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0124-629 
TITLE Social Service Case Activity Log 
DESCRIPTION Log used by the social workers to keep track of individual resident's contacts and activities which is used for reference purposes. 
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 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0137-629 
TITLE Social Service Records 
DESCRIPTION Documents relating to client care and training which are duplicates from other units for reference use by the staff. 
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 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0131-629 
TITLE Speech Therapy Files 
DESCRIPTION Documents relating to an individual resident's program in speech therapy which are used to keep track of any progress or regression. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to 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 0146-629 
TITLE Staff In-Service Attendance Lists 
DESCRIPTION Rosters of staff members listing the in-services they have attended which are used to monitor their certification requirements. 
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 0112-629 
TITLE Staff In-Service Files 
DESCRIPTION Short in-service training sessions taught by professional and non-professional support staff to other staff members which are required either for promotions or to fulfill position expectations. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. Delete from computer when no longer useful. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0427-629 
TITLE State Summaries of Medical Assistance 
DESCRIPTION Program statistics of average payments made by clients. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0431-629 
TITLE Statistical Reports 
DESCRIPTION Statistics gathered on patients and used to make a variety of reports about patients and patient care. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0454-629 
TITLE Statistical Studies - Special 
DESCRIPTION Studies completed either at the request of the Central Office or community SRS related groups, or in-house data needed to make future plans. 
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 0414-629 
TITLE Stock Requisitions 
DESCRIPTION Completed internal forms used by Purchasing Unit to record orders of expendable goods. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-075 

SERIES ID 0296-629 
TITLE Stores Requisitions 
DESCRIPTION Completed internal forms (IM-1105) used to requisition supplies by and for various organizational units in the agency. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0680-629 
TITLE Student Records 
DESCRIPTION Documents relating to the rotation of students in training at the various state hospitals as a degree requirement. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(1)(9) 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0418-629 
TITLE Subject Files 
DESCRIPTION Records related to general activities of the office: "Outstanding Projects, Vehicle Cost Reports, KRDC, Work Therapy Payroll, Development of Leisure Time and Activities, Records Dispositions," 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 2013-05-16
K.A.R. NUMBER 53-2-075 

SERIES ID 0295-629 
TITLE Subject Files 
DESCRIPTION Wide variety of documents related to multiple aspects of logistical and administrative activities at the agency. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-075 

SERIES ID 0122-629 
TITLE Subject Files - Activity 
DESCRIPTION Wide variety of documents relating to resident activities including special Olympics materials. 
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 2013-01-30
K.A.R. NUMBER 53-2-093 

SERIES ID 0679-629 
TITLE Subject Files - Administrative 
DESCRIPTION Documents relating to the administrative and operational responsibilities of the agency. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then contact the archives for appraisal, if not accepted for transfer to the archives, then destroy. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0678-629 
TITLE Subject Files - Business Office 
DESCRIPTION Wide variety of documents relating to the function and operation of the business office. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then contact the archives for appraisal, if not accepted for transfer to the archives, then destroy. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0173-629 
TITLE Subject Files - Chaplain 
DESCRIPTION Variety of documents relating to the services of chaplain for the residents 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 0676-629 
TITLE Subject Files - Clinical Services 
DESCRIPTION Wide variety of documents relating to functioning of the office. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then contact the archives for appraisal, if not accepted for transfer to the archives, then destroy. 
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 0256-629 
TITLE Subject Files - Community Services 
DESCRIPTION Wide variety of documents relating to the administration of the community services program. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. Portions may be restricted. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0168-629 
TITLE Subject Files - General 
DESCRIPTION Records related to the employee training and career development program: correspondence, reports, publications, personnel records, and other materials. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-10-13  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-076 

SERIES ID 0138-629 
TITLE Subject Files - Music Therapy 
DESCRIPTION Wide variety of documents relating to the administration of the music therapy program. 
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 0416-629 
TITLE Subject Files - Non-Routine 
DESCRIPTION Wide variety of documents related to the physical plant activities of a non-routine nature. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-075 

SERIES ID 0172-629 
TITLE Subject Files - Reimbursement 
DESCRIPTION Wide variety of financial documents relating to the reimbursement unit. 
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 0294-629 
TITLE Subject Files - Reimbursement Unit 
DESCRIPTION Miscellaneous documents regarding operations of the Reimbursement Unit. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0417-629 
TITLE Subject Files - Routine 
DESCRIPTION Records related to routine activities of the office: correspondence, receipts, bid sheets, reports, gasoline reports, copies of vouchers, etc. 
RETENTION See Comments 
COMMENTS See also Subject Files, Non-Routine. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-075 

SERIES ID 0670-629 
TITLE Subject Files - Security 
DESCRIPTION Wide variety of documents relating to the activities of the security section. 
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 0174-629 
TITLE Subject Files - Sewing Room 
DESCRIPTION Variety of documents relating to the activities and administration of the sewing room. 
RETENTION See Comments 
COMMENTS Retain until no longer needed, then transfer to the archives for purging. Portions may be restricted. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0101-629 
TITLE Subject Files - Staff Training 
DESCRIPTION Wide variety of documents relating to the administration of the staff training program. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-13
K.A.R. NUMBER 53-2-093 

SERIES ID 0292-629 
TITLE Summary of Expenditures by Object Code Reports 
DESCRIPTION Monthly computer reports listing by object code all funds budgeted, expended, encumbered, and balances. 
RETENTION See Comments 
COMMENTS This is not a CASK report. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0675-629 
TITLE Sunday Worship Bulletins 
DESCRIPTION Programs scheduled for Sunday worship services offered by the chaplainry services staff. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer 2 copies to the archives, destroy the remainder. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0226-629 
TITLE Supported Family Living Reimbursement Files 
DESCRIPTION Documents relating to payments made to supported family living providers to reimburse families with mentally retarded children living in their home. 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 39-709b 
APPROVED 1993-04-15  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-096 

SERIES ID 0401-629 
TITLE Survey Reports - Joint Commission on Accreditation of Hospital Organizations 
DESCRIPTION Reports of surveys, including deficiencies, contingencies and resurvey information, related to the accreditation standards of the Joint Commission on Accreditation of Hospital Organizations. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0399-629 
TITLE Survey Reports - Medicaid (Periodic Medical Review) 
DESCRIPTION Reports of Medicaid surveys, including deficiencies, contingencies, and plans for correction. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0400-629 
TITLE Survey Reports - Medicare 
DESCRIPTION Reports of Medicare surveys, including deficiencies, contingencies, and plans for correction. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0398-629 
TITLE Survey Reports - Risk Management 
DESCRIPTION Reports of site visits made by surveyors from the Department of Health and Environment used to substantiate compliance with laws and regulations. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-16
K.A.R. NUMBER 53-2-087 

SERIES ID 0438-629 
TITLE Survey Results - College of American Pathologists 
DESCRIPTION Surveys of results of hospital laboratory work on specimens in comparison to other labs and used for proficiency testing and required for accreditation. 
RETENTION 003 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-05-17
K.A.R. NUMBER 53-2-087 

SERIES ID 0139-629 
TITLE Surveys and Questionnaires 
DESCRIPTION Survey forms and general questionnaires sent to Intermediate Care Facilities for the Mentally Retarded by federal agencies to be filled out regarding various aspects of health care. 
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 0410-629 
TITLE Test Protocols 
DESCRIPTION Test protocols, notes, and copies of the psychological reports used for review and comparison purposes on patients. 
RETENTION See Comments 
COMMENTS Retain for 10 years after the date of last discharge or 1 year beyond the date that patients who are minors reach their majority, whichever is longer. 
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 0677-629 
TITLE Therapeutic Passes 
DESCRIPTION Patient passes given to the reimbursement office to verify days spent away from the facility and used for reimbursement purposes. 
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 0681-629 
TITLE Tile Floor Records 
DESCRIPTION Documents recording the frequency of floor care to ensure proper maintenance. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1994-01-13  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-099 

SERIES ID 0291-629 
TITLE Time Report Work Sheets 
DESCRIPTION Completed forms used to input monthly time data into KIPPS computer system. 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0290-629 
TITLE Time Reports - Daily 
DESCRIPTION Internal reports submitted by each unit listing time work for each employee daily (sign-in and -out sheets). 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1988-07-14 
K.A.R. NUMBER 53-2-075 

SERIES ID 0279-629 
TITLE Time Schedules - Monthly 
DESCRIPTION Record of time worked by employees - compiled from Daily Time Reports (q.v.). 
RETENTION 005 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0134-629 
TITLE Toll Log 
DESCRIPTION Log used to record long distance calls not on the KANS-A-N line made by staff. 
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 0118-629 
TITLE Tool Control Files 
DESCRIPTION Documents used to monitor the distribution of tools within the facilities. 
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 0683-629 
TITLE Traffic Courtesy Reminder Log 
DESCRIPTION Log maintained by the security officers of improper parking by visitors in the parking lots. 
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 0188-629 
TITLE Training Sheets 
DESCRIPTION Forms used to track and analyze the task performances of residents in training programs which are used to assess the effectiveness of the program. 
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 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0407-629 
TITLE Treatment Program Plans 
DESCRIPTION A variety of documents relating to the Treatment Program Plan and required to meet accreditation standards. 
RETENTION 010 cldr yrs 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1991-01-17  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-087 

SERIES ID 0191-629 
TITLE Tuition Assistance Records 
DESCRIPTION Documents related to the administration of tuition assistance programs for employees including applications, information on tuition assistance programs elsewhere, and educational institutions. 
RETENTION See Comments 
COMMENTS Retain 1 year after employee's tenure, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0297-629 
TITLE Utilization Sheets 
DESCRIPTION Daily summary of housekeeping staff activities by building and task. 
RETENTION 001 fisc yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0283-629 
TITLE VRU Billing Records 
DESCRIPTION Documents related to purchases of goods and services by the Vocational Rehabilitation Unit. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0220-629 
TITLE Volunteer Applications 
DESCRIPTION Applications submitted by individuals interested in volunteer work at state hospitals. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1993-04-15  ; Revised 2013-05-13
K.A.R. NUMBER 53-2-096 

SERIES ID 0686-629 
TITLE Volunteer Program Files 
DESCRIPTION Documents relating to the function and activities of the volunteer 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 2013-05-20
K.A.R. NUMBER 53-2-099 

SERIES ID 0284-629 
TITLE Vouchers - Receipts 
DESCRIPTION DA forms 100, 103, 120, and 123 used to make payments to individuals and organizations, periodic abstracts, and occasional copies of invoices and other supporting materials. 
RETENTION 003 fisc yrs 
COMMENTS Includes a sub-series of duplicates of DA forms 103 which may be destroyed immediately. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0423-629 
TITLE Ward Log Books 
DESCRIPTION Working data (daily status of patients) & log of patient information used to meet deadlines & expedite patient paperwork including: admission, legal status, changes in venue, discharge & summaries. 
RETENTION 003 cldr 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 0587-629 
TITLE Warning Form 
DESCRIPTION Copies of form completed by Security Department officers and given to staff or visitors for parking or traffic infractions as a reminder to obey all traffic and parking regulations. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1997-04-10  ; Revised 2013-05-20
K.A.R. NUMBER 53-2-111 

SERIES ID 0115-629 
TITLE Wash and Finishing Records 
DESCRIPTION Daily wash and finishing reports including wash room weights and finishing count. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-14
K.A.R. NUMBER 53-2-093 

SERIES ID 0690-629 
TITLE Weekly Fire Alarm System Tests 
DESCRIPTION Documents relating to weekly testing of the fire panel and manual stations conducted to ensure proper maintenance of the systems. 
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 0259-629 
TITLE Weekly/Monthly Duplicating Tally 
DESCRIPTION Tally of the usage and costs accrued on photoduplication machines on a weekly and monthly basis which is used for accounting purposes to the company. 
RETENTION 001 fisc yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0426-629 
TITLE Welfare Eligibility Records 
DESCRIPTION Documents relating to the eligibility of clients to qualify for welfare payments. 
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 0247-629 
TITLE Work Therapy Benefit Fund 
DESCRIPTION Financial records related to the administration of the Work Therapy Benefit Fund which helps fund projects for residents. 
RETENTION See Comments 
COMMENTS Retain according to general schedule (KAR 53-3-1) entries where applicable, otherwise retain 3 fiscal years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS Portions may be restricted. 
APPROVED 1992-07-09  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-093 

SERIES ID 0282-629 
TITLE Workers Compensation Files 
DESCRIPTION Records regarding employee accidents reported to the state workers compensation system: Report of Employee Injury, WC form 1101A, correspondence, vouchers, notes, medical reports, etc. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0287-629 
TITLE Workshop Earnings Listings 
DESCRIPTION Records of pay earned by residents participating in workshop program as applied to re-imbursement for care provide to them. 
RETENTION See Comments 
COMMENTS Obsolete records series - destroy immediately. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-05-15
K.A.R. NUMBER 53-2-075 

SERIES ID 0436-629 
TITLE X-Ray Film and Report 
DESCRIPTION Reports and film for of x-rays performed on patients. 
RETENTION See Comments 
COMMENTS Retain for 10 years after the date of last discharge or one year beyond the date that patients who are minors reach their majority, whichever is longer. 
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 

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

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


SERIES ID 0103-629 
TITLE Cemetery Records 
DESCRIPTION Documents listing deceased residents buried at the facilities including name and grave number. 
RETENTION Permanent 
COMMENTS Retain permanently or transfer to the archives. 
DISPOSITION Permanent 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1992-07-09  ; Revised 2013-05-13
K.A.R. NUMBER 53-2-093 

SERIES ID 0156-629 
TITLE Correspondence - Medical Records 
DESCRIPTION Correspondence removed from Client Records (q.v.) and established as a separate series. 
RETENTION See Comments 
COMMENTS Retain and dispose of in conjunction with associated Client Records (q.v.). 
DISPOSITION See Comments 
RESTRICTIONS KSA 76-12b11 & 45-221(a)(3) 
APPROVED 1989-04-27  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-079 

SERIES ID 0167-629 
TITLE Grade Books 
DESCRIPTION Records of student grades for specific courses given. 
RETENTION 010 cldr yrs 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 1988-10-13  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-076 

SERIES ID 0102-629 
TITLE Residents by Age Records 
DESCRIPTION Index cards listing the residents by age and their birthdate which are used for reference purposes. 
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 2013-05-13
K.A.R. NUMBER 53-2-093 

SERIES ID 0221-629 
TITLE Speech and Hearing Outpatient Reports 
DESCRIPTION Monthly summary reports used for billing purposes containing outpatient's name and date and length of treatment. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 65-5602 & 45-221(a)(1)(3) 
APPROVED 1993-04-15  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-096 

SERIES ID 0108-629 
TITLE Subject Files - Volunteer Services 
DESCRIPTION Wide variety of documents relating to the administration of the volunteer services division. 
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 2013-01-30
K.A.R. NUMBER 53-2-093 

SERIES ID 0285-629 
TITLE Vending - Records of Daily Sales 
DESCRIPTION Daily records of sales receipts from vending machines - internal form "A." 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1988-07-14  ; Revised 2013-01-30
K.A.R. NUMBER 53-2-075 

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

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


SERIES ID 0338-629 
TITLE Patient Activity Fund Records 
DESCRIPTION Documents concerning the financial accounting of the patient activity fund including bank statements, deposit books and slips, check registers, and canceled checks. 
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 

Agency Number: 039-009
Department for Aging and Disability Services
Multiple subunits/subunit not defined

SERIES ID 0019-629 
TITLE Audit Reports/Responses & Financial Management Reviews/Responses 
DESCRIPTION Responses and other information provided by the agency for audits conducted by the Legislative Division of Post-Audit and other state and/or federal auditing agencies. May include personal health information. 
RETENTION See Comments 
COMMENTS Retain 6 fiscal years beyond final report, then transfer to State Archives for purging. 
DISPOSITION Archives 
RESTRICTIONS K.S.A. 45-221(a)(3); HIPAA 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0772-629 
TITLE Bond Records 
DESCRIPTION Supporting documentation relating to payments and reconciliation of bonds. 
RETENTION Retain 5 fiscal years beyond life of bond. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0773-629 
TITLE Contracts/Grants Awarded by DBHS to Contractors/Grantees 
DESCRIPTION Legal agreements with individuals and organizations including all associated documentation. 
RETENTION See Comments 
COMMENTS Retain 6 fiscal years after final payment. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27 
K.A.R. NUMBER 53-2-166 

SERIES ID 0026-629 
TITLE Employee Personnel Files - Office Copies 
DESCRIPTION Copies of documents in agency's Employee Personnel Files associated with employment of specific personnel (applications, evaluations, etc.) maintained for convenience of reference. 
RETENTION See Comments 
COMMENTS Retain for length of employee's tenure plus 5 calendar years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 1995-04-13  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-104 

SERIES ID 0774-629 
TITLE Grants Awarded to DBHS 
DESCRIPTION Applications and associated documents for federal, state, and private grants. 
RETENTION See Comments 
COMMENTS Retain 6 fiscal years beyond final grant transaction, then transfer original applications and annual and final performance reports to the archives for purging, destroy remaining documents. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0775-629 
TITLE ICF/MR, NF/MH, and PRTF Forms 
DESCRIPTION Intermediate Care Facility for Persons with Mental Retardation (ICF/MR), Nursing Facility for Mental Health (NF/MH), and Psychiatric Review Technique (PRTF). Informational documents relating to cost reports, certifications, appeals and rate setting. 
RETENTION See Comments 
COMMENTS Retain 6 fiscal years following rate implementation. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0776-629 
TITLE Managed Care Organization (MCO) Contracts 
DESCRIPTION Contract agreements, performance and all other reports, correspondence relating to performance, contract scope or deliverables, service payments under such contracts, policy and procedures of MCO, financial and settlement reports. 
RETENTION 6 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0769-629 
TITLE Official Letters and Memoranda 
DESCRIPTION Correspondence stating policy, rules and regulations, interpretive guidelines, and the like related to any Community Supports & Services program. 
RETENTION See Comments 
COMMENTS Retain in office 5 calendar years, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0778-629 
TITLE Parent (Family) Fee Program Manuals and Printed Materials 
DESCRIPTION Program manual, sliding fee scales, and other published program documents. 
RETENTION See Comments 
COMMENTS Retain sliding fee scales for 10 years. Retain all other program material one year beyond date superseded or no longer in effect. Transfer one copy of each to State Archives for purging. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0777-629 
TITLE Parent (Family) Fee Program Participants 
DESCRIPTION Informational documents relating to eligible children, income for fee base, fee variances requests, and supporting documents. 
RETENTION 6 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0770-629 
TITLE Plans of Care, Extraordinary Funding and Home Modifications 
DESCRIPTION Documents related to MR/DD waiver, Money Follows the Person, Traumatic Brain Injury, and Technology Assisted, and other Community Supports & Services programs. 
RETENTION 006 fiscal years 
COMMENTS Maintain in office one (1) year, then transfer to State Records Center for five (5) years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0771-629 
TITLE Program Grants 
DESCRIPTION Records related to Traumatic Brain Injury Program, Money Follows the Person Program, the Systems Transformation Program, and any other Community Supports & Services program grants. 
RETENTION 006 fiscal years 
COMMENTS Program manager to maintain records for 1 year following close of grant. Then transfer grant records to State Records Center for 5 years. Intra-agency contact for potentially additional related information is DBHS/Management Operations. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

Agency Number: 039-010
Department for Aging and Disability Services
Addiction and Prevention Services

Beginning in FY2013, Kansas Dept. on Aging became the Kansas Department for Aging and Disability Services, inheriting certain programs from the former Dept. of Social and Rehabilitation Services.


SERIES ID 0761-629 
TITLE 1915(b)(c) Waiver Approval and Renewals 
DESCRIPTION Final Waiver documents and CMS approval documents related to substance abuse community based managed care programs. 
RETENTION 10 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0759-629 
TITLE All AAPS grants and contracts 
DESCRIPTION All grants and contracts specific to the Alcohol and Addiction Prevention Services (AAPS) program. 
RETENTION 10 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0760-629 
TITLE All Other Alcohol and Addiction Prevention Services (AAPS) Policies and Procedures 
DESCRIPTION All final policy and procedure documents for AAPS programs. 
RETENTION 10 fiscal years 
COMMENTS Retain for 10 fiscal years, then transfer to the State Archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0762-629 
TITLE External Quality Review Organization Reports 
DESCRIPTION All final reports related to the Prepaid Inpatient Health Plan (PIHP) program. 
RETENTION 10 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0765-629 
TITLE Prepaid Inpatient Health Plan (PIHP) Contracts 
DESCRIPTION All contracts and amendments related to the PIHP program. 
RETENTION 10 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0766-629 
TITLE Prepaid Inpatient Health Plan (PIHP) Policy and Procedures 
DESCRIPTION All final Policy and Procedure documents for the PIHP program. 
RETENTION 10 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0768-629 
TITLE Project Applications 
DESCRIPTION Provider applications to provide specialty services. 
RETENTION 10 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0767-629 
TITLE Substance Abuse/Prevention Services Block Grant Application 
DESCRIPTION All annual Block Grant applications related to substance abuse/prevention services. 
RETENTION 10 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

Agency Number: 039-011
Department for Aging and Disability Services
Mental Health Services

Beginning in FY2013, Kansas Dept. on Aging became the Kansas Department for Aging and Disability Services, inheriting certain programs from the former Dept. of Social and Rehabilitation Services.


SERIES ID 0779-629 
TITLE Constituent Complaint Files 
DESCRIPTION All correspondence and memoranda, case logs, and intake logs relating to complaints submitted by constituents. 
RETENTION 5 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS K.S.A. 45-221(a)(14) 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0780-629 
TITLE Customer Relations and Referral Services Program Files 
DESCRIPTION Correspondence, area office plans, and other documents relating to the establishment and administration of the Customer Relations and Referral Services Program. 
RETENTION See Comments 
COMMENTS Retain 5 fiscal years, then transfer to the State Archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0781-629 
TITLE Facility Licenses 
DESCRIPTION All licensing and supporting documentation for Community Mental Health Centers (CMHC), Residential Care Facilities (RCF), Psychiatric Residential Treatment Facilities (PRTF), and Private Psychiatric Hospitals (PPH). 
RETENTION 5 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0782-629 
TITLE Grants and Contracts - Funded 
DESCRIPTION Pertinent documents relating to applications for federal, state, and private grants and their subsequent implementation. 
RETENTION 5 fiscal years beyond end of grant or contract period. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0783-629 
TITLE Medicaid Funded Programs 
DESCRIPTION Official reports, determinations, contracts, and policies/procedures related to Medicaid funded mental health programs, including Community Based Managed Care Services, waiver exceptions for Serious Emotional Disturbances (SED), and Psychiatric Residential Treatment Facilities (PRTF). 
RETENTION 006 fiscal years 
COMMENTS Retain for 6 fiscal years, then transfer to the State Archives for purging. 
DISPOSITION Archives 
RESTRICTIONS K.S.A. 45-221(a) 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

SERIES ID 0785-629 
TITLE Nursing Facilities Mental Health Screens 
DESCRIPTION When a Kansan seeks to access nursing facility services, the first step is to conduct a broad-based assessment or "screening" of the overall health and functioning levels to determine whether nursing facility-level of care is necessary. This initial screening process is conducted by or under the management of the Kansas Department on Aging. After that initial screening, if there is an indication that mental health services may also be needed, a second level evaluation or "screen" as to mental health and functioning levels is conducted by a Community Mental Health Center (CMHC), and SRS - because SRS licenses CMHCs and management publicly funded mental health services - becomes programmatically responsible. Based upon the results of that screening, the person may be identified for placement in one of the Nursing Facility-Mental Health (NFMH) facilities in Kansas, also licensed by SRS. Both the initial screening for NFMH services and periodic (generally annual) re-screening for those services are presented to SRS staff for review and NFMH placement approval. SRS has only a copy of the screen for service approval/program management purposes. 
RETENTION 6 fiscal years 
DISPOSITION Destroy 
RESTRICTIONS K.S.A. 45-221(a)(3) 
APPROVED 2011-04-28  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-167 

SERIES ID 0784-629 
TITLE Subject Files 
DESCRIPTION Correspondence, notes, reports, and other documents related to SRS programs, policies, and procedures. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2011-01-27  ; Revised 2013-05-21
K.A.R. NUMBER 53-2-166 

Agency Number: 039-012
Department for Aging and Disability Services
Health Occupations Credentialing

In FY2012, most health occupations credentialing services and programs were transferred from the Kansas Department of Health and Environment to the newly-formed Kansas Department for Aging and Disability Services (formerly Dept. on Aging).


SERIES ID 0199-264 
TITLE Activity Director/Social Services Designee and Operator Course Curricula 
DESCRIPTION Curricula, samples, program plans, etc. relating to proposed courses which must be approved by the Department of Health and Environment. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0200-264 
TITLE Activity Director/Social Services Designee and Operator Courses Files 
DESCRIPTION Application, correspondence, course materials, etc. relating to the approval process for Activity Director/Social Services Designee and Operator Courses. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0791-264 
TITLE Address Change Notifications 
DESCRIPTION Notices submitted to the agency indicating an address change for credentialed or regulated individuals or groups. 
RETENTION See Comments 
COMMENTS Retain until record is updated and verified, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0201-264 
TITLE Administrator Program Statistics 
DESCRIPTION Statistics about administrators' performance on the examination. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0792-264 
TITLE Adult Care Home Administrator Examination Statistics 
DESCRIPTION Statistics listing the cumulative performance for adult care home administrators on the national and state examinations. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0202-264 
TITLE Approved Instructors 
DESCRIPTION Applications and supporting documentation relating to the approval process for instructors to teach the various training courses. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(4) 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0793-264 
TITLE Certified Nurse Aide, Certified Medication Aide, Home Health Aide Course Approval 
DESCRIPTION Applications and supporting documentation relating to the approval process for CAN, CMA, and HHA courses. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0794-264 
TITLE Certified Nurse Aide, Certified Medication Aide, Home Health Aide Course Rosters 
DESCRIPTION Aattendance rosters for courses approved by the Department of Health and Environment. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0795-264 
TITLE Complaint Files 
DESCRIPTION Documents relating to investigations into complaints made against licensed professionals, certified occupations individuals, or facilities which did not result in further action. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0204-264 
TITLE Complaints and Legal Actions 
DESCRIPTION Documents of complaints and legal actions taken against adult care home administrators including: correspondence, hearing records, legal orders, affidavits, and documents. 
RETENTION See Comments 
COMMENTS If duplicate, keep until no longer useful, then destroy. Otherwise transfer to the archives. 
DISPOSITION See Comments 
RESTRICTIONS KSA 45-221(a)(11) 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0205-264 
TITLE Computerized Certificates, Nurse, Home Health, and Medication Aides 
DESCRIPTION Copies of nurse's aide, home health aide, medication aide certificates issued by department used for reference. 
RETENTION Permanent 
DISPOSITION Permanent 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0206-264 
TITLE Continuing Education - Subsequent Approval Forms 
DESCRIPTION Completed forms requesting the approval of continuing education for adult care home administrators after their completion. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0796-264 
TITLE Continuing Education Program Files 
DESCRIPTION Applications, correspondence, course descriptions, etc. relating to the approval of continuing education programs required for licensed professionals. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0207-264 
TITLE Continuing Education Programs 
DESCRIPTION Records concerning the approval of continuing education courses for adult care home administrators including: applications, correspondence, course descriptions, etc. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0797-264 
TITLE Continuing Education Subsequent Approval Forms 
DESCRIPTION Applications, brochures, etc. relating to the approval of continuing education credits required to maintain a license to practice in the state of Kansas. 
RETENTION 005 cldr yrs 
COMMENTS Some material may be returned to the licensee/applicant. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0798-264 
TITLE Correspondence - Activity Directors, Social Service Designee and Operators 
DESCRIPTION Incoming and outgoing memos and letters that relate to routine matters regarding Activity Directors, Social Service Designess and Operators. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0800-264 
TITLE Criminal History Background Abstracts 
DESCRIPTION Reports submitted by the KBI to the KDHE regarding criminal history problems of applicants to long term care nursing facility jobs to ensure that only qualified applicants are hired. 
RETENTION 020 cldr yrs 
COMMENTS Retain in office 1 calendar year, transfer to the records center for 19 calendar years, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(10) 
APPROVED 2005-04-14  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0809-264 
TITLE Criminal Record Check Request Forms 
DESCRIPTION Completed forms submitted to the KBI for a criminal background check on applicants for employment at health facilities. Reports from background checks are part of series 0800-264, "Criminal History Background Abstracts". 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS  
APPROVED 2009-01-08  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-158 

SERIES ID 0801-264 
TITLE Current Certificate Receipts for Certified Nurse Aides 
DESCRIPTION Receipt tabs removed from the certificates issued to certified nurse aides and maintained for convenience of reference. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0212-264 
TITLE Current Certificate Receipts for Nurses' Aides 
DESCRIPTION Receipt tabs once issued to nurse's aides and used for reference. 
RETENTION Permanent 
DISPOSITION Permanent 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0213-264 
TITLE Disapproved Instructors 
DESCRIPTION Applications, resumes, correspondence, etc. relating to course instructors denied authorization to teach the various training courses. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(6) 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0214-264 
TITLE Dropped or Failed Applicants Files 
DESCRIPTION Applications for adult care home administrator license that have failed the examination or dropped applications including applications, correspondence, transcripts, job records and qualifications. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(6) 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0215-264 
TITLE Equivalency Statements for Certified Nurses' Aides 
DESCRIPTION Documents relating to equivalency statements allowing the substitution of course work for the Certified Nurse Aide program. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0216-264 
TITLE Examination Results 
DESCRIPTION Examination reports, results, and individual test scores of licensees. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0217-264 
TITLE Fraudulent Certificates or Licenses 
DESCRIPTION Affidavits, correspondence, evidence, etc. relating to fraudulent certificates or licenses. 
RETENTION 005 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0219-264 
TITLE Health Occupation Credentialing Applications 
DESCRIPTION Application and supporting documentation relating to individuals applying for certification as required by the Health Occupations Credentialing Act. 
RETENTION 001 cldr yr 
DISPOSITION Destroy 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0802-264 
TITLE Health Occupations Credentialing Program Statistics 
DESCRIPTION Numeric and graphic data summary reports detailing the operation of the licensing and certification programs. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS KSA 45-221(a)(9) 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0220-264 
TITLE Home Health Agency Files 
DESCRIPTION Survey reports, correspondence, etc. relating to home heath agency inspections conducted by the agency to ensure compliance with state and federal requirements. 
RETENTION 005 fisc yrs 
COMMENTS Meets federal requirements. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1999-10-07  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-121 

SERIES ID 0221-264 
TITLE Insufficient Funds Checks 
DESCRIPTION Documentation of checks returned for insufficient funds including: canceled checks and correspondence. 
RETENTION 003 fisc yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0222-264 
TITLE License Renewals 
DESCRIPTION Documents of the renewal or nonrenewal of adult care home administrators including: lists of administrators and summary statements. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0223-264 
TITLE License Stubs 
DESCRIPTION Tear off stubs from adult care home administrator licenses used as a record of licenses issued. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0225-264 
TITLE Medication Aide Expired Certificates 
DESCRIPTION Documents relating to medication aide certificates which have expired and not been renewed. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0226-264 
TITLE Medication Aide, Nurse Aide and Home Health Aide Program (Course) Approval 
DESCRIPTION Applications and documentation regarding the approval of nurse's aide, medication and home health aide training, including applications, correspondence, curriculum descriptions and instructor, etc. 
RETENTION See Comments 
COMMENTS Transfer to another series upon completion of course. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0804-264 
TITLE Name Change Notification Files 
DESCRIPTION Correspondence, legal documents, etc. relating to name changes of credentialed or regulated individuals or groups. 
RETENTION See Comments 
COMMENTS Retain until record is updated and verified, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0805-264 
TITLE Non-Kansas Certified Nurse Aide Courses 
DESCRIPTION Correspondence, curriculum, etc. describing other states' Certified Nurse Aide programs and maintained for convenience of reference. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0228-264 
TITLE Nurses' Aide Program History 
DESCRIPTION General information pertaining to the development and revision of the nurse's aide, medication aide, and home health aide program, regulations and statutes. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0229-264 
TITLE Nurses' Aide, Home Health Aide and Medication Aide Database Printouts 
DESCRIPTION Numerical and alphabetical listings on database used for reference. 
RETENTION See Comments 
COMMENTS Retain until superseded, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0230-264 
TITLE Nurses' Aide, Medication Aide and Home Health Aide Course Rosters 
DESCRIPTION Attendance rosters for approved courses, including attendance rosters to which the course approval is attached. 
RETENTION 003 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0231-264 
TITLE Nursing Home Files 
DESCRIPTION Survey reports, correspondence, etc. relating to nursing home inspections conducted by the agency to ensure compliance with state and federal requirements. 
RETENTION 005 fisc yrs 
COMMENTS Meets federal requirements. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1999-10-07  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-121 

SERIES ID 0232-264 
TITLE Out of State Nurses' Aide Course Approvals 
DESCRIPTION Course curriculum and correspondence relating to the approval of nurse's aide courses offered by other states. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0233-264 
TITLE Prior Approved Continuing Education Attendance Reports 
DESCRIPTION Documents relating to the licensed professions and health occupations credentialing programs where courses are approved under authority of long-term sponsorship. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0234-264 
TITLE Program History Files 
DESCRIPTION Documents relating to the deveopment and revision of the certified nurse aide, certified medication aide, and home health aide programs. 
RETENTION 002 cldr yrs 
COMMENTS Retain in office 2 calendar years, then transfer to the archives for purging. 
DISPOSITION Archives 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0235-264 
TITLE Reading File 
DESCRIPTION Documents produced by the department for reference purposes. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0236-264 
TITLE Requests for Applications 
DESCRIPTION Requests for application materials, packets, or general information relating to the various licensing and certification programs. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0237-264 
TITLE Sponsors of Approved CAN, CMA, HHA, SSD, AD and Operator Courses 
DESCRIPTION Correspondence, course plans, curriculum, instructors, etc. relating to the approval of the various certification courses. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy. 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0241-264 
TITLE Subject Files - Programs 
DESCRIPTION General subject files used in the administration of adult care home administrators, nurse's and medication aide, dietitian's licensing, health occupation credentialing and other programs. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then contact the archives for appraisal, if not accepted, then destroy. 
DISPOSITION See Comments 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0242-264 
TITLE Subject Files - Secretary 
DESCRIPTION Various subject files used in the performance of secretary's duties for the health occupations credentialing section, including supplies information and computer database operation information. 
RETENTION See Comments 
COMMENTS Retain until no longer useful, then destroy 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 1990-04-19  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-084 

SERIES ID 0244-264 
TITLE Unpaid and Returned Certificates 
DESCRIPTION Certified nurse aide, certifed medication aide, and home health aide certificates issued but not paid for and not made or mailed and returned as undeliverable. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

SERIES ID 0245-264 
TITLE Used Examination Answer Sheets 
DESCRIPTION Answer sheets completed for the various examinations. 
RETENTION 002 cldr yrs 
DISPOSITION Destroy 
RESTRICTIONS None 
APPROVED 2001-04-12  ; Revised 2013-06-03
K.A.R. NUMBER 53-2-126 

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