Record Retention Schedule A

0001-0000

Articles/Certificates of Incorporation

Permanent

Permanent

0002-0000

By-Laws of the Hospital Board

Permanent

Permanent

0003-0000

Certificate of Need Application

10 yrs after project completion

Destroy

0004-0000

Deeds

7 yrs after transfer of title

Destroy

0005-0000

Employee Opinion Surveys/Suggestions

3 yrs

Destroy

0006-0000

Financial Transaction Status Reports

0007-0001

Financial Transaction Status Reports (Original)

3 yrs

Destroy

0007-0002

Financial Transaction Status Reports (Copy)

As updated

Destroy

00008-0000

Licensure Files

Includes: license, annual renewals, correspondence, and surveys by the Department of Health and Senior Services.  Note: License is renewed annually.

3 yrs after expiration

Destroy

0009-0000

Organization Charts

0009-0001

Organization Charts (Original)

Permanent

Permanent

0009-0002

Organization Charts (Copy)

Periodic review

Destroy

0010-0000

Policy and Procedures Manuals

0010-0001

Policy and Procedures Manuals (Original)

Permanent

Permanent

0010-0002

Policy and Procedures Manuals (Copy)

3 yrs after update

Destroy

0011-0000

Quality Assurance Reports – Departmental (Copy)

3 yrs

Destroy

0012-0000

Research Reports and Studies

Permanent

Permanent

0013-0000

Statistical Reports

0013-0001

Statistical Reports – Annual

Permanent

Permanent

0013-0002

Statistical Reports – Quarterly and Monthly

3 yrs

Destroy

0013-0003

Statistical Reports – Weekly

1 yr

Destroy

0013-0004

Statistical Reports – Daily

1 month

Destroy

0013-0005

Statistical Reports– (Copy)

Periodic review

Destroy

Human Resources/Personnel

0050-0000

Residency Personnel File

65 yrs

Destroy

0051-0000

Student Education File

Includes: grades, evaluation, and work schedules, etc.

65 yrs

Destroy

0052-0000

Student Application Log/Intern Register

65 yrs

Destroy

0053-0000

Residents Surgical Procedures Performed

Consists of a listing containing names of residents and procedure performed during four (4) year residency.

20 yrs

Destroy

0054-0000

Employee Medical Records

40 yrs

Destroy

Planning

0100-0000

Planning Subject File

Used for long range planning and development of the hospital.

0100-0001

Planning Subject File – Plans

Permanent

Permanent

0100-0002

Planning Subject File – Workpapers

Periodic review

Destroy

Marketing – Auxiliary

0150-0000

Donor Files

Include: name, address, and amount of donation.

3 yrs after update

Destroy

0151-0000

News Clippings and Ads

3 yrs

Destroy

0152-0000

Prospect Cards

Consist of index cards of prospective donors for fund raising.

3 yrs after update

Destroy

Marketing – Public Relations

0200-0000

Photographs

Permanent

Permanent

0201-0000

Press Releases

Permanent

Permanent

0202-0000

Public Service Announcements

Permanent

Permanent

0203-0000

Publications

0203-0001

Publications (Original)

Permanent

Permanent

0203-0002

Publications (Copy)

Periodic review

Destroy

Marketing – Volunteer Services

0250-0000

Sign-In Sheets

3 yrs

Destroy

0251-0000

Training Materials and Handouts

3 yrs after update

Destroy

0252-0000

Volunteer Application Files – Adult and Junior

Include: application, reference letters, interview sheet, check sheet, and Utilization Form which indicates position, needs, job description and placement.

6 yrs after termination

of employment

Destroy

Education

0300-0000

Educational Programs

Includes: manuals and program outlines, etc.

3 yrs after update

Destroy

0301-0000

Education Training Files

Includes: R.N., L.P.N., Unit Secretaries and Nursing Technicians.  Contains test booklets and results.

6 yrs after termination

 of employment

Destroy

Education – In-Service Education

0350-0000

Cardio – Pulmonary Resuscitation (CPR) Training

Includes: test results, test booklets, test result strips, and skill sheet.

3 yrs

Destroy

0351-0000

CPR Certificate Roster

3 yrs

Destroy

0352-0000

First Aid Roster

3 yrs

Destroy

0353-0000

Screening Registration Form

Includes: diabetes, hypertension, glaucoma, breast, colon-rectal and cholesterol screens, and information release form.

3 yrs

Destroy

Nursing - Administration

0400-0000

Nursing Licenses (Copy)

6 yrs after termination

of employment

Destroy

0401-0000

Nursing Schedules

7 yrs

Destroy

0402-0000

Twenty-Four Hour Report

3 yrs

Destroy

Nursing – Ambulatory Care

0450-0000

Ambulance Log Slips

7 yrs

Destroy

0451-0000

Ambulance Records Book/Register

10 yrs after final entry

Destroy

Nursing – Central Supply

0500-0000

Equipment Use Record

Records date used and by whom.

3 yrs

Destroy

0501-0000

Steam Sterilization Control Record

Includes: Bouse-Dick chart test, graph, load card, gas sterilizer load card, and biological monitoring form, etc.

3 yrs

Destroy

0502-0000

Syringe and Needle Control Record

3 yrs

Destroy

0503-0000

Syringe and Needle Inventory Sheet

1 yr

Destroy

0504-0000

Syringe and Needle Worksheet

3 yrs

Destroy

0505-0000

Washer/Sterilizer Cleaning Log Sheet

3 yrs

Destroy

Nursing – Surgery/Operating Room

0550-0000

Autoclave Graphs – Sterilization

3 yrs

Destroy

0551-0000

Birth Logs

Permanent

Permanent

0552-0000

Hospital Infection Statistical report

3 yrs

Destroy

0553-0000

Infection Report Form

3 yrs

Destroy

0554-0000

Operating Room Cancellation List

1 yr

Destroy

0555-0000

Operating Room Charge Sheet (Copy)

Original maintained by Finance.

3 yrs

Destroy

0556-0000

Operating Room Reservation Sheet

1 yr

Destroy

0557-0000

Operating Room Log

10 yrs

Destroy

0558-0000

Patient Record (Copy)

Used to monitor patient’s progress after surgery. Original located in patient’s medical record.

2 yrs

Destroy

0559-0000

Temperature and Humidity Log

3 yrs

Destroy

Nursing – Anesthesiology/Recovery Room

0600-0000

Arthroscopy Video Tapes

5 yrs

Destroy

0601-0000

Crash Cart Checklist

Lists: contents of each cart, date, and nurses signatures.

5 yrs

Destroy

0602-0000

Defibrillator Checklist

3 yrs

Destroy

0603-0000

Pre-Operative and Post-Operative Checklists

3 yrs

Destroy

0604-0000

Recovery Room Log

Includes minor surgery and same-day surgery.

10 yrs

Destroy

0605-0000

Weekly Duty List/Schedule

7 yrs

Destroy

Nursing – Emergency Room

0650-0000

Emergency Department Log and/or Card Files

3 yrs

Destroy

0651-0000

Emergency Room Daily Statistics

1 yr

Destroy

0652-0000

Mobile Intensive Care Unit Audio Tapes

3 yrs

Destroy

Professional Services – Laboratory

0700-0000

Blood Bank – Immunohematology Proficiency and Clinical Laboratory Test Reports (Copy)

Includes: record of transfusions and cross matches.  Originals maintained in patient medical record.  May also include Test Requisitions 

5 yrs

Destroy

0701-0000

Appointment Log

3 yrs after final entry

Destroy

0702-0000

Blood Bank Register

Permanent

Permanent

0703-0000

Exfoliative Cytology Reports – Pap Smears

0703-0001

Exfoliative Cytology Reports – Positive or Questionable Result

50 yrs

Destroy

0703-0002

Exfoliative Cytology Reports – Negative Result

2 yrs

Destroy

0704-0000

Graphs

Printouts indicating barbiturates, alcohol, cocaine, and opiates, etc.

2 yrs

Destroy

0705-0000

Instrument Maintenance Reports/Machine Calibrations

7 yrs

Destroy

0706-0000

Laboratory Test Log Books

7 yrs after final entry

Destroy

0707-0000

Machine Log

7 yrs

Destroy

0708-0000

Quality Control reports – Blood Bank

7 yrs

Destroy

0709-0000

Workbooks – Urine Screening Tests

2 yrs

Destroy

0710-0000

Specimen Records

Includes: identifying information, test results and reports.  Also used for Quality Control and Proficiency Test Results

0710-0001

Specimen Reports – Immunohematology - Blood Bank

Test Reports, Test Results, and Identifying Information

10 yrs

Destroy

0710-0002

Specimen Records – Pathology Test Reports

20 yrs

Destroy

0710-0003

Specimen Records – General Test Reports

2 yrs

Destroy

0711-0000

Bone Marrow Reports

20 yrs

Destroy

0712-0000

Blood Bank Donor and Recipient Cards

5 yrs

Destroy

0713-0000

Blood Bank Employee Signatures, Initials and Identification Codes

6 yrs after termination

of employment

Destroy

0714-0000

Accession Log

2 yrs

Destroy

0715-0000

Laboratory Test Request

5 yrs

Destroy

Professional Services – Pathology

0750-0000

Autopsy Reports (Copy)

Original maintained in Medical Records.

20 yrs

Destroy

0751-0000

Death Register Books

Permanent

Permanent

0752-0000

Death Slips and Mortician’s Releases

7 yrs

Destroy

0753-0000

Pathology Report on Lab Results (Copy)

Original located in patient’s medical record.

10 yrs

Destroy

Professional Services – Psychiatry

0800-0000

Social Services Patient Files – Notes and Workpapers

10 yrs form most recent discharge or age 23, whichever is longer

Destroy

0801-0000

Social Services Patient Files – Summary Sheet

20 yrs

Destroy

0802-0000

Social Services Patient Files – Index

20 yrs

Destroy

Professional Services – Pediatrics

0850-0000

Nursery Daily Statistics

3 yrs

Destroy

0851-0000

Pneumogram

0851-0001

Pneumogram – Interpretation Report

23 yrs

Destroy

0851-0002

Pneumogram – Graph

5 yrs

Destroy

Professional Services – Cardiopulmonary

0900-0000

Electrocardiograms/Echocardiograms

0900-0001

Electrocardiograms/Echocardiograms – Diagnostic and Interpretation Report

10 yrs after most recent discharge or age 23, whichever is later

Destroy

0900-0002

Electrocardiograms/Echocardiograms – Graphs

5 yrs

Destroy

0901-0000

Holter Monitor

0901-0001

Holter Monitor - Diagnostic and Interpretation Report

10 yrs after most recent discharge or age 23, whichever is later

Destroy

0901-0002

Holter Monitor – Graph

5 yrs

Destroy

0902-0000

Machine Calibration Log

Life of the instrument

plus 2 yrs

Destroy

0903-0000

Outpatient Medical Charts

10 yrs after most recent discharge or age 23, whichever is later

Destroy

0904-0000

Work Schedules

3 yrs

Destroy

Professional Services – Neuro-Sciences

0950-0000

Electroencephalograms

0950-0001

Electroencephalograms – Explanation and Interpretation Report

10 yrs after most recent discharge or age 23, whichever is later

Destroy

0950-0002

Electroencephalograms – Graphs

5 yrs

Destroy

0951-0000

Machine Calibration Log

Life of the instrument

plus 2 yrs

Destroy

0952-0000

Work Schedules

7 yrs

Destroy

Professional Services – Dietary

1000-0000

Cashier Tapes – Cafeteria

Used for account verifications.

7 yrs

Destroy

1001-0000

Diet Information Sheet – Daily

1 yr

Destroy

1002-0000

Dietary Instructions Log

3 yrs after final entry

Destroy

1003-0000

Food Tally – Daily Production Sheet

3 yrs

Destroy

1004-0000

Patient Meal Count – Daily

3 yrs

Destroy

Professional Services – Diagnostic and Therapeutic Services

1050-0000

Outpatient Files

10 yrs after most recent discharge or age 23, whichever is later

Destroy

1051-0000

Respiratory Therapy Patient Kardex Index Cards

3 yrs after most

recent discharge

Destroy

Professional Services – Pharmacy Records

1100-0000

Antibiotic Sensitivity Patterns – Graph

5 yrs

Destroy

1101-0000

Barbiturate Records

5 yrs

Destroy

1102-0000

Narcotic Books and Records

5 yrs

Destroy

1103-0000

Patient Profile Record System

Contains: patients address, name, age group, date medication is dispensed, prescription number or designation, strength and quantity of drug dispensed, initial of dispensing pharmacist, and date of refill.

N.J.A.C.  13:39-9.43.

5 yrs from date of last entry in the profile record

Destroy

1104-0000

Pharmacist/Intern Signature and/or Initial Identification

5 yrs after termination

of employment

Destroy

1105-0000

Pharmacy Requisition

7 yrs

Destroy

1106-0000

Prescription Books

5 yrs after last entry

Destroy

Professional Services – Housekeeping

1150-0000

Daily Patient Interview Form

3 yrs

Destroy

1151-0000

Daily Supervisor’s Report

3 yrs

Destroy

1152-0000

Linen Inventory

3 yrs

Destroy

1153-0000

Patient Dismissal Notice to Housekeeping

3 yrs

Destroy

1154-0000

Project List – Work Order

3 yrs

Destroy

1155-0000

Supply Inventory

3 yrs

Destroy

1156-0000

Weekly Inspection Report

3 yrs

Destroy

Professional Services – Patient Management

1200-0000

Appeals

Hospital costs appeals filed by patients.

7 yrs after final settlement

 or payment

Destroy

1201-0000

Diagnosis Related Group Analysis Files

Includes a financial and clinical analysis of services provided.

7 yrs

Destroy

1202-0000

Incident Reports

1202-0001

Incident Reports (Original)

7 yrs after incident, final settlement or payment

Destroy

1202-0002

Incident Reports (Copy)

Periodic review

Destroy

1203-0000

Patient Complaint Files and Litigation Case File

7 yrs after final settlement

or payment

Destroy

1204-0000

Social Services Discharge Planning File (Copy)

Includes individual patient worksheet and referral notes.  Original maintained in medical records.

3 yrs after discharge

Destroy

Professional Services – Radiology

1250-0000

Annual Reports of Radiation Surveys

Permanent

Permanent

1251-0000

Daily Calibration Standards Check in Does Calibrator

10 yrs

Destroy

1252-0000

Daily Check of Incoming and Outgoing Materials

2 yrs

Destroy

1253-0000

Daily Dose Report per Patient

2 yrs

Destroy

1254-0000

Daily Flood Check – Nuclear Camera Check

10 yrs

Destroy

1255-0000

Daily Radiation Monitoring Report

10 yrs

Destroy

1256-0000

Daily Radiation Monitoring Report

10 yrs

Destroy

1257-0000

Daily Radiation Survey – Area of  Injection

10 yrs

Destroy

1258-0000

Daily Survey Meter Check

2 yrs

Destroy

1259-0000

Equipment Quality Testing – Monthly Report

10 yrs

Destroy

1260-0000

Individual Monthly Badge Report

10 yrs after termination

of employment

Destroy

1261-0000

Individual Report of Radiation Exposure (JCAHO)

10 yrs after termination

 of employment

Destroy

1262-0000

License Files – Nuclear Regulatory Commission (NRC)

Includes federal and state licenses required for the operation of radiation emitting equipment.

10 yrs after expiration

Destroy

1263-0000

Nuclear Radiation Technologist Certification

10 yrs after expiration

Destroy

1264-0000

Patient Cards

Used to provide an x-ray history of a patient.

10 yrs after inactive

Destroy

1265-0000

Patient Sign-In Roster

3 yrs after final entry

Destroy

1266-0000

Register of all Radiation Producing Equipment

10 yrs after disposal

of equipment

Destroy

1267-0000

Semiannual Survey of Calibration Standards Retested

3 yrs

Destroy

1268-0000

Semiannual Survey Report of Meters Recalibrated and Re-tested

3 yrs

Destroy

1269-0000

Weekly Bar Phantom Check Report – Calibration Report

3 yrs

Destroy

1270-0000

Weekly Radiation Survey of Entire Radiology Department

3 yrs

Destroy

1271-0000

Work Schedules

7 yrs

Destroy

1272-0000

X-Ray Films

5 yrs

Destroy

1273-0000

X-Ray Interpretation (Copy)

Original maintained in Medical Record.

5 yrs

Destroy

1274-0000

X-Ray Technician Certification

10 yrs after expiration

Destroy

1275-0000

Inventor of  all Sealed Radioactive Materials

3 yrs

Destroy

1276-0000

Sealed Source Records – Leak Tests

3 yrs

Destroy

1277-0000

Unsealed Source Records – Area Contamination Wipe Tests

3 yrs

Destroy

1278-0000

Survey of Radioactive Material Received

3 yrs

Destroy

1279-0000

Survey of Waste Generated in Controlled Areas

3 yrs

Destroy

1280-0000

Nuclear Medicine Dose Calibrator – Constancy Test, Linearity Test, Accuracy Test and Geometry Test

3 yrs

Destroy

1281-0000

Nuclear Medicine Radiopharmaceutical Dosage – Dose Determination Test

3 yrs

Destroy

1282-0000

Nuclear Medicine Imaging Service – Uniformity Test and Resolution Test

3 yrs

Destroy

1283-0000

Nuclear Medicine Well Counter – Constancy Test

3 yrs

Destroy

1284-0000

Mammograms – X-rays and Interpretive Report

(21 CFR 900.12(c)4)

10 yrs

Destroy

1285-0000

Radiation Oncology Treatment Patient Records

(N.J.A.C.  8:43G-28.16 (b))

2 yrs after death of patient or until patient obtains age of 90, or for 5 yrs,

whichever is longer

Destroy

Finance

Note: The State Agency General Records Retention Schedule should be consulted for all Financial Records that are maintained by a New Jersey State Hospital.

1300-0000

Census

Statistical reports that provide total number of admission, discharges, transfers, and deaths.

1300-0001

Census –Annual

7 yrs

Destroy

1300-0002

Census – Monthly and Quarterly

3 yrs

Destroy

1300-0003

Census – Weekly

1 yr

Destroy

1300-0004

Census – Daily

1 month

Destroy

1300-0005

Census (Copy)

As updated

Destroy

1301-0000

Daily Bed Count

3 yrs

Destroy

Finance – Admissions/Registration

1450-0000

Admission Register/Log

3 yrs

Destroy

1451-0000

Daily Reservation Sheets

1 yr

Destroy

Finance – Budget and Reimbursements

1500-0000

Annual Hospital Rate Submission

20 yrs

Destroy

1501-0000

Hospital Rate Appeals

7 yrs after settlement

Destroy

1502-0000

Medicare Cost Reports

3 yrs

Destroy

1503-0000

Monthly Detail Analysis Report

1503-0001

Monthly Detail Analysis Report (Original)

3 yrs

Destroy

1503-0002

Monthly Detail Analysis Report (Copy)

As updated

Destroy

Finance - Accounting

Note: The State Agency General Records Retention Schedule should be consulted for all Financial Accounting Records that are maintained by a New Jersey State Hospital.

Finance – Patient Billing

1550-0000

Assessment Reports of Patients Accounts – Monthly Status Report

3 yrs

Destroy

1551-0000

Departmental Allowance Reports

3 yrs

Destroy

1552-0000

Monthly Agency Paid and Open Account Report

3 yrs

Destroy

1553-0000

Monthly Payment Register

7 yrs

Destroy

1554-0000

Monthly Trial Balance  - Patient

Lists all costs per patient.

3 yrs

Destroy

1555-0000

Patient Billing File

Includes: Admission Form (Copy), verification documentation, insurance company correspondence, detailed billing list, and uniform bill.

7 yrs after final action

or write-off

Destroy

1556-0000

Record of Refund

7 yrs

Destroy

Finance – Materials Management/Procurement

1600-0000

Cost Containment Report – Cost Savings Report

1600-0001

Cost Containment Report – Annual

Permanent

Permanent

1600-0002

Cost Containment Report – Monthly

3 yrs

Destroy

1601-0000

Itemized Listing of Receivables

1601-0001

Itemized Listing of Receivables – Monthly

3 yrs

Destroy

1601-0002

Itemized Listing of Receivables – Daily

1 yr

Destroy

Transportation Services

1650-0000

Escort Assignment Slip

2 yrs

Destroy

1651-0000

Transport Travel Log

3 yrs

Destroy

1652-0000

Vehicle Maintenance File

7 yrs after disposal of vehicle

Destroy

Medical Records

1700-0000

Fetal Monitoring Strips

23 yrs

Destroy

1701-0000

Medical Records – Inpatient/Outpatient

Includes all disciplines

0701-0001

Individual Patient Charts

Contains: bedside notes, admission form, medical chart, medication prescribed, emergency room report, Ambulatory Care Services Report, and all required documentation according to licensing and accreditation bodies.

10 yrs after most recent discharge or age 23, whichever is later

Destroy

1701-0002

Discharge Summary Sheet

20 yrs

Destroy

1701-0003

Medical Records of Deceased Individuals

10 yrs

Destroy

1702-0000

Subpoenas and Related Correspondence

3 yrs from final action

Destroy

Security

1750-0000

Daily Incident Log/Daily Blotter

3 yrs after final entry

Destroy

1751-0000

Incident Reports

3 yrs

Destroy

Maintenance

1800-0000

Air Conditioning/HVAC Filter Change Log

3 yrs after final entry

Destroy

1801-0000

Annual Boiler Inspection Report

3 yrs

Destroy

1802-0000

Building Plans and Specifications

Permanent

Permanent

1803-0000

Conductivity Testing of Electrical Receptacles – Annual

3 yrs

Destroy

1804-0000

Emergency Generator Log

3 yrs after final entry

Destroy

1805-0000

Fire Prevention Checklist

1805-0001

Fire Prevention Checklist – Annual Report

7 yrs

Destroy

1805-0002

Fire Prevention Checklist – Quarterly Report

3 yrs

Destroy

1806-0000

Fire/Electrical Safety Training Programs

Includes: course outlines, handouts, and brochures, etc.

3 yrs after update

Destroy

1807-0000

Freezer Temperature Readings Log

3 yrs after final entry

Destroy

1808-0000

Monthly Fire Drill Report

3 yrs

Destroy

1809-0000

Operating Engineer’s Daily Log

7 yrs after final entry

Destroy

1810-0000

Preventive Maintenance Duct Cleaning Report

3 yrs

Destroy

1811-0000

Quarterly Inspection Report of Operating Room Equipment

3 yrs

Destroy

1812-0000

Quarterly Sewer Cleaning Inspection Room

7 yrs

Destroy

1813-0000

Sprinkler Inspection Semiannual Report

3 yrs

Destroy

1814-0000

Trash Incineration Daily Report

Consists of: statistical report on amount of trash incinerated, boxes of needles, hazardous waste, medical waste, weight and temperature.

7 yrs

Destroy

Medicine Division

1850-0000

Daily Consultations with Other Departments

Concerning Medication Given to Patients.

2 yrs

Destroy

1851-0000

Explorations and Discharges – Records of Results of Medications Given  (Research)

Permanent

Permanent

1852-0000

Residency Certificates

Permanent

Permanent

1853-0000

Student Applications – Denied

3 yrs

Destroy

Infection Control

1900-0000

Antibiotic Audit Survey Report

3 yrs

Destroy

1901-0000

Environmental Sanitation Inspection Report

3 yrs

Destroy

1902-0000

Immediate/Infection Report Form Received From Nurses/Doctor

3 yrs

Destroy

1903-0000

Weekly Report of Antibiotic Orders

5 yrs

Destroy

Quality Assurance

1950-0000

Program Assessment/Evaluation Reports – Periodic/Program Audit Reports

3 yrs

Destroy

1951-0000

Quality Assurance Annual Evaluations

Permanent

Permanent

1952-0000

Quality Assurance Investigative Case File – Patient Care and Research

Contains Quality Assurance Problem Identification Log and all supporting documentation.

1952-0001

Quality Assurance Investigative Case File - Patient Care

7 yrs after problem

is resolved

Destroy

1952-0002

Quality Assurance Investigative Case File – Research (Original)

7 yrs after problem

is resolved

Destroy

1952-0003

Quality Assurance Investigative Case File– Research (Copy)

3 yrs after problem

is resolved

Destroy

1953-0000

Quality Assurance Reports

Contains clinical disciplines and ancillary departments – monthly and quarterly summary reports.

7 yrs

Destroy

Program Evaluation/Joint Commission Accreditation Health Organizations (JCAHO)

2000-0000

Facility and Program Evaluation Inspection Reports

Includes: goals and objectives, quarterly progress reports, final progress reports, evaluations, and surveys.  Evaluations are conducted every three (3) years.

7 yrs

Destroy

2001-0000

Problem Identification Summary

Used to indicate and track problems.

7 yrs

Destroy

2002-0000

Special Reporting and Evaluation Reports

Permanent

Permanent

Utilization

2050-0000

Emergency Services Review

3 yrs

Destroy

2051-0000

Federal and Non-Federal Termination of Benefits Letters

7 yrs

Destroy

2052-0000

Hospital Patient Stay Review

Includes inappropriate length of stay letters and replies.

3 yrs

Destroy

2053-0000

Investigative Case File

Includes problem identification sheet.

7 yrs after problem

 is resolved

Destroy

2054-0000

Patient Care Monitoring Forms (Evaluation)

3 yrs after discharge

 of patient

Destroy

2055-0000

Patient Discharge Forms – Billing

Includes: insurance carrier coverage forms, denial of benefit letters, charge slips, and physicians review recommendation.

7 yrs

Destroy

2056-0000

Public Welfare Certification of Coverage

7 yrs

Destroy

Rehabilitation Services

2100-0000

Attendance Sign-In Book

7 yrs

Destroy

2101-0000

Charge Slips

3 yrs

Destroy

2102-0000

Combined Activity Analysis

7 yrs

Destroy

2103-0000

Contracts/Agreements for Services

7 yrs after termination

of contract

Destroy

2104-0000

Daily Progress Statistical Report

Lists: patients, date of visits, length of time, classification or degree of difficulty, patients not attending, discharges, and charges.

3 yrs

Destroy

2105-0000

Education Program

Includes: attendance sheet, agenda, and bank account.

7 yrs

Destroy

2106-0000

Electromylogram (E.M.G.)

2106-0001

Electromylogram (E.M.G.) – Diagnostic Interpretation Report

10 yrs form most recent discharge or age 23, whichever is later

Destroy

2106-0002

Electromylogram (E.M.G.) – Graphs

5 yrs

Destroy

2107-0000

Inventory and Release Form for Physical Therapy Equipment

7 yrs

Destroy

2108-0000

Patient Medical Record – Outpatient

Includes: medical chart, progress notes, orders, and admission form.

10 yrs form most recent discharge or age 23, whichever is later

Destroy

2109-0000

Patient Medical Discharge Summary – Outpatient

20 yrs

Destroy

2110-0000

Patient Kardex

As updated

Destroy

2111-0000

Speech Therapist Licenses (Copy)

6 yrs after termination

of employment

Destroy

2112-0000

Training Request

3 yrs after completion

of training

Destroy

2113-0000

Work Schedule

7 yrs

Destroy

RESEARCH

21150-0000

Basic Research File – Nonhuman (Hardcopy and Electronic)                                                                                     Research file of experimental and statistical data.   File contains but is not limited to: logs, notebooks, code cards and sheets, observations, records on patients or healthy volunteers, interviews, questionnaires, examinations,  laboratory tests data including machine readings and slides, culture specimens, abstracts of non-clinical records on individuals’ birth/death certificate (copy), project, indexes, charts/graphs/diagrams/drawings, punch cards, tabulations, analyses, progress reports, feeder reports, and supporting documentation.

7 yrs after close of project

Destroy

21151-0000

Investigational New Drug and Device File, Food and Drug Administration (FDA) – Clinical Trial Documents (Hardcopy and Electronic)                                                                                    

Investigational drug and device research/studies document file essential to the conduct of a Clinical Trial. Records related to patient case histories which include: patient participation informed consent, observations of individuals administered the drug/used in a control group, case report forms, signed and dated additional consent forms, medical records, physician progress notes, hospital charts, and the nurses' notes.  (Title 21: FDA Chapter 1, FDA Administration, DHHS, Subchapter D, Drugs for Human use, Investigational New, PART 312.62)

21151-0001

Investigational New Drug and Device File, Food and Drug Administration (FDA) – Clinical Trial Documents – Approved (Hardcopy and Electronic)                                                                                    

7 yrs after the

date of marketing approval 

Destroy

21151-0002

Investigational New Drug and Device File, Food and Drug Administration (FDA) – Clinical Trial Documents – Discontinued (Hardcopy and Electronic)                                                                                    

7 years  after FDA notified of discontinuance

Destroy

21152-0000

Human Subject Documentation - Food and Drug Administration (FDA)

Records related to patient participation in medical research trials. The records are maintained in compliance with the federal Records Research Subjects Review Board and Western Institutional Review Board.  (Title 21: FDA Chapter 1, FDA Administration, DHHS, Subchapter A – General, Sec. 56.115 IRB records)

3 yrs after completion

of research

Destroy

21153-0000

Research Projects End Product/Result 

End product and/or result of all research projects which include but are not limited to:  report findings and conclusions, documented advancements in treatment of disease, development of new medical devices, use of establish methods, or other medical/non-medical findings including records with value in continuing research, summary/final project reports, article reprints, academic monographs, graphic compilations, analyses, and supporting documentation.

Permanent

Permanent

21154-0000

Animal Welfare File - National  Institute of Health (NIH) Office of Laboratory Animal Welfare

21154-0001

Animal Welfare File -  Animal Welfare General Records

File includes copy of the Public Health Service (PHS) Assurance, minutes of IACUC meetings, records of applications, proposals, and proposed significant changes in the care and use of animals and whether IACUC approval was given or withheld, records of semiannual IACUC reports and recommendations (including minority views) as forwarded to the Institutional Official, and records of accrediting body determinations

3 yrs after project has closed

Destroy

21154-0002

Animal Welfare File  - Animal Disease Investigation Reports

Animal disease investigation reports prepared at the request of an investigator, detailing examination, pathology, and treatment for each animal.

7 yrs

Destroy

21154-0003

Animal Welfare File - Animal Health Certificates

Health certificates issued for the animals used in research.

5 yrs

Destroy

21155-0004

Animal Welfare File - Pedigree History

Pedigree history providing data concerning the generational history of each strain, related weaning information, and other key genetic data. File contains pedigree registration forms, registration history records, pedigree documentation which may be provided by animal suppliers, necropsy records, weight records, breeding performance history, and quarantine records.

50 yrs

Destroy

21154-0005

Animal Welfare Documents - Records of Disposition of Laboratory Animals

Records of disposition of laboratory animals required by the US Department of Agriculture.

5 yrs

Destroy

21155-0000

Patent and Invention Licensing

21155-0001

Patent and Licensing – Experimental and Statistical Data

File of patient experimental and statistical data which includes logs or notebooks with recorded patient observations and data used as evidence for establishing medical patents or inventions rights

10 yrs after expiration of patent or license

Destroy

21155-0002

Patent and Licensing – Invention Report

Employee invention reports on which patent application will or will not be filed.