AGENCY: Box Elder County (Utah). Pioneer Care Center

SERIES: 4748
TITLE: Hill-Burton community service assurance reports
DATES: 1994.
ARRANGEMENT: Chronological

DESCRIPTION: These are copies of the triennial report required to be submitted to the Department of Health and Human Services by 42 Code of Federal Regulations (CFR) 124.509 (1989). The reports provide assurances that the facility will serve patients from the community without regard to race, age, or ability to pay. This policy is a condition for receiving federal assistance through the Hill-Burton Act for the construction and modernization of health care facilities.

The report includes the identification number; name and address of facility; fiscal year end; type of facility; change in status (yes/no), if yes, transfer of status change; primary geographic area served; governmental third party payer programs (Medicare, Medicaid); and existence of organized emergency rooms; number of admissions; length of operations; number of patients that stayed in facility previous night; questions on type of case; number of Veterans Administration patients; number of Black residents, Hispanics; number per age category; signature of administrator, and date report was completed.

RETENTION

DISPOSITION

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series were specifically approved by the State Records Committee.

APPROVED: 12/1990

FORMAT MANAGEMENT

Paper copy: Retain in Office for 4 years and then destroy.

APPRAISAL

Administrative

This disposition is based on the administrative needs expressed by the center. The Department of Health and Human Services does not specify any retention period. The center wants to maintain for one year after subsequent report has been submitted, for a total of 4 years.

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