agency function and records summary … · renewal schedules were updated ... (if machine readable...

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June 14, 2018 AGENCY FUNCTION AND RECORDS SUMMARY Board of Nursing Most occupations and professions that require a state license are licensed and regulated by one of 38 boards and commissions. Kentucky is an autonomous board state, which means that these 38 agencies are not organized under an umbrella agency, but rather function as independent, autonomous unites of state government. The Board of Nursing was established in 1950 by KRS314.011, which charged it with regulating the practice of nursing in Kentucky. The mission of the Board is to enforce public policy related to the safe and effective practice of nursing in the interest of public welfare. It examines applicants and issues or review licenses to qualified candidates, hears charge against licenses and determines whether to revoke licenses and prosecute those violating laws pertaining to nurses, approves curricula and standards, for schools of nursing and monitors competency standards for nurses. In addition, the Board approves providerships for mandatory continuing education and pre-licensure programs of nursing, enforces the Nursing Practice Act and issues nursing practice opinions. The Board consists of 16 members appointed by the Governor for four year terms. The Board is self-supporting through fees assessed for professional licensure and receives no general fund tax appropriation. Additions to the Schedule: Series 06917, Jurisprudence Exam Guide Proposed retention: Maintain current version in Agency. Retain previous exams and materials for five (5) years after revisions, then destroy. Retention Rationale: This series has primary administrative value as it documents information used to administer licensing examinations for licensed nurses in Kentucky. Revision to the Schedule: Changes in Retention: Series 00746, Master File Folder - Registered Nurse and Practical Nurse Current retention: Retain permanently. Forward to the Archives and Records Management Division annually for microfilming. Once microfilm is approved by agency, microfilm will serve as permanent record copy and all other copies may be destroyed. Proposed retention: Retain in Agency permanently. Retention Rationale: This series has primary administrative and research value as it documents that all licensing requirements have been met and provides information for research over time.

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June 14, 2018

AGENCY FUNCTION AND RECORDS SUMMARY

Board of Nursing

Most occupations and professions that require a state license are licensed and regulated by one of 38 boards and commissions. Kentucky is an autonomous board state, which means that these 38 agencies are not organized under an umbrella agency, but rather function as independent, autonomous unites of state government.

The Board of Nursing was established in 1950 by KRS314.011, which charged it with regulating the practice of nursing in Kentucky. The mission of the Board is to enforce public policy related to the safe and effective practice of nursing in the interest of public welfare. It examines applicants and issues or review licenses to qualified candidates, hears charge against licenses and determines whether to revoke licenses and prosecute those violating laws pertaining to nurses, approves curricula and standards, for schools of nursing and monitors competency standards for nurses. In addition, the Board approves providerships for mandatory continuing education and pre-licensure programs of nursing, enforces the Nursing Practice Act and issues nursing practice opinions. The Board consists of 16 members appointed by the Governor for four year terms.

The Board is self-supporting through fees assessed for professional licensure and receives no general fund tax appropriation.

Additions to the Schedule:

• Series 06917, Jurisprudence Exam GuideProposed retention: Maintain current version in Agency. Retain previous exams and materials for five (5) years after revisions, then destroy. Retention Rationale: This series has primary administrative value as it documents information used to administer licensing examinations for licensed nurses in Kentucky.

Revision to the Schedule:

Changes in Retention:

• Series 00746, Master File Folder - Registered Nurse and Practical NurseCurrent retention: Retain permanently. Forward to the Archives and Records Management Division annually for microfilming. Once microfilm is approved by agency, microfilm will serve as permanent record copy and all other copies may be destroyed. Proposed retention: Retain in Agency permanently. Retention Rationale: This series has primary administrative and research value as it documents that all licensing requirements have been met and provides information for research over time.

June 14, 2018

Revision to the Schedule: (cont.)

• Series 00772, School Visit Report FileCurrent retention: Retain site visit reports for six (6) years, then destroy. If a program closes, maintain site visit reports until one (1) year after program is closed and any appeal is complete, then destroy. Proposed retention: Retain compliant reports in Agency for eight (8) years, then destroy. Retain non-compliant reports in Agency until program achieves compliance and all requirements have been met or program is closed, then destroy. Retention Rationale: This series has primary administrative value as it documents visits to approved nursing schools. It is only necessary to keep the most current reports, as any major problems will be documented in the Board Minutes, a permanent record.

• Series 00775, Application for Continuing Education Provider Approval FileCurrent retention: Destroy five (5) years after provider non-renewal. Proposed retention: Retain in Agency and destroy two (2) years after provider non-renewal. Retention Rationale: Renewal schedules were updated from five to two years. This series has primary administrative value as it is used as a reference resource. The series is also subject to fiscal audit.

• Series 00776, Continuing Education Provider Renewal Application FileCurrent retention: Retain in agency for five (5) years. Destroy after audit. Proposed retention: Retain in Agency for two (2) years. Destroy after audit. Retention Rationale: Renewal schedules were updated from five to two years. This series has primary administrative value as it is used as a reference resource. The series is also subject to fiscal audit.

• Series 00779, Individual Request for Review of Continuing Education ActivityCurrent retention: Retain in agency for six (6) years. Destroy after audit. Proposed retention: Retain in Agency for two (2) years. Destroy after continuing education audit. Retention Rationale: Licenses are renewed annually. Retaining these documents for two years still allows for a review of the past two renewals. Added “continuing education” to clarify which audit is being referenced. This series has primary administrative value as it documents continuing education hours earned.

• Series 04398, Continuing Education Audit FileCurrent retention: Destroy five (5) years following the end of the audit year in which continuing education credits were earned. Proposed retention: Destroy two (2) years following the end of the audit year in which continuing education credits were earned. Retention Rationale: Licenses are currently renewed annually, and a two-year retention still allows for a review of the past two renewals. This series has primary administrative value because it provides the agency with the substantiated compliance of licensees in regard to continuing education credits through a mandated audit.

June 14, 2018

Revision to the Schedule: (cont.)

• Series 05460, Advisory Opinion Statements Folder Current retention: Record copies of Advisory Opinion Statements (AOS) should be retained permanently. Forward two (2) copies of AOS issued in paper to the Archives and Records Management Division when issued. Forward one (1) copy of AOS held in electronic format or issued for general public distribution on the agency's web site. Retain one (1) copy in agency. Destroy excess copies when no longer needed. Proposed retention: Retain record copies of Advisory Opinion Statements (AOS) permanently. Forward two (2) copies of AOS issued in paper to the Archives and Records Management Division when issued; or forward one (1) copy of AOS held in electronic format or issued for general public distribution on the agency's web site. Retain one (1) copy in agency. Destroy excess copies when no longer needed. Retention Rationale: This series has primary administrative value as it is referred to on numerous occasions, is reviewed and revised periodically to maintain currency. May be referred to in order to track evolution of practice matters addressed by Board.

• Series 05470, Dialysis Technician Initial Credential Application Current retention: Retain permanently. Forward to the Archives and Records Management Division annually for microfilming. Once microfilm is approved by agency, microfilm will serve as permanent record copy and all other copies may be destroyed. Proposed retention: Retain permanently. Retention Rationale: This series has primary administrative value as it may be used for investigation information and documents eligibility of person to receive credential.

Closed Series:

Series 00777, Refresher Course Provider Approval Application File Series 05471, Refresher Course Provider Renewal Application File

Staff also made administrative changes to the following two series without changing retention or disposition:

Series 05459, Prelicensure Nursing Program Nurse Faculty/Clinical Instructor Record Series 06109, Nursing Practice Inquiries

1920 2. SERIES NO. 06917

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Courtney GilmoreDATE 05/14/2018 PHONE NO. 502 429 7182

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Jurisprudence Exam Guide

7. VARIANT TITLE

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

Original

Duplicate

10. INFORMATION SUMMARIZED IN:

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Chronological by exam year and version

13. INDEX/FINDING AID(S)

14. DATE SPAN:

In Agency

From 2008 To Present

State Records Center

From To

State Archives

From: To

15. VOLUME:In Agency State Records Center State Archives

16. ANNUAL ACCUMULATION

less than 1cft

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 2nd Year: 3-5 Years: More than 5 years:

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents the Board of Nursing's contributions on updates and revisions to the jurisprudence exam required for applicants. The exam is required to be completed by applicants for licensure by exam, endorsement, or reinstatement as a Licensed Practical Nurse (LPN), Registered Nurse (RN), or an Advanced Practice Registered Nurse (APRN). The exam consists of thirty-five (35) questions on Kentucky nursing laws and Advisory Opinion Statements, and is housed with the National Council of State Boards of Nursing (NCSBN) who oversees its administration.

1. RECORD GROUP CODE

OTHER:Electronic Paper

General Government

Nursing, Board of

Credentials

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: the Jurisprudence Exam Study Guide, instructions, exam questions, and an answer key.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

22. VITAL RECORD?

Yes/NoV

23. If Yes, VITAL RETENTION PERIOD?

Maintain current version.

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

C

KRS 61.878(1)(g) - Information used for licensing jurisprudence examination

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?) 27. AUDIT RETENTION REQUIREMENT

28. LEGAL RETENTION REQUIREMENT? (Yes/No) If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X I

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

30. RATIONALE FOR RETENTION

This series has primary administrative value as it documents information used to administer licensing jurisprudence examinations for licensed nurses in Kentucky.

31. AGENCY RETENTION

32. DISPOSITION INSTRUCTIONS:

Maintain current version in Agency. Retain previous exams and materials for five (5) years after revisions, then destroy.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

Date

06917

Joseph Isaac

1920 2. SERIES NO. 00746

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Joyce A. BonickDATE 02/02/2010 PHONE NO. 502.429-3300

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Master File Folder - Registered Nurse and Practical Nurse

7. VARIANT TITLE

NA

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

NAOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

NA

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by licensed nurse

13. INDEX/FINDING AID(S)

NA

14. DATE SPAN:

In Agency

From 1911 To Present

State Records Center

From To1982 Present

State Archives

From: 1911 To Present

15. VOLUME:In Agency State Records Center State Archives

331cf

16. ANNUAL ACCUMULATION 17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 5 2nd Year: 5 3-5 Years: 3 More than 5 years:

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents the initial licensure of registered nurses and practical nurses in accordance with Kentucky Nursing Laws and Regulations KRS 314.00 and 201 KAR 20:056-500 and subsequent license activities.

1. RECORD GROUP CODE

OTHER:Paper Microform Computer Disk

General Government

Nursing, Board of

Credentials

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: Application for licensure, test results, program validation, continuing competency certificates, original out-of-state license, CGFNS Visa Screen Certificate, internship verification, name, address, DOB, SSN and related documents and related correspondence.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

License Renewal Application File (00759); Reinstatement Application File (00760)

22. VITAL RECORD?

Yes/NoV

23. If Yes, VITAL RETENTION PERIOD?

P

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

C

KRS 61.878 (1)(a) Personal information. Agencies should consult legal counsel regarding open records matters..

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

State

27. AUDIT RETENTION REQUIREMENT

3

28. LEGAL RETENTION REQUIREMENT? (Yes/No) N If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X P

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

X 3

X P

30. RATIONALE FOR RETENTION

This series has primary administrative and research value as it documents that all licensing requirements have been met and provides information for research over time.

31. AGENCY RETENTION

1

32. DISPOSITION INSTRUCTIONS:

Retain in Agency permanently.

33. RECORDS CENTER RETENTION:

P

34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

P

Date

Y

00746

Joseph Isaac

1920 2. SERIES NO. 00772

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Patricia SpurrDATE 04/08/2010 PHONE NO. 502/429.3300

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

School Visit Report File

7. VARIANT TITLE

NA

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

Respective schoolOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

Minutes of Board or Commission Meetings (M0008)

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by school name

13. INDEX/FINDING AID(S)

NA

14. DATE SPAN:

In Agency

From 1982 To Pres

State Records Center

From ToNA

State Archives

From: NA To

15. VOLUME:In Agency State Records Center State Archives

1 cf NA NA

16. ANNUAL ACCUMULATION

.07 cf

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 4 2nd Year: 2 3-5 Years: 1 More than 5 years: 1

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents the reports of visits to nursing education programs by Board representatives to verify that programs comply with the standards that have been set. In accordance with KRS 314.111 and 201 KAR 20:260-360, nursing programs must meet the specifications or be subject to closure.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: information related to governing institution, faculty and student records, administrative policies, clerical assistance, course syllabi, physical facilities, library and learning resources, clinical facilities.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

Pass Rates - Registered Nurse/Licensed Practical Nurse (00774); Annual Report from Approved Nursing Programs (00773)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Minutes of Board or Commission Meetings (M0008)

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

NA

27. AUDIT RETENTION REQUIREMENT

NA

28. LEGAL RETENTION REQUIREMENT? (Yes/No) N If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X I

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

30. RATIONALE FOR RETENTION

This series has primary administrative value as it documents visits to approved nursing schools. It is only necessary to keep the most current reports, as any major problems will be documented in the Board Minutes, a permanent record.

31. AGENCY RETENTION

I

32. DISPOSITION INSTRUCTIONS:

Retain compliant reports in Agency for eight (8) years, then destroy. Retain non-compliant reports in Agency until program achieves compliance and all requirements have been met or program is closed, then destroy.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

I

Date

N

00772

Joseph Isaac

1920 2. SERIES NO. 00775

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary Jane OswaldDATE 04/15/2010 PHONE NO. 502-329-7000

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Application for Continuing Education Provider Approval File

7. VARIANT TITLE

NA

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

Respective providerOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

NA

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by name of provider

13. INDEX/FINDING AID(S)

NA

14. DATE SPAN:

In Agency

From 12/80 To Pres

State Records Center

From ToNA

State Archives

From: NA To

15. VOLUME:In Agency State Records Center State Archives

NA NA

16. ANNUAL ACCUMULATION 17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 3 2nd Year: 1 3-5 Years: ** More than 5 years:

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents that the provider has met Board requirements to present continuing education programming to nurses in the Commonwealth of Kentucky. A licensed nurse in Kentucky must have 14 continuing education contact hours or the equivalent every year, to be earned between November 1st and October 31st, to retain his/her professional license. Under the terms of 201 KAR 20:220, the provider requests an application for approval as a provider and the Board assigns the potential provider a permanent, nontransferable number. The regulation states the necessary standards and requirements to be approved as a provider and to continue as a provider. The Board may deny, revoke, suspend, or probate approval of any provider, continuing education activity, or other approved entity for just cause.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: initial provider approval application, check-list for initial provider approval application, provider fact sheet, provider agreement, sample vitae format, provider's philosophy and objectives, administrator and planner/consultant, related documents and related correspondence.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Provider Renewal Application File

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

NA

27. AUDIT RETENTION REQUIREMENT

NA

28. LEGAL RETENTION REQUIREMENT? (Yes/No) If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X I

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

30. RATIONALE FOR RETENTION

This series has primary administrative value as it is used as a reference resource. The series is also subject to fiscal audit.

31. AGENCY RETENTION

I

32. DISPOSITION INSTRUCTIONS:

Retain in Agency and destroy two (2) years after provider non-renewal.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

I

Date

N

00775

Jackie Arnold

1920 2. SERIES NO. 00776

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary Jane OswaldDATE 04/02/2010 PHONE NO. 502/329-7000

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Continuing Education Provider Renewal Application File

7. VARIANT TITLE

NA

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

NAOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

NA

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by name of provider

13. INDEX/FINDING AID(S)

NA

14. DATE SPAN:

In Agency

From 1992 To Pres

State Records Center

From ToNA

State Archives

From: NA To

15. VOLUME:In Agency State Records Center State Archives

4 cf NA NA

16. ANNUAL ACCUMULATION

1 cf

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 2 2nd Year: 1 3-5 Years: 0 More than 5 years: NA

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents the renewal of Board approval for providers of continuing education for nurses. It documents a provider's activities such as course and curriculum offerings, evaluations of the courses, and proposed schedules. The first time approval of a provider is in effect until December 31st of the second year from the initial approval date. Renewals of approval are then for five year periods. The initial provider approval file (00775) is retained until the provider has not renewed providership for five years. There is a fee to providers for renewal and this series is audited fiscally every two years.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: application, announcement samples, evaluations, proposed schedules, and correspondence.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

Initial Provider Approval File (00775)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Print File (E0006)

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

State

27. AUDIT RETENTION REQUIREMENT

3

28. LEGAL RETENTION REQUIREMENT? (Yes/No) If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X 5

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

X 3

30. RATIONALE FOR RETENTION

This series has primary administrative value as it is used as a reference resource. The series is also subject to fiscal audit.

31. AGENCY RETENTION

5

32. DISPOSITION INSTRUCTIONS:

Retain in Agency for two (2) years. Destroy after audit.

33. RECORDS CENTER RETENTION:

na

34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

5

Date

Y

00776

Jackie Arnold

1920 2. SERIES NO. 00777

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary Jane OswaldDATE 04/10/2010 PHONE NO. 502/329-7000

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Refresher Course Provider Approval Application File

7. VARIANT TITLE

NA

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

NAOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

Minutes of Board or Commission Meetings (M0008); Committee Reports (04648)

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by provider name

13. INDEX/FINDING AID(S)

NA

14. DATE SPAN:

In Agency

From 1987 To Present

State Records Center

From ToNA

State Archives

From: NA To

15. VOLUME:In Agency State Records Center State Archives

.5 cf NA NA

16. ANNUAL ACCUMULATION

0

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 1 2nd Year: NA 3-5 Years: NA More than 5 years: NA

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

CLOSED SERIES: This series documents a provider's application to present refresher courses to nurses. Under the terms of KRS 314.041 and KRS 314.051, nurses are required to continually update their credentials through refresher courses. Approved refresher course means an organized learning experience, designed, planned, and evaluated to meet behavioral objectives designed to update knowledge with current nursing theory and clinical practice. By design, a refresher course consists of didactic and clinical learning experiences which address current professional entry level competencies by licensure category. Beginning in 1987, providers had to apply, and be approved before offering these courses, which is what this file represents. 201 KAR 20:380 mandates that refresher courses be offered and the providers approved. These courses were required initially due to a shortage of nurses. The demand for refresher courses cycle with the need for nurses.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: name of nurse administrator; instructor qualifications; course syllabus - requirements and prerequisites; fees; objectives; content; time frame; teaching methods; evaluation; instructional materials; completion requirements; course presentation dates; contact hour credit for continuing education; clinical practice ratio; and approval period

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

NA

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Minutes of Board or Commission Meetings (M0008); Committee Meetings (04648)

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

NA

27. AUDIT RETENTION REQUIREMENT

NA

28. LEGAL RETENTION REQUIREMENT? (Yes/No) If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X I

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

30. RATIONALE FOR RETENTION

This series has primary administrative value as it documents information about the providers.

31. AGENCY RETENTION

I

32. DISPOSITION INSTRUCTIONS:

Destroy five (5) years after refresher course is no longer offered.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

I

Date

N

00777

Jackie Arnold

1920 2. SERIES NO. 00779

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary StewartDATE 04/08/2010 PHONE NO. 502/329-7000

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Individual Request for Review of Continuing Education Activity

7. VARIANT TITLE

NA

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

NAOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

NA

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by name of individual

13. INDEX/FINDING AID(S)

NA

14. DATE SPAN:

In Agency

From 1993 To Pres

State Records Center

From ToNA

State Archives

From: NA To

15. VOLUME:In Agency State Records Center State Archives

1 cf NA NA

16. ANNUAL ACCUMULATION

.25 cf

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 2 2nd Year: 2 3-5 Years: 1 More than 5 years: NA

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents the process of applying for approval for specific courses. These would include courses that an individual has taken outside of an approved program. This may include out-of-state courses. The Board requires continuing education hours, and nurses can claim these hours retroactively for thirty (30) days after end of earning period.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: application; course schedule or syllabus; certificate of attendance.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

NA

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

NA

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

State

27. AUDIT RETENTION REQUIREMENT

3

28. LEGAL RETENTION REQUIREMENT? (Yes/No) If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X 6

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

X 3

30. RATIONALE FOR RETENTION

This series has primary administrative value as it documents continuing education hours earned. The hours can be claimed retroactively for thirty (30) days after of earning period.

31. AGENCY RETENTION

6

32. DISPOSITION INSTRUCTIONS:

Retain in Agency for two (2) years. Destroy after continuing education audit.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

6

Date

Y

00779

Jackie Arnold

1920 2. SERIES NO. 04398

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary Jane OswaldDATE 04/10/2010 PHONE NO. 502/329-7000

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Continuing Education Audit File

7. VARIANT TITLE

CE Audit

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

NAOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

Activity Report (M0029)

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Chronological by date of licensure period

13. INDEX/FINDING AID(S)

NA

14. DATE SPAN:

In Agency

From 1989 To Pres

State Records Center

From ToNA

State Archives

From: NA To

15. VOLUME:In Agency State Records Center State Archives

16 cf NA NA

16. ANNUAL ACCUMULATION

3 cf

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: Daily 2nd Year: 20 3-5 Years: 6 More than 5 years: NA

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents audits required of the nursing/licensee population to determine compliance with the continuing education requirements for licensure renewal, as provided for in KRS 314.073 and 201 KAR 20:215(3). Audit responses are reviewed for the number of hours, dates of completion and approval source. Audit responses found to be deficient are processed through the Investigation Branch through the disciplinary action process. Fourteen hours, or the equivalent per year, earned between November 1st and October 31st, will satisfy continuing education requirements.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: audit letter; certificate of completion; name, address, license number; continuing education courses; continuing education credits; dates of completion.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

NA

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Activity Reports (M0029); (If disciplinary action is required: Investigations Alert Verification Report (00793); Investigative and Disciplinary Report (00794); Investigative Folders (00796); Hearing Transcripts (00797))

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

State-Compliance

27. AUDIT RETENTION REQUIREMENT

328. LEGAL RETENTION REQUIREMENT? (Yes/No) Y If yes, cite statute and state length of retention period required.

201 KAR 20:215 Section 3 (1)-3 years

29. APPRAISAL CRITERIA Years

Administrative Retention Value

Legal Retention ValueX

X

5

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

3

X 3

30. RATIONALE FOR RETENTION

This series has primary administrative value because it provides the agency with the substantiated compliance of licensees in regard to continuing education credits through a mandated audit.

31. AGENCY RETENTION

I

32. DISPOSITION INSTRUCTIONS:

Destroy two (2) years following the end of the audit year in which continuing education credits were earned.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

5

Date

Y

04398

Jackie Arnold

1920 2. SERIES NO. 05459

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Patricia SpurrDATE 04/15/2010 PHONE NO. 502-329-7033

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Prelicensure Nursing Program Nurse Faculty/Clinical Instructor Record

7. VARIANT TITLE

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

Original

Duplicate

10. INFORMATION SUMMARIZED IN:

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by program of nursing

13. INDEX/FINDING AID(S)

14. DATE SPAN:

In Agency

From 2000 To Present

State Records Center

From To

State Archives

From: To

15. VOLUME:In Agency State Records Center State Archives

2cf

16. ANNUAL ACCUMULATION 17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: Varies2nd Year: Varie 3-5 Years: Varie More than 5 years: Varie

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents nurses who function as faculty, either nurse faculty or clinical instructors, for prelicensure nursing programs in Kentucky.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: Name of program of nursing, type of program, type of appointment, name of appointee, KY RN license number, appointment date, employment status, initial preparation in nursing, additional education obtained, teaching and clinical responsibilities, experience in assigned clinical or functional area, experience in the application of principles of teaching and learning, signature of appointee, signature of nurse administrator.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

C

KRS 61.878 (1)(a) Personal information. Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?) 27. AUDIT RETENTION REQUIREMENT

28. LEGAL RETENTION REQUIREMENT? (Yes/No) If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X I

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

30. RATIONALE FOR RETENTION

This series has primary administrative value as a reference resource.

31. AGENCY RETENTION

I

32. DISPOSITION INSTRUCTIONS:

Retain in Agency and destroy one (1) year after termination of employment.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

I

Date

05459

Joseph Isaac

1920 2. SERIES NO. 05460

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary Jane OswaldDATE 03/15/2010 PHONE NO. 502-329-7007

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Advisory Opinion Statements Folder

7. VARIANT TITLE

AOS Folder

8. RECORD IS:

D

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

KBN Practice Consultant Files, electronic documentOriginal

Duplicate

10. INFORMATION SUMMARIZED IN:

Board Minutes (M0008)

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Numerical chronological listing based on date of issuance

13. INDEX/FINDING AID(S)

14. DATE SPAN:

In Agency

From 1983 To Present

State Records Center

From To

State Archives

From: To

15. VOLUME:In Agency State Records Center State Archives

1 CF

16. ANNUAL ACCUMULATION

.01 CF

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 2nd Year: 3-5 Years: More than 5 years:

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents the Advisory Opinion Statement (AOS) published by the Board. In 1983, the Kentucky Board of Nursing began publishing advisory opinion statements on various nursing practice issues. These statements are issued as guideposts to licensees who wish to engage in safe nursing practice. When studying practice issues, the Kentucky Board of Nursing reviews and considers applicable standards of practice statements issued by professional nursing organizations; the educational preparation of both Registered Nurses and Licensed Practical Nurses as provided in the prelicensure nursing education programs in Kentucky; and, when applicable, the organized post-basic educational programs for Advanced Registered Nurse Practitioners. Kentucky Board of Nursing also gathers information regarding practice issues from nurses in relevant practice settings, including staff nurses, supervisors, nurse faculty members, and /or representatives from state nursing associations, among others. The Kentucky Board of Nursing reviews applicable opinions issued by the Office of the Attorney General. When multiple inquiries are received on the same practice matter, the Kentucky Board of Nursing publishes an advisory opinion statement for wide dissemination. An opinion statement is an advisory opinion of the Kentucky Board of Nursing as to what constitutes safe nursing practice; its not a regulation of the Board and therefore does not have the force and effect of law. The opinions are revised frequently as medical knowledge becomes available and retained in agency.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: advisory opinions on practice manners, initial approval date, revision date(s), de-publication date.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

Practice Committee Meeting Report (M0049)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Board Minutes (M0008)

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?) 27. AUDIT RETENTION REQUIREMENT

28. LEGAL RETENTION REQUIREMENT? (Yes/No) N If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X

XP

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

P

X P

30. RATIONALE FOR RETENTION

This series has primary administrative value as it is referred to on numerous occasions, is reviewed and revised periodically to maintain currency. May be referred to in order to track evolution of practice matters addressed by Board.

31. AGENCY RETENTION

P

32. DISPOSITION INSTRUCTIONS:

Retain record copies of Advisory Opinion Statements (AOS) permanently. Forward two (2) copies of AOS issued in paper to the Archives and Records Management Division when issued; or forward one (1) copy of AOS held in electronic format or issued for general public distribution on the agency's web site. Retain one (1) copy in agency. Destroy excess copies when no longer needed.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

P

Date

N

05460

Jackie Arnold

1920 2. SERIES NO. 05470

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary Jane OswaldDATE 04/10/2010 PHONE NO. 502-329-7007

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Dialysis Technician Initial Credential Application

7. VARIANT TITLE

DT Initial Application File

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

Original

Duplicate

10. INFORMATION SUMMARIZED IN:

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Numeric by DT credential number

13. INDEX/FINDING AID(S)

Electronic Database for DT credential number

14. DATE SPAN:

In Agency

From 2001 To Present

State Records Center

From To

State Archives

From: To

15. VOLUME:In Agency State Records Center State Archives

10 CF

16. ANNUAL ACCUMULATION

1.5 CF

17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 2nd Year: 3-5 Years: More than 5 years:

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents applicant's eligibility for Dialysis Technician credential as stated in 201 KAR 20:470. Data is entered into the Dialysis Technician electronic database.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: Name, address, gender; social security number; date of birth; name and address of DT training program completed; month and year of enrollment; month and year of completion; employment information as DT; disciplinary/criminal convictions history; notarized signature; and photograph

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

Source Document (03066); Electronic Receipts Transaction Record; DT training Program List of Graduates

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Electronic Database; DT Renewal Application File; DT Reinstatement Application File

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

C

KRS 61.878 (1)(a) Personal information. Agencies should consult legal counsel regarding open records matters..

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

State

27. AUDIT RETENTION REQUIREMENT

3 years

28. LEGAL RETENTION REQUIREMENT? (Yes/No) If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X P

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

X 3

30. RATIONALE FOR RETENTION

This series has primary administrative value as it may be used for investigation information and documents eligibility of person to receive credential.

31. AGENCY RETENTION

4 years

32. DISPOSITION INSTRUCTIONS:

Retain permanently.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION

P

35. TOTAL RETENTION

P

Date

Y

05470

Joseph Isaac

1920 2. SERIES NO. 05471

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Mary Jane OswaldDATE 04/15/2010 PHONE NO. 502-329-7000

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Refresher Course Provider Renewal Application File

7. VARIANT TITLE

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

Original

Duplicate

10. INFORMATION SUMMARIZED IN:

Minutes of Board or Commission Meetings (M0008); Committee Reports (04648)

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Alphabetical by Provider Name

13. INDEX/FINDING AID(S)

14. DATE SPAN:

In Agency

From 1987 To Present

State Records Center

From To

State Archives

From: To

15. VOLUME:In Agency State Records Center State Archives

0.5 CF

16. ANNUAL ACCUMULATION 17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: 1 2nd Year: 3-5 Years: More than 5 years:

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

CLOSED SERIES: This series documents the practice of renewal of providership for refresher courses. It documents a provider's activities such as proposed schedules. Providers are approved for a two (2) year period, then must be reapproved through the renewal process. The file represents that renewal. The initial provider file (00777) is retained until the provider has not offered any courses for five (5) years.

1. RECORD GROUP CODE

OTHER:Paper

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: Application; announcement samples; evaluations; proposed schedules; and correspondence

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

Refresher Course Approval Application File (00777)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

Print File (E0006)

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?)

State

27. AUDIT RETENTION REQUIREMENT

3

28. LEGAL RETENTION REQUIREMENT? (Yes/No) N If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X 4

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

30. RATIONALE FOR RETENTION

This series has primary administrative value as it is used as a reference resource.

31. AGENCY RETENTION

4

32. DISPOSITION INSTRUCTIONS:

Retain in Agency for four (4) years. Destroy after audit.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

Date

Y

05471

Jackie Arnold

1920 2. SERIES NO. 06109

3. ORIGINATING AGENCY

4. ADMINISTRATIVE UNIT

5. SUBUNIT

COMPILER Sharron Mercer DATE 05/12/2011 PHONE NO. 502.429.3307

IDENTIFICATION AND DESCRIPTION

6. TITLE OF RECORD

Nursing Practice Inquiries

7. VARIANT TITLE

8. RECORD IS:

O

PRD 320

Rev. 4/86

Public Records

Division

Record Description and Analysis

Department for

Libraries and Archives

9. LOCATION(S) OF ALTERNATIVE COPIES (Original or Duplicate(s))

Original

Duplicate

10. INFORMATION SUMMARIZED IN:

11. MEDIUM (If Machine Readable Record, Complete and Attach Form PRD 320M)

12. ARRANGEMENT/SORT SEQUENCE (Alpha, Numeric, Chronological, Random, etc.): Explain in detail.

Chronological by date

13. INDEX/FINDING AID(S)

14. DATE SPAN:

In Agency

From 2009 To Present

State Records Center

From To

State Archives

From: To

15. VOLUME:In Agency State Records Center State Archives

3cf

16. ANNUAL ACCUMULATION 17. REFERENCE RATE (Number of times you use each year's accumulation)

1st Year: Varies2nd Year: Varie 3-5 Years: More than 5 years:

18. FUNCTION AND USE (What purpose is/was record created? What activity, process or transaction does it document

This series documents communications to the Nursing Practice Consultant (NPC) from nurses and the general public regarding scope of practice and adherence to Kentucky Nursing Laws, Administrative Regulations, and Kentucky Board of Nursing (KBN) Advisory Opinion Statements. Responses are based on current nursing statutes, administrative regulations, and KBN issued advisory opinions. The responses help guide the actions of nurses in their nursing practice.

1. RECORD GROUP CODE

OTHER:Paper Computer Disk

General Government

Nursing, Board of

Professional Support

SECTION

19. CONTENTS (Documents in this file? Information on this form? Data Elements in this computer file, etc.)

Series may contain: Name of person contacting KBN, date, time, questions(s) asked and response(s) from NPC.

20. INPUT RECORDS (What records flow into, or provide information to create this record?)

21. OUTPUT RECORDS (What records flow out of the information in this record series?)

22. VITAL RECORD?

Yes/No

23. If Yes, VITAL RETENTION PERIOD?

24. VITAL RECORDS PROTECTION INSTRUCTIONS

25. ACCESS RESTRICTIONS? Yes/NoIf yes, explain restrictions and attach copy of authority (KRS, KAR, CFR, etc.)

Agencies should consult legal counsel regarding open records matters.

26. IS RECORD SUBJECT TO AUDIT?If yes, list AUDITING AGENCY (Federal, State, Internal?) 27. AUDIT RETENTION REQUIREMENT

28. LEGAL RETENTION REQUIREMENT? (Yes/No) N If yes, cite statute and state length of retention period required.

29. APPRAISAL CRITERIA Years

Administrative Retention ValueLegal Retention Value

X 2

ANALYSIS

Fiscal Retention Value

Research Retention Value

Intrinsic Retention Value

30. RATIONALE FOR RETENTION

This series has primary administrative value as it documents routine correspondence between the agency and licensees regarding board decisions, statutory law and regulations that govern the nursing profession.

31. AGENCY RETENTION

2

32. DISPOSITION INSTRUCTIONS:

Retain in Agency for two (2) years, then destroy.

33. RECORDS CENTER RETENTION: 34. ARCHIVES CENTER RETENTION 35. TOTAL RETENTION

2

Date

N

06109

Jackie Arnold

General Government

Nursing, Board of

Credentials

SeriesRecords Title and Description Function and Use

STATE AGENCY RECORDS RETENTION SCHEDULE

Record Group

1920

Number

STATE ARCHIVES AND RECORDS COMMISSION

Public Records Division

Kentucky Department for Libraries and Archives

This series documents the Board of Nursing's contributions on updates and revisions to the jurisprudence exam required for applicants. The exam is required to be completed by applicants for licensure by exam, endorsement, or reinstatement as a Licensed Practical Nurse (LPN), Registered Nurse (RN), or an Advanced Practice Registered Nurse (APRN). The exam consists of thirty-five (35) questions on Kentucky nursing laws and Advisory Opinion Statements, and is housed with the National Council of State Boards of Nursing (NCSBN) who oversees its administration.

Series may contain: the Jurisprudence Exam Study Guide, instructions, exam questions, and an answer key.

Maintain current version in Agency. Retain previous exams and materials for five (5) years after revisions, then destroy.

Jurisprudence Exam Guide (V)

06917

Contents

Retention and Disposition

Access Restrictions KRS 61.878(1)(g) - Information used for licensing jurisprudence examination

Thursday, June 07, 2018 Page 1 of 1

General Government

Nursing, Board of

Credentials

SeriesRecords Title and Description Function and Use

STATE AGENCY RECORDS RETENTION SCHEDULE

Record Group

1920

Number

STATE ARCHIVES AND RECORDS COMMISSION

Public Records Division

Kentucky Department for Libraries and Archives

This series documents the initial licensure of registered nurses and practical nurses in accordance with Kentucky Nursing Laws and Regulations KRS 314.00 and 201 KAR 20:056-500 and subsequent license activities.

Series may contain: Application for licensure, test results, program validation, continuing competency certificates, original out-of-state license, CGFNS Visa Screen Certificate, internship verification, name, address, DOB, SSN and related documents and related correspondence.

Retain in Agency permanently.

Master File Folder - Registered Nurse and Practical Nurse (V)

00746

Contents

Retention and Disposition

Access Restrictions KRS 61.878 (1)(a) Personal information. Agencies should consult legal counsel regarding open records matters..

Thursday, June 07, 2018 Page 1 of 1

General Government

Nursing, Board of

Professional Support

SeriesRecords Title and Description Function and Use

STATE AGENCY RECORDS RETENTION SCHEDULE

Record Group

1920

Number

STATE ARCHIVES AND RECORDS COMMISSION

Public Records Division

Kentucky Department for Libraries and Archives

This series documents the reports of visits to nursing education programs by Board representatives to verify that programs comply with the standards that have been set. In accordance with KRS 314.111 and 201 KAR 20:260-360, nursing programs must meet the specifications or be subject to closure.

Series may contain: information related to governing institution, faculty and student records, administrative policies, clerical assistance, course syllabi, physical facilities, library and learning resources, clinical facilities.

Retain compliant reports in Agency for eight (8) years, then destroy. Retain non-compliant reports in Agency until program achieves compliance and all requirements have been met or program is closed, then destroy.

School Visit Report File

00772

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

This series documents that the provider has met Board requirements to present continuing education programming to nurses in the Commonwealth of Kentucky. A licensed nurse in Kentucky must have 14 continuing education contact hours or the equivalent every year, to be earned between November 1st and October 31st, to retain his/her professional license. Under the terms of 201 KAR 20:220, the provider requests an application for approval as a provider and the Board assigns the potential provider a permanent, nontransferable number. The regulation states the necessary standards and requirements to be approved as a provider and to continue as a provider. The Board may deny, revoke, suspend, or probate approval of any provider, continuing education activity, or other approved entity for just cause.

Series may contain: initial provider approval application, check-list for initial provider approval application, provider fact sheet, provider agreement, sample vitae format, provider's philosophy and objectives, administrator and planner/consultant, related documents and related correspondence.

Retain in Agency and destroy two (2) years after provider non-renewal.

Application for Continuing Education Provider Approval

File

00775

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

This series documents the renewal of Board approval for providers of continuing education for nurses. It documents a provider's activities such as course and curriculum offerings, evaluations of the courses, and proposed schedules. The first time approval of a provider is in effect until December 31st of the second year from the initial approval date. Renewals of approval are then for five year periods. The initial provider approval file (00775) is retained until the provider has not renewed providership for five years. There is a fee to providers for renewal and this series is audited fiscally every two years.

Series may contain: application, announcement samples, evaluations, proposed schedules, and correspondence.

Retain in Agency for two (2) years. Destroy after audit.

Continuing Education Provider Renewal Application File

00776

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

Thursday, June 07, 2018 Page 1 of 4

General Government

Nursing, Board of

Professional Support

SeriesRecords Title and Description Function and Use

STATE AGENCY RECORDS RETENTION SCHEDULE

Record Group

1920

Number

STATE ARCHIVES AND RECORDS COMMISSION

Public Records Division

Kentucky Department for Libraries and Archives

CLOSED SERIES: This series documents a provider's application to present refresher courses to nurses. Under the terms of KRS 314.041 and KRS 314.051, nurses are required to continually update their credentials through refresher courses. Approved refresher course means an organized learning experience, designed, planned, and evaluated to meet behavioral objectives designed to update knowledge with current nursing theory and clinical practice. By design, a refresher course consists of didactic and clinical learning experiences which address current professional entry level competencies by licensure category. Beginning in 1987, providers had to apply, and be approved before offering these courses, which is what this file represents. 201 KAR 20:380 mandates that refresher courses be offered and the providers approved. These courses were required initially due to a shortage of nurses. The demand for refresher courses cycle with the need for nurses.

Series may contain: name of nurse administrator; instructor qualifications; course syllabus - requirements and prerequisites; fees; objectives; content; time frame; teaching methods; evaluation; instructional materials; completion requirements; course presentation dates; contact hour credit for continuing education; clinical practice ratio; and approval period

Destroy five (5) years after refresher course is no longer offered.

Refresher Course Provider Approval Application File

00777

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

This series documents the process of applying for approval for specific courses. These would include courses that an individual has taken outside of an approved program. This may include out-of-state courses. The Board requires continuing education hours, and nurses can claim these hours retroactively for thirty (30) days after end of earning period.

Series may contain: application; course schedule or syllabus; certificate of attendance.

Retain in Agency for two (2) years. Destroy after continuing education audit.

Individual Request for Review of Continuing Education Activity

00779

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

This series documents audits required of the nursing/licensee population to determine compliance with the continuing education requirements for licensure renewal, as provided for in KRS 314.073 and 201 KAR 20:215(3). Audit responses are reviewed for the number of hours, dates of completion and approval source. Audit responses found to be deficient are processed through the Investigation Branch through the disciplinary action process. Fourteen hours, or the equivalent per year, earned between November 1st and October 31st, will satisfy continuing education requirements.

Series may contain: audit letter; certificate of completion; name, address, license number; continuing education courses; continuing education credits; dates of completion.

Destroy two (2) years following the end of the audit year in which continuing education credits were earned.

Continuing Education Audit File

04398

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

Thursday, June 07, 2018 Page 2 of 4

General Government

Nursing, Board of

Professional Support

SeriesRecords Title and Description Function and Use

STATE AGENCY RECORDS RETENTION SCHEDULE

Record Group

1920

Number

STATE ARCHIVES AND RECORDS COMMISSION

Public Records Division

Kentucky Department for Libraries and Archives

This series documents nurses who function as faculty, either nurse faculty or clinical instructors, for prelicensure nursing programs in Kentucky.

Series may contain: Name of program of nursing, type of program, type of appointment, name of appointee, KY RN license number, appointment date, employment status, initial preparation in nursing, additional education obtained, teaching and clinical responsibilities, experience in assigned clinical or functional area, experience in the application of principles of teaching and learning, signature of appointee, signature of nurse administrator.

Retain in Agency and destroy one (1) year after termination of employment.

Prelicensure Nursing Program Nurse Faculty/Clinical Instructor Record

05459

Contents

Retention and Disposition

Access Restrictions KRS 61.878 (1)(a) Personal information. Agencies should consult legal counsel regarding open records matters.

This series documents the Advisory Opinion Statement (AOS) published by the Board. In 1983, the Kentucky Board of Nursing began publishing advisory opinion statements on various nursing practice issues. These statements are issued as guideposts to licensees who wish to engage in safe nursing practice. When studying practice issues, the Kentucky Board of Nursing reviews and considers applicable standards of practice statements issued by professional nursing organizations; the educational preparation of both Registered Nurses and Licensed Practical Nurses as provided in the prelicensure nursing education programs in Kentucky; and, when applicable, the organized post-basic educational programs for Advanced Registered Nurse Practitioners. Kentucky Board of Nursing also gathers information regarding practice issues from nurses in relevant practice settings, including staff nurses, supervisors, nurse faculty members, and /or representatives from state nursing associations, among others. The Kentucky Board of Nursing reviews applicable opinions issued by the Office of the Attorney General. When multiple inquiries are received on the same practice matter, the Kentucky Board of Nursing publishes an advisory opinion statement for wide dissemination. An opinion statement is an advisory opinion of the Kentucky Board of Nursing as to what constitutes safe nursing practice; its not a regulation of the Board and therefore does not have the force and effect of law. The opinions are revised frequently as medical knowledge becomes available and retained in agency.

Series may contain: advisory opinions on practice manners, initial approval date, revision date(s), de-publication date.

Retain record copies of Advisory Opinion Statements (AOS) permanently. Forward two (2) copies of AOS issued in paper to the Archives and Records Management Division when issued; or forward one (1) copy of AOS held in electronic format or issued for general public distribution on the agency's web site. Retain one (1) copy in agency. Destroy excess copies when no longer needed.

Advisory Opinion

Statements Folder

05460

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

This series documents applicant's eligibility for Dialysis Technician credential as stated in 201 KAR 20:470. Data is entered into the Dialysis Technician electronic database.

Series may contain: Name, address, gender; social security number; date of birth; name and address of DT training program completed; month and year of enrollment; month and year of completion; employment information as DT; disciplinary/criminal convictions history; notarized signature; and photograph

Retain permanently.

Dialysis Technician Initial Credential Application

05470

Contents

Retention and Disposition

Access Restrictions KRS 61.878 (1)(a) Personal information. Agencies should consult legal counsel regarding open records matters..

Thursday, June 07, 2018 Page 3 of 4

General Government

Nursing, Board of

Professional Support

SeriesRecords Title and Description Function and Use

STATE AGENCY RECORDS RETENTION SCHEDULE

Record Group

1920

Number

STATE ARCHIVES AND RECORDS COMMISSION

Public Records Division

Kentucky Department for Libraries and Archives

CLOSED SERIES: This series documents the practice of renewal of providership for refresher courses. It documents a provider's activities such as proposed schedules. Providers are approved for a two (2) year period, then must be reapproved through the renewal process. The file represents that renewal. The initial provider file (00777) is retained until the provider has not offered any courses for five (5) years.

Series may contain: Application; announcement samples; evaluations; proposed schedules; and correspondence

Retain in Agency for four (4) years. Destroy after audit.

Refresher Course Provider Renewal Application File

05471

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

This series documents communications to the Nursing Practice Consultant (NPC) from nurses and the general public regarding scope of practice and adherence to Kentucky Nursing Laws, Administrative Regulations, and Kentucky Board of Nursing (KBN) Advisory Opinion Statements. Responses are based on current nursing statutes, administrative regulations, and KBN issued advisory opinions. The responses help guide the actions of nurses in their nursing practice.

Series may contain: Name of person contacting KBN, date, time, questions(s) asked and response(s) from NPC.

Retain in Agency for two (2) years, then destroy.

Nursing Practice Inquiries

06109

Contents

Retention and Disposition

Access Restrictions Agencies should consult legal counsel regarding open records matters.

Thursday, June 07, 2018 Page 4 of 4