AGENCY: Davis County (Utah). Health Department. Administration Division

SERIES: 10721
TITLE: Monthly nursing home death report
DATES: undated
ARRANGEMENT: None

DESCRIPTION: This report is submitted by nursing homes and assisted living facilities reporting deaths that occurred during the previous month. This report is required by UCA 26-2-23(3) (1995). It is used to determine whether certificates have been received. The record is kept by the local health department. The information includes the month of the report, the nursing home's (or assisted living facility) name, death date, deceased's name, the age at death, medical attendant's name, and the name of the funeral home or funeral director.

RETENTION

Retain for 1 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series is authorized by Archives general schedule Transitory tracking records, GRS-1720

AUTHORIZED: 06/21/2019

FORMAT MANAGEMENT

Paper: Retain in Office for 1 year and then destroy.

APPRAISAL

Administrative

PRIMARY DESIGNATION

Public

---