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Tennessee Secretary of State Tre Hargett
Records Management Division
RDA
RDA Management System
RDA Details
RDA
RDA: 2977
Database ID: 1171
Record Series Title: Long Term Services and Support Member Files
Record Series Abstract: This records series includes Long Term Services and Support (LTSS) member files utilized by the "Quality Accountability & Innovation" and "Operations" teams. The files include Long Term Services and Support Pre-Admission Evaluation (PAE) records, Pre-Admission Screening and Residential Review (PASRR) records, member application records (CHOICES,Employment and Community First CHOICES, 1915(c) Waivers,and Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities),member correspondence, member medical records, enrollment records, audit records containing member information, and utilization control records.
Record Series Active: Yes
Cut Off at End of: Other
If Other, Explain: Cutoff for Long Term Services and Supports records will be upon death of member or disenrollment of member (whichever occurs first in time).
Total Retention: 10 Years 0 Months
Retention End Action: Destroy
Disposition Notes: Long Term Services and Support (LTSS) records are largely generated based on member needs and requirements. Records are maintained in electronic or paper format. Once electronic records are verified as accurate, paper records are destroyed. Once the retention period is complete, records are thoroughly reviewed a final time by Long Term Services and Support record stewards. If deemed appropriate for destruction, Long Term Services and Support record stewards submit a request for destruction of records to TennCare’s Project Management Office. Once the request is approved, the records are destroyed.
View Signed Form: Form Not Received
Worksheet
Worksheet ID: 1171
Record Location: 310 Great Circle Road 2nd Floor (East) file storage rooms Nashville, TN. 37243, Richards and Richards off-site storage
File Arrangement: Alphabetical
Media Format Generated: Both
Media Format Stored: Paper/Electronic
Date Range: 2001 to current
Annual Accumulation: 689 cubic foot/paper 4,482.485 MB/electronic
Current Volume: 67 cubic foot/paper 214,700 MB/electronic
Record Value: Administrative, Legal
Audit Requirements: Both
Reference Frequency:
Current Year per Month: 3600
Past Year: 3600
2 - 5 Years: 3600
Over 5 Years: 3600
Data Update Frequency: Daily
Information Shared Outside of State: Yes
If Shared, List Agencies: Centers for Medicare and Medicaid Services
Essential Record: Yes - Original
Essential Record Stored: 310 Great Circle Road 2nd floor (East) file storage rooms. Nashville, TN 37243 Richards and Richards off-site storage.
Essential Record Media Type: Paper
Confidential: Yes
Confidential Legal Citation: 42 CFR 431.306
Media Recommendation: Current Format
Media Recommendation Other:
Agency Retention: 10 years
Agency Retention - Years Active: 1 year
Agency Retention - Years Inactive: 9 years
Records Center Retention Period: As determined by agency space constraints up to 10 years after retention period begins.
Final Disposition after Retention Expires: Destroy
Legal Citation: RULES AND REGS. 1200-13-1-.01 et al.
Record Sample: No Sample
Legal Documentation: No Legal Documentation
Electronic Records Plan Inventory
System Name: TennCare Pre-Admission Evaluation System,(TPAES) Tennessee Medical Eligibility Determination System (TMED), SharePoint, L:Drive
IT-ABC Number:
Hardware Description: Production servers in the North and South Data centers on a combination of virtual and physical Cisco ACI servers and or VMware server. Along with a G400 Hitachi SAN.
Software Description: TennCare Pre-Admission Evaluation System (TPAES) installed on a virtual server in the North Data Center. Tennessee Eligibility Determination System (TEDS)installed on a combination of virtual and physical Cisco ACI servers
System Location: TennCare Pre-Admission Evaluation System(TPAES)North Data Center. Tennessee Eligibility Determination System (TEDS) North Data Center (SharePoint) (L Drive) (F Drive) (TMED)
Backup Procedures: TennCare Pre-Admission Evaluation System(TPAES)STS maintains all backup plans for this hardware. Tennessee Eligibility Determination System (TEDS)all data is replicated between two G400 Hitachi SANS.
Disaster Recovery: TennCare Pre-Admission Evaluation System(TPAES)restore from tape to a new virtual server. Tennessee Eligibility Determination System (TEDS)Production in the South Data Center with companion failover hardware in the North Data Center.
Data Migration Description: Tennessee Pre-Admission Eligibility System (TPAES) If the need for data migration arises, it will be done by STS server admins with assistance of DXC application administrators. TEDS will go live in Fall 2019 - No data in production yet - If the need for data migration arises, it will be done by STS server administrators with assistance of Delloitte application administrators.
Metadata Description: TennCare Pre-Admission Evaluation System(TPAES) File name, date created, file type "Metadata format" is not applicable to Tennessee Eligibility Determination System (TEDS) The System is not online at this time.
Contact Information
Contact Name: Thomas Wood
Job Title: Assistant Director of Training and Communication
Address 1: 310 Great Circle Road
Address 2:
City: Nashville
Zip: 37243
Phone: 615-507-6022
Email: Thomas.Wood@tn.gov
Agency: Division of TennCare
Agency Head: Dr. Wendy Long
Director: Patti Killingsworth
Allotment Code: 31865
Status
Action Requested: New RDA
Comments
  Date Comments
Records Management Division (RMD): 08-23-2018 No recommended changes.
Tennessee State Libary and Archives: 08-23-2018 No recommended changes.
Comptroller Audit Review: 2018-08-24 We have reviewed RDA 2977 from an audit standpoint. We concur with the recommended retention and disposition specifications.
Agency: 08-30-2018 Agency Concurs
RMD Director Recomendations: 09-18-2018 RDA 2977 is a request to revise an RDA. The retention period will change from five years to ten years and destroy. The format will change to paper/electronic. The Title, Abstract, Cut Off, Disposition Notes, and Worksheet have been updated. Recommend approval of request to revise RDA 2977.
Signed Form Received: 2018-09-18
PRC Meeting Date: 10-30-2018
PRC Comments: PRC approves RDA 2977.
PRC Action: Approved
RDA History
ID RDA PRC Reviewed PRC Action
1171 2977 2018-10-30 Approved