Medical Records and the Law

Special Disclosure Concerns 337confidentiality and ensures the availability of the records for access bypatients.In developing procedures for the disposition of patient records uponclosure of the healthcare facility, health information professionals mustconsider a number of statutory and regulatory requirements, includingstate licensing and record retention laws, as well as Medicare requirementsand, if applicable, federal laws governing records of patients undergoingtreatment for alcohol and drug abuse. Many states requireapproval from the state department of health or licensing authoritybefore implementing any plan regarding disposition of records uponclosure. 222When a healthcare organization closes, the records usually must betransferred to another location. Most state laws do not specify wherethe records should be kept; however, they require the healthcare organizationto notify the licensing agency in writing about the arrangementsmade for safekeeping of the records. 223 This notification shouldinclude the location of the storage facility and the name of the personacting as custodian. 224 In some states, the licensing agency will acceptcustody of the records after closure. At least one state requires thehealthcare organization to index the records and deliver them to theagency for safekeeping. 225 Most states, however, encourage the closinghealthcare organization to transfer its records to another healthcare facilityin the area. 226 Nebraska requires the closing hospital to transferrecords to the licensed facility to which the patient is transferred; otherwise,the closing hospital should dispose of all remaining records byshredding, mutilation, incineration, or other equally effective protectivemeasure. 227 Utah regulations suggest returning the records to the attendingphysician if that person still is in the community. 228 Where noother facility is located nearby (for example, in remote rural areas) and222See, e.g., La. Rev. Stat. 40:2109(E); La. Admin. Code tit. 48I, ch. 93, § 9307.223See, e.g., Cal. Code Regs. tit. 22, § 70751(d); Kan. Admin. Regs. 28-34-9a(d)(2); 902 Ky.Admin. Regs. 20:016(3)(11)(3); N.J. Admin. Code tit. 8, § 43G-15.1(c); N.D. Admin.Code § 33-07-01.1-20(1)(a)(4).224Ibid.225See Tenn. Code Ann. § 68-11-308; Tenn. Dept. of Health Hospital Rule 1200-8-1-.06(f ).226See, e.g., Ind. Admin. Code tit. 410, r. 15-1-9(2)(b)(2)I; Miss. Code Ann. § 41-9-79.227Neb. Admin. R. & Regs. tit. 175, ch. 9, § 006.07A5.228Utah Admin. Code 432-100-33(4)(e) (regulation also allows a hospital to store itsrecords at another hospital or approved medical records storage facility).