If you’re thinking about retirement, it’s prudent to start planning well in advance. If you are a solo practitioner, will you sell or wind down your practice? If you are in a group practice or employed, what are your obligations regarding providing notice of retirement? What are your state licensing board’s requirements regarding retirement? How will you retain your medical and business records? How will you notify your staff and patients of your plan to retire? What do your contracts with health insurers require when you retire from practice? Do you need to purchase professional liability insurance “tail coverage”? 

Review all contracts pertaining to your practice and consider seeking the advice of an attorney who specializes in business and/or healthcare law, your professional liability insurance carrier, your state board, and your state association for advice regarding these questions and the many other issues that arise in the retirement process. 

Here, we will discuss a few issues related to retirement from a risk management perspective. 

Patient Notification
Patients have a right to, and you have a legal and ethical duty to provide, continuity of care. Failure to provide continuity of care could result in allegations of patient abandonment. Patients should be provided with enough time to find another physician, so that they can begin to transition their care to another provider.

Written notification should be sent via mail 90 days prior to retirement to patients who have been seen within the last two years. A copy of the letter should be placed in the patient’s medical record.
The letter should include the following items:

• The date the practice will close or the date you will retire.
• The importance of seeking continued care.
• Information about where the patient’s medical records will be located.
• Notification that a copy of the patient’s records will be sent to another podiatrist of the patient’s choice upon receipt of the patient’s written authorization.
• A medical record release authorization form.
• A statement of how long the patient’s records will be retained.
• A permanent mailing address (or P.O. Box) for all future record requests if the records will not be maintained at the current location.

Patients receiving ongoing care and treatment should also receive verbal notification with a discussion of their plan of treatment and coordination of follow-up care, all of which should be documented in the patient’s medical record.

Office staff should begin to let patients know of the physician’s retirement when patients call to schedule appointments several months in advance. Notifications should state when you are retiring and a telephone number and address where patients can request a copy of their medical records. Other patient notification efforts include:

• Posting an announcement on the practice’s website.
• Placing an advertisement in the local newspaper a few weeks prior to the office closing. 

Medical Record Retention
It is recommended that you retain patient records for at least 10 years after the most recent encounter for adults (for minors, up to the age of majority plus the state statute of limitations – or 10 years after the most recent encounter, whichever is longest) after you retire. Records should be secured as required by HIPAA and available for patients and subsequent healthcare providers to access if requested.

The HIPAA Right of Access Rule requires covered entities to provide access or supply a copy of the requested medical records as soon as possible, but no later than 30 days after the request is received. The 21st Century Cures Act prohibits providers from blocking patient information when requested from a patient or a healthcare provider. Therefore, it is prudent to review your contract with your EHR vendor to ensure that you have access to your medical records after you retire.

If you are selling your practice, or if you designate a physician to be the custodian of your records, and that physician agrees, you may release your custodial rights of medical records to that physician. An agreement for transfer retention of medical records form should be signed by the retiring physician and the new physician and each physician should retain a copy of the agreement. The agreement should state that the new physician:

• Agrees to be the custodian of your medical and billing records.
• Will maintain the records in a safe and secure manner.
• Will make the records available to your patients and to any physician to whom a patient requests a copy be sent.
• Will make the records available to you in the event you require them for any reason.
• Will preserve the records for at least 10 years following transfer of custody.

However, you cannot automatically transfer your patient’s care to the new provider. You may tell your patients that the new provider is taking over your practice and they can continue care with the new provider. However, you should advise patients they are free to select any provider they choose.
If you retain custody of your records, provide your patients with specific information regarding how they can request a copy of their medical records after you retire.

Telephone Service
For solo practitioners who retire, consider continuing the practice’s phone service for several months to advise patients of your office closure and provide instructions for obtaining alternate care or obtaining a copy of their medical records. If another physician purchases your practice, ask him/her to take your calls and inform patients of your retirement. Be sure to include this provision in the sales contract.

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The information contained on the PICA Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. All information contained on the blog is subject to change.