When medical practices merge or are acquired, patient care continuity is only part of the equation, proper handling of medical records is equally critical. These transitions come with unique challenges in ensuring HIPAA compliance, maintaining record accessibility, and deciding who will retain custody of legacy files. Mishandling this process can lead to privacy violations, data loss, or service disruptions.
This guide walks through best practices for managing patient records during a merger or acquisition, whether you’re expanding your group or acquiring a solo practitioner’s practice.
Why Patient Records Must Be Handled Carefully During Transitions
Medical records are not just administrative files, they are legal documents protected under HIPAA and, in some cases, state-specific privacy laws. They include sensitive health information (PHI) that must be maintained securely, with limited and documented access.
During a transition of ownership:
- Patients may continue care under the new provider.
- Some patients may choose to leave, requiring copies of their records.
- Legacy systems may differ, leading to potential data fragmentation.
Failing to organize and transfer these files properly can expose the organization to fines, lawsuits, and reputational damage.
Step 1: Review Existing Recordkeeping Practices and Contracts
Before any changes are made, each party should:
- Conduct an audit of how records are currently stored (paper, EMR, hybrid).
- Review existing agreements about custodianship or offsite storage vendors.
- Identify record formats and platforms in use by each practice.
If EMR systems are incompatible or records are stored in boxes, a coordinated plan will be needed to unify them.
Step 2: Assign Record Custody and Responsibility
HIPAA requires that a designated custodian of records is clearly identified. This person or entity must be responsible for:
- Fulfilling access requests from patients.
- Protecting the integrity and confidentiality of all patient data.
- Complying with retention laws, which may vary by state or specialty.
In most cases, the acquiring entity assumes custodianship of the records. However, this should be stated explicitly in acquisition agreements or merger documentation.
Step 3: Notify Patients of Changes
HIPAA’s Privacy Rule requires covered entities to provide notice of any material changes to the use and disclosure of PHI. A merger or acquisition qualifies.
Patients should be informed:
- That a transition has occurred.
- Who now controls their records.
- How to request copies or transfers of their medical history.
This is often done via mailed letters, updated Notice of Privacy Practices (NPP), and signs posted in the office.
Step 4: Plan for Data Integration or Segregation
If both practices used electronic records:
- Evaluate EMR system compatibility.
- Map out data migration to preserve continuity.
- Keep audit trails to prove HIPAA compliance.
For paper records:
- Digitizing may be the best option for long-term efficiency.
- Offsite storage may be used to house legacy files while keeping digital records for new visits.
It’s important to decide whether to integrate all records into one system or keep older records in a separate, accessible archive.
Step 5: Ensure Proper Retention and Shredding of Unnecessary Files
Retention laws typically require providers to maintain patient records for 7–10 years after the last visit (longer for minors). After that:
- Files may be shredded or deleted, but only if done securely.
- Use a HIPAA-compliant vendor that provides certificates of destruction.
During a merger, it’s tempting to discard outdated files to make room, but be sure you’re not violating legal retention rules in the process.
Step 6: Work with a Trusted Records Management Partner
Given the legal and logistical complexity, many practices turn to third-party providers for:
- Scanning and digitization of paper records.
- Secure offsite document storage.
- Custodial services for long-term record management and access requests.
Outsourcing record transitions ensures compliance, improves operational efficiency, and reduces the burden on your internal team during an already hectic time.
A smooth merger or acquisition isn’t just about systems and staff, it’s about records, too. Patient data must be secured, accessible, and transitioned according to HIPAA regulations. Whether you’re acquiring a new provider group or being absorbed into one, handling medical records properly protects both your patients and your practice.
With the right plan, your records won’t get lost in the shuffle, they’ll become a valuable part of your unified care experience.
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