Closing or relocating a medical practice in New York City is a major undertaking, one that involves far more than notifying patients, transferring equipment, or settling final billing. One of the most critical responsibilities that remains long after the doors close is the proper management, retention, and release of patient medical records.
Whether you are a solo practitioner retiring, a provider joining a hospital system, or a multisite NYC practice consolidating locations, you are legally responsible for ensuring patient records remain secure, accessible, and compliant long after your final day of operations.
This is why more practices across Manhattan, Brooklyn, Queens, the Bronx, and Staten Island rely on professional Medical Records Custodian services to handle the long-term storage, compliance, and release-of-information needs that follow a closure or transition.
This article explains what NYC providers must know about custodianship, retention laws, compliance requirements, and what to look for when choosing a custodian.
Why Medical Record Custodians Are Essential in NYC
New York has some of the strictest healthcare compliance expectations in the country, including retention requirements, privacy protections, and patient access rules. When a provider closes a practice, those responsibilities do not disappear.
A qualified medical records custodian:
- Securely stores patient charts
- Manages retention schedules according to NY law
- Handles patient record requests
- Provides copies to legal or insurance entities
- Maintains HIPAA compliance
- Documents all activity to protect the former provider
Without a custodian, a practice risks noncompliance, patient complaints, and legal exposure—issues that can arise years after closing.
NYC’s Complex Medical Record Retention Requirements
New York State has strict retention rules that every closing practice must follow.
For Adult Patients
Records must be retained for at least 6 years from the date of the last patient encounter.
For Minors
Records must be kept for at least 6 years, and until the patient turns 21, whichever is longer.
For OB/GYN and Maternity Records
Retention periods may extend to 21–23 years depending on documentation type.
For Hospitals and Ambulatory Centers
There are additional NYS DOH requirements that custodians must understand.
For Behavioral Health Records
Retention rules differ and often require special handling and protections.
A medical records custodian ensures these laws are followed precisely so the practice remains compliant long after closure.
Why NYC Practices Cannot Rely on DIY Record Storage
Some providers consider storing charts at home, in the office, or in a rented storage unit. These approaches are risky and often illegal.
Common problems with DIY record retention:
- No HIPAA-compliant access controls
- No chain-of-custody documentation
- No secure release-of-information process
- Limited protection from fire, theft, or water damage
- No backup system
- No process for retention tracking or destruction
- Difficulty responding to patient requests promptly
HIPAA violations can cost $10,000–$50,000 per incident, and patients can file complaints for inaccessible records.
A professional custodian eliminates these risks.
Responsibilities of a Medical Records Custodian (NYC-Specific Needs)
A qualified NYC custodian performs several critical functions:
1. Secure Long-Term Record Storage
Custodians store records (paper or digital) in:
- HIPAA-compliant facilities
- Climate-controlled environments
- Monitored and access-controlled spaces
NYC practices often face added risks like limited office storage, building restrictions, and high rent, making professional storage essential.
2. Patient Request Management
Patients frequently need copies long after a practice closes for:
- Continuing care
- School requirements
- Insurance claims
- Legal matters
- Personal records
A custodian handles:
- Identity verification
- Authorization processing
- Electronic or physical delivery
- Logging each request for compliance
This protects the former provider from HIPAA violations.
3. Release of Information (ROI) for Legal & Insurance Needs
NYC providers often receive requests from:
- Attorneys
- Insurers
- Workers’ compensation cases
- Government agencies
Custodians ensure:
- Proper authorization
- Secure document delivery
- Fee transparency
- Full audit trails
This process shields the closed practice from mishandling or accidental disclosures.
4. Compliance With NY Retention Laws
Custodians track:
- Retention timelines
- Expiration dates
- Destruction schedules
Once records reach the end of their legal life, the custodian handles secure destruction and issues certificates of destruction.
5. Digital Conversion & EMR Migration (Optional)
Many closing practices choose to:
- Scan charts before custody
- Move records into EMRs for easier access
- Reduce long-term storage costs
- Improve patient request turnaround times
Digitization is especially valuable in NYC where space is limited and hybrid provider teams are common.
Scenarios Where NYC Providers Need a Medical Records Custodian
Custodianship is required or strongly recommended in the following situations:
1. Practice Closure (Retirement or Career Change)
The most common scenario. Providers must ensure continuous record access for years beyond closure.
2. Practice Sale or Acquisition
If the new practice or hospital does not assume all historical records, a custodian must retain them.
3. Physician Relocation
Providers moving out of state often cannot manage NY record retention requirements remotely.
4. Group Practice Dissolution
When partners split, a third-party custodian ensures neutrality and compliance.
5. Multi-Site Consolidation
NYC practices frequently merge or relocate to reduce overhead; historical records remain in custody.
6. Unexpected Provider Departure
Custodians can step in quickly to maintain continuity and prevent compliance gaps.
What NYC Medical Practices Should Look for in a Custodian
Choosing the right custodian is essential for protecting both the provider and the patient population.
Here are the most important criteria:
1. HIPAA and NYS Compliance Expertise
A custodian must understand:
- HIPAA Privacy Rule
- New York retention requirements
- NY SHIELD Act
- 42 CFR Part 2 (behavioral health)
- NYC-specific documentation rules (for certain specialties)
2. Ability to Handle Both Paper and Digital Records
NYC practices vary widely in technology adoption. A good custodian must:
- Store paper safely
- Manage EMR data
- Scan and digitize charts when needed
3. Reliable Patient Communication
Patients should have:
- A convenient request portal
- Email and phone support
- Clear instructions
- Reasonable turnaround times
Poor service will lead to patient complaints, reflecting back on the former practice.
4. Transparent Pricing Structure
Providers should receive:
- A clear custody fee schedule
- Per-request fees
- Storage costs
- Destruction costs
- Optional digitization pricing
Avoid custodians who:
- Hide fees
- Offer unclear retention terms
- Do not provide documentation
5. Proven Chain-of-Custody Procedures
Providers should confirm:
- Records are barcoded
- Movement is tracked
- All actions are logged
- Access is restricted
- Requests include full audit trails
6. Disaster Recovery and Backup Systems
Given NYC’s density and risk profile, a custodian should offer protection against:
- Fire
- Water damage
- Power outages
- Cybersecurity threats
7. Experience with NYC Practice Closures
The custodian should understand the unique challenges of NYC operations, including:
- Building access and logistics
- High-volume records
- Multi-location transitions
- Complex specialty practices
The Transition Process: What NYC Providers Can Expect
A professional custodian follows a structured, compliant process:
1. Inventory and Assessment
Your charts are inventoried, counted, and categorized.
2. Secure Pickup
Records are barcoded, boxed, and transported securely from your office.
3. Storage and/or Digitization
Depending on your needs:
- Paper records are stored securely
- Charts can be scanned into digital formats
4. Patient Notification (if required)
NY practices may need to notify patients of the custodian’s contact information.
5. Release-of-Information Services Begin
Patients, attorneys, and insurers contact the custodian directly, not the provider.
6. Retention Tracking
The custodian monitors timelines and manages destruction at the appropriate time.
Why NYC Medical Practices Choose Third-Party Custodians
NYC providers overwhelmingly choose custodians for three reasons:
1. Compliance Protection
Eliminates the risk of HIPAA complaints, state investigations, or improper disclosure.
2. Operational Freedom After Closure
Providers can retire or relocate without ongoing administrative responsibilities.
3. Patient Service and Continuity
Patients receive timely, professional access to their records.
For any medical practice closing or transitioning in New York City, choosing a qualified medical records custodian is not optional; it is essential for compliance, patient care continuity, and long-term liability protection.
A reliable custodian ensures:
- Secure storage
- Proper retention
- Efficient patient access
- Full HIPAA and NYS compliance
- Peace of mind long after the last patient visit
Emerald Document Imaging offers HIPAA-compliant medical record custodial services tailored to New York’s unique regulatory and operational environment, supporting retiring providers, relocating practices, multisite groups, and organizations undergoing mergers or acquisitions.
