(a) To recognize that medical records are an
integral part of the practice of podiatrists as defined in T.C.A. §
(b) To give podiatrists, their professional
and non-professional staff, and the public direction about the content,
transfer, retention, and destruction of those records.
(2) Applicability. This rule regarding
medical records shall apply only to those records, the information for which
was obtained by podiatrists or their supervisees, for purposes of services
provided in any clinical setting other than a hospital as defined by T.C.A.
a hospital emergency room, or hospital outpatient facility.
(a) Duty to Create and Maintain Medical
Records - As a component of the standard of care and of minimal competency, a
podiatrist must cause to be created and cause to be maintained a medical record
for every encounter between a patient and either the podiatrist or licensed
member of the podiatrist's staff. All imaging studies and interpretations of
such studies are considered to be part of the patient's medical records. For
purposes of this Rule, a patient is defined as a person for whom the podiatrist
has undertaken to diagnose or treat or for whom the podiatrist has participated
in such diagnosis or treatment.
Notice - Any notice required by these rules to be provided to a patient shall
be issued within thirty (30) days of the date of the event that triggers the
notice requirement, and shall be accomplished by mailing to the last known
address of the patient.
- In order to meet the minimum level of competency required of podiatrists, the
medical records required by this rule shall:
1. Be recorded in such a manner as to be
legible to an ordinary reasonable person, including those persons who are not
licensed healthcare professionals;
2. Include all information and documentation
listed in T.C.A. §
3. Contain such additional information that
is necessary to insure that a subsequent reviewing or treating physician can
both ascertain the basis for the diagnosis, treatment plan, and outcomes, and
provide continuity of care for the patient.
1. Inapplicability of Notice Requirements -
None of the notice requirements of this subparagraph (d) are required for
patients who have had fewer than three (3) office encounters with the
podiatrist or his licensed supervisees over the eighteen (18) month period that
immediately precedes the event that would otherwise trigger the
2. Records of Podiatrists
upon Death or Retirement - When a podiatrist retires or dies while in practice,
patients seen by the podiatrist in his office during the immediately preceding
eighteen (18) months shall be notified by the podiatrist, or his authorized
representative, urged to find a new podiatrist, and informed that upon
authorization copies of the patient's medical records will be sent to the new
podiatrist or other physician.
Records of Podiatrists upon Departure from a Group - The responsibility for
notifying patients of a podiatrist
who leaves a group practice for any reason
other than death shall be governed by the podiatrist
's employment contract. If
the employment contract does not address the notification issue, the group
shall be responsible for notifying the podiatrist
's patients that the
has departed from the group.
Whoever is responsible for the notification must notify patients seen by the
podiatrist in his office during the eighteen (18) months immediately preceding
(ii) Those patients
shall also be notified of the podiatrist's new address and offered the
opportunity to have copies of their medical records forwarded to the departing
podiatrist at his new practice. A group shall not withhold the medical records
of any patient who has authorized their transfer to the departing podiatrist or
any other podiatrist or other physician.
(iii) The choice of podiatrist in every case
should be left to the patient, and the patient should be informed that upon
authorization his records will be sent to the podiatrist or other physician of
the patient's choice.
Sale of a Podiatry Practice - A podiatrist
or the estate of a deceased
may sell the elements that comprise his practice, which include the
goodwill of the practice and the opportunity to take over the patients of the
seller by purchasing the medical records. Therefore, the transfer of medical
records of patients upon the sale of a podiatry practice is subject to the
(i) The podiatrist (or the estate)
must ensure that all medical records are transferred to another podiatrist,
other physician, or entity that is held to the same standards of
confidentiality as provided in these rules.
(ii) Patients seen by the podiatrist in his
office during the immediately preceding eighteen (18) months shall be notified
that the podiatrist (or the estate) is transferring the practice to another
podiatrist, other physician, or entity who will retain custody of their medical
records and that at their written request copies of their records will be sent
to another podiatrist, other physician, or entity of their choice.
5. Failure to Adequately Provide
for Transfer of Records or Notice to Patients. It shall be a prima facie
violation of T.C.A. §
and (10) for a podiatrist to depart from his
group, retire, or sell his practice without making provision for the security
or transfer of patient medical records, or otherwise establish a secure method
of patient access to his medical records.
Retention of Medical Records - Medical
records shall be retained for a period of not less than seven (7) years from
's or his supervisees' last professional contact with the patient
except for the following:
1. Medical records
for incompetent patients, other than those who are incompetent solely because
they are minors, shall be retained until at least one (1) year after the
2. Medical records
of minors shall be retained for a period of not less than one (1) year after
the minor reaches the age of majority or ten (10) years from the date of the
podiatrist's or his supervisees' last professional contact with the patient,
whichever is longer.
Notwithstanding the foregoing, no medical record involving services which are
currently under dispute shall be destroyed until the dispute is
Destruction of Medical Records
1. No medical
record shall be singled out for destruction other than in accordance with
established office operating procedures.
2. Medical records shall be destroyed only in
the ordinary course of business according to established office operating
procedures that are consistent with these rules.
3. Physical copies of medical records may be
destroyed by burning, shredding, or other method that safeguards patient
protected health information from any use or disclosure that is in violation of
any state or federal laws or regulations.
4. Any recordable and erasable media device
upon which electronic medical records have been stored must be rendered
inaccessible, cleaned, or scrubbed by overwriting the data, degaussing the
media (using magnetic field to neutralize the data stored on magnetic media),
or other method that safeguards patient protected health information. Simply
discarding a data storage device without rendering the data stored upon it
inaccessible, cleaned, or scrubbed does not constitute compliance with this
5. When medical records are
destroyed, the time, date and circumstances of the destruction shall be
recorded and maintained for future reference. The record of destruction need
not list the individual patient medical records that were destroyed but shall
be sufficient to identify which group of destroyed records contained a
particular patient's medical records.
(4) In addition to the requirements of this
rule, podiatrists must also comply with the Health Insurance Portability and
Accountability Act (HIPAA) and the regulations promulgated thereto. Failure to
comply with HIPAA shall constitute violation of this rule.
Mandatory Release of Patient Records
(a) Upon request from a patient or the
patient's authorized representative, an individual registered with this Board
shall provide a complete copy of the patient's records or a summary of such
records which were maintained by the provider.
(b) It shall be the provider's option as to
whether copies of the records or a summary will be given to the
(c) Requests for records
shall be honored by the provider in a timely manner.
(6) Violations - Violation of any provision
of these rules is grounds for disciplinary action pursuant to T.C.A.
(7) This rule shall be applied prospectively.
A podiatrist shall not be found to be in violation of this rule if the
violation occurred before the effective date of this rule.