Closing a medical practice, whether due to retirement, sale, moving, handling of an estate or other reason, can seem a daunting task. It is not something we are specifically trained to do, it is usually a once-in-a-career occurrence, and there are many steps to take. In order to break it down into digestible bites, CAP’s Risk Management & Patient Safety Department has provided the following guidelines to assist you through the process.
Closing Your Practice Checklist
The American Academy of Family Practitioners has an excellent checklist available for download: American Academy of Family Practice (AAFP) Closing Your Practice Checklist. This checklist is applicable to most types of practice, not just family practice. The California Medical Association also has an excellent booklet you can purchase, “Closing a Medical Practice.”
Put together your legal and financial team. Closure of a practice requires legal and financial advice. Early retention of an attorney and an accountant is like the old adage, “an ounce of prevention is worth a pound of cures.” Think of them as your teammates; get them onboard and in contact with each other as early as possible.
Attorneys are responsible for handling legal issues that can become far bigger problems later, some of which you may not even be aware. They also can bring stability and predictability for the sale/transfer of your practice. For example, an attorney can help prevent breach of your existing contracts such as leases, draft contracts for the sale of your practice and transfer of assets/liabilities and prepare documentation for the custody and handling of your patients’ medical records.
Similarly, accountants will look at financial issues, possibly saving you a lot of money. There are tax implications and financial obligations associated with the closure or transfer of a practice. If it can be prevented, you do not want to receive a bill for something you did not even think of months or years down the road.
You need to let patients know that you are closing your practice to give them time to find another provider, obtain copies of their records and assist with the transfer of care. CAP’s Risk Management & Patient Safety Department has several letter templates that you can modify to suit your circumstances: practice closure template (Sample Letter: Closing a Medical Practice) and a template for leaving a group (Sample Notification Letter to Patient: Physician Leaving Group). You should also include a record release if the patient wants their own copy of their records (Authorization for Use and Disclosure of Medical Information) and/or an authorization for transfer of medical records to a new provider (Sample Authorization Form: Transfer of Medical Records). Be sure to notify patients where your records will be maintained.
Patients with differing levels of acuity should receive appropriate notification. High risk/acuity patients, those undergoing aggressive treatment or/and those on your follow up schedule, send notification via certified mail with return receipt requested and via regular U.S. Mail. For all others, regular U.S. Mail is adequate.
Even after closing their practice, physicians are responsible for patient record retention. For adults, at least ten (10) years after last date of treatment, including death. For minors, at least ten (10) years or age 19, whichever is longer. If you are closing your practice, you need to look at record retention companies. If you are selling your practice, the purchasing physician will generally be the person responsible for retaining your records. Either way, you are ultimately responsible for the proper retention of the records.
Remember, your patient records are your records. Patients are entitled to copies of their records at reasonable copying charges. Never give patients your original records. Without the originals, you cannot verify the care and treatment you provided or/and a patient can improperly modify the records.
CAP Membership Services
Be sure to notify CAP's Membership Services Department at 1-800-252-7706 by October 31st of the year. This is to prevent the obligation of next year's assessment.
For the closure, sale or other transfer of your practice, or any other risk or patient safety issue, please call the CAP Hotline at 800-252-0555 for further assistance.
Michael Valentine, JD
Senior Risk Manager
If you have questions about this article, please contact us. This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.