Rules & Regulations of the State of Tennessee
Title 1155 - Board of Podiatric Medical Examiners
Chapter 1155-04 - General Rules Governing Orthotists, Prothetists, and Pedorthists
Section 1155-04-.22 - PATIENT RECORDS
Universal Citation: TN Comp Rules and Regs 1155-04-.22
Current through April 3, 2024
(1) Purpose - The purpose of this rule is:
(a) To recognize that patient records are an
integral part of the practice of orthotists, prosthetists, and pedorthists as
defined in T.C.A. §
63-3-201.
(b) To give orthotists, prosthetists,
pedorthists, their professional and non-professional staff, and the public
direction about the content, transfer, retention, and destruction of those
patient records.
(2) Applicability - This rule regarding patient records shall apply only to those records, the information for which was obtained by orthotists, prosthetists, pedorthists, or their supervisees, for purposes of services provided in any clinical setting other than those ., provided in a hospital as defined by T.C.A. § 68-11-302(4), a hospital emergency room, or hospital outpatient facility.
(3) Patient Records -
(a) Duty to Create and Maintain Records - As
a component of the standard of care and of minimal competency, an orthotist,
prosthetist, or pedorthist must cause to be created and cause to be maintained
a patient record for every encounter between a patient and the orthotist,
prosthetist, or pedorthist. For purposes of this Rule, a patient is defined as
a person for whom the orthotist, prosthetist, or pedorthist has undertaken to
treat or for whom the orthotist, prosthetist, or pedorthist has participated in
treatment.
(b) Notice - Any notice
to be provided to a patient required by these rules 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.
(c) Content - In order to
meet the minimum level of competency required of orthotists, prosthetists, and
pedorthists, the patient 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. §
63-2-101(c)(4), to the extent applicable;
3. Contain such additional information that
is necessary to ensure that a subsequent reviewing or treating healthcare
professional can both ascertain the basis for the treatment plan and outcomes,
and provide continuity of care for the patient.
(d) Transfer -
1. Applicability of Notice Requirements - The
notice requirements of this part are only required for patients who have
either:
(i) Had three (3) or more office
encounters with the orthotist, prosthetist, or pedorthist over the eighteen
(18) month period that immediately precedes the event that would otherwise
trigger the notice or
(ii) Had
their initial evaluation and treatment plan developed by the orthotist ,
prosthetist, or pedorthist.
2. Records of Orthotist, Prosthetist, or
Pedorthist upon Death or Retirement - When an orthotist, prosthetist, or
pedorthist retires or dies while in practice, patients who meet the
requirements of 1155-04-.22(3)(d) 1. shall be notified by the orthotist,
prosthetist, or pedorthist, or his authorized representative; urged to find a
new orthotist, prosthetist, or pedorthist; and informed that upon patient or
patient's representative's authorization copies of the patient's records will
be sent to the new orthotist, prosthetist, or pedorthist.
3. Patient Records of Orthotist, Prosthetist,
or Pedorthist upon Departure from a Group - The responsibility for notifying
patients of an orthotist, prosthetist, or pedorthist who leaves a group
practice for any reason other than death shall be governed by the employment or
professional services contract of the orthotist, prosthetist, or pedorthist. If
such contract does not address the notification issue, or if an employment or
professional services contract does not exist, the group shall be responsible
for notifying the patients of the orthotist, prosthetist, or pedorthist that
the orthotist, prosthetist, or pedorthist has departed from the group.
(i) Whoever is responsible for the
notification referenced in the immediately preceding paragraph must notify
patients of the orthotist, prosthetist, or pedorthist who meet the requirements
of 1155-04-.22(3)(d) 1.
(ii) The
orthotist, prosthetist, or pedorthist who is departing from a practice group
must provide the practice group with his new practice address. Failure to
provide this information within two (2) weeks of the departure date from the
practice group will relieve the practice group of any obligation to provide the
new address of the orthotist, prosthetist, or pedorthist as set out in (iii)
below.
(iii) These patients shall
also be notified of the orthotist's, prosthetist's, or pedorthist's new
address, if known and provided by the departing orthotist, prosthetist, or
pedorthist, and offered the opportunity to have copies of their patient records
forwarded to the departing orthotist, prosthetist, or pedorthist at his new
practice. A group shall not withhold the patient records of any patient who has
authorized their transfer to the departing orthotist, prosthetist, or
pedorthist or any other orthotist, prosthetist, or pedorthist.
(iv) The choice of orthotist, prosthetist, or
pedorthist in every case should be left to the patient, and the patient should
be informed that, upon authorization, his patient records will be sent to the
orthotist, prosthetist, or pedorthist of the patient's choice.
4. Sale of an Orthotist,
Prosthetist, or Pedorthist's Practice - An orthotist, prosthetist, or
pedorthist or the estate of a deceased orthotist, prosthetist, or pedorthist,
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 those records; provided that nothing herein shall be deemed to
preclude the ultimate decision-making rights of the patient. Therefore, the
transfer of patient records upon the sale of an orthotist, prosthetist, or
pedorthist's practice is subject to the following:
(i) The orthotist, prosthetist, or pedorthist
(or the estate) must ensure that all patient records are transferred to another
orthotist, prosthetist, or pedorthist or entity that is held to the same
standards of confidentiality as provided in these rules.
(ii) Patients seen by the orthotist,
prosthetist, or pedorthist who meet the requirements of 1155-04-.22(3)(d) 1.
shall be notified that the orthotist, prosthetist, or pedorthist (or the
estate) is transferring the practice to another orthotist, prosthetist, or
pedorthist, or entity who will retain custody of their patient records and
that, upon written authorization by the patient or the patient's
representative, the copies of their patient records will be sent to another
orthotist, prosthetist, or pedorthist.
5. Failure to Adequately Provide for Transfer
of Patient Records or Notify Patients - It shall be a prima facie violation of
T.C.A. §
63-3-204(b)(9) and (10) for a orthotist, prosthetist, or
pedorthist to depart from his group, retire, or sell his practice without
making written provisions for the security or transfer of patient records, or
otherwise establish and memorialize in writing a secure method of patient
access to his patient records.
(e) Retention of Records - Patient records
shall be retained for a period of not less than seven (7) years from the
orthotist's, prosthetist's, or pedorthist's last professional contact with the
patient except for the following:
1. Patient
records for incompetent patients, other than those who are incompetent solely
because they are minors, shall be retained at least until one (1) year after
the patient's death or alleviation of incompetency.
2. Patient 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 orthotist's,
prosthetist's, or pedorthist's last professional contact with the patient,
whichever is longer.
3.
Notwithstanding the foregoing, no patient record involving services which are
currently under dispute shall be destroyed until the dispute is
resolved.
4. Nothing herein shall
be deemed to supersede any federal or state law or regulation requiring
providers to retain patient records for periods longer than the time stated
above.
(f) Destruction
of Records -
1. No patient record shall be
singled out for destruction other than in accordance with established office
operating procedures.
2. Patient
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
patient 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 patient 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 from any
use or disclosure that is in violation of any state or federal laws or
regulations. Simply discarding a data storage device without rendering the data
stored upon it inaccessible, cleaned, or scrubbed does not constitute
compliance with this rule.
5. When
patient 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 records that were destroyed
but shall be sufficient to identify which group of destroyed patient records
contained a particular patient's records.
(4) In addition to the requirements of this rule, orthotists, prosthetists, and pedorthists must also comply with the Health Insurance Portability and Accountability Act (HIPAA) and the regulations promulgated thereto if such entity is considered a Covered Entity as defined by HIPAA. Failure to comply with HIPAA shall constitute violation of this rule unless the provider proves to the satisfaction of the Board that he is not required to comply with HIPAA.
(5) Mandatory Release of Patient Records -
(a)
Pursuant to T.C.A §
63-2-102 and 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. The provider may charge a
reasonable fee for production of such records as authorized in T.C.A. §
63-2-102.
(b) It shall be the
provider's option as to whether copies of the patient records or a summary will
be given to the patient, in accordance with T.C.A. §
63-2-101(a)(1).
(c) Requests for
patient records shall be honored by the provider in accordance with timelines
identified in T.C.A. §
63-2-101.
(d) Nothing herein shall be deemed to
supersede any federal or state law or regulation.
(6) Violations - Violation of any provision of these rules is grounds for disciplinary action pursuant to T.C.A. §§ 63-3-204(b)(9) and 63-3-204(b)(10).
(7) This rule shall be applied prospectively. An orthotist, prosthetist, or pedorthist shall not be found to be in violation of this rule if the violation occurred before the effective date of this rule.
Authority: T.C.A. §§ 63-3-201, 63-3-202, and 68-11-302.
Disclaimer: These regulations may not be the most recent version. Tennessee may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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