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S.C. ADC 61-91 SEC. 703 - Patient Records; Record Maintenance

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Patient records are the property of the ambulatory surgical facility; the original record shall not be removed without court order. Patient records must be stored in a manner that ensures protection and security of those records.

When a patient is transferred to an emergency facility, a transfer summary, including the diagnosis and medication administration record, must accompany the patient or sent immediately thereafter. Documentation of the information forwarded shall be maintained in the facility's patient record.

Patient records are confidential and only made available to individuals granted access to that information, in accordance with state and federal laws. The facility shall have a written policy designating the persons allowed to access confidential patient information. Records generated by contracted providers are to be maintained by the facility that has admitted the patient. Appropriate information shall be provided to assure continuity of care.

The hospital is responsible for deciding how records will be stored, although it must be readily retrievable and accessible by hospital staff, as well as for regulatory compliance inspections.  

When a patient is discharged, his medical record must be completed within 60 days and filed appropriately. If the hospital were to close for any reason, it shall arrange for the preservation of all records in compliance with applicable law. The Department's Division of Health Licensing must be notified in writing, with a description of the arrangements and the location of the records.

Medical records must be maintained for at least six years following the discharge of the patient. Other regulatory compliance documents must be kept for 12 months or until the next Division of Health Licensing inspection, whichever is longer.


Current as of June 2015