South Carolina Medical Records Retention Laws (2026 Guide)

South Carolina physicians must retain adult patient medical records for at least 10 years from the last date of treatment under S.C. Code Section 44-115-120. Records for minor patients must be kept for at least 13 years. Hospitals follow the same 10-year baseline under state licensing Regulation 60-16, Section 1107.

Understanding how long healthcare providers must keep your medical records in South Carolina is important for patients and providers alike. Whether you need access to old treatment records, are a physician planning for retirement, or a hospital administrator reviewing compliance policies, South Carolina law sets clear minimum retention periods that every provider must follow.

This guide covers the specific state statutes, federal requirements under HIPAA and Medicare, patient access rights, proper destruction procedures, practice closure obligations, and answers to frequently asked questions about medical records retention in South Carolina.

South Carolina Medical Records Retention Requirements for Physicians

The primary state law governing medical records retention in South Carolina is the Physicians' Patient Records Act, S.C. Code Title 44, Chapter 115. This act establishes the minimum standards for how physicians handle, store, and eventually dispose of patient records.

10-Year Minimum for Adult Patients

Under S.C. Code Section 44-115-120, physicians in South Carolina must retain medical records for adult patients for at least 10 years from the last date of treatment. This means the clock starts ticking from the patient's most recent visit, not from the date the record was first created.

If a patient returns for treatment at any point during that 10-year window, the retention period resets and begins counting again from the new last date of treatment.

13-Year Minimum for Minor Patients

For patients who are minors, S.C. Code Section 44-115-120 extends the minimum retention period to at least 13 years from the last date of treatment. This extended period accounts for the fact that minor patients cannot independently exercise their legal rights until they reach adulthood.

The 13-year requirement ensures that records remain available well past the patient's 18th birthday in most cases, giving the patient time to request their records as an adult.

What the Retention Period Covers

The Physicians' Patient Records Act applies broadly to all medical records maintained by physicians licensed in South Carolina. This includes:

• Patient history and examination notes
• Diagnostic test results and laboratory reports
• Treatment plans and progress notes
• Prescriptions and medication records
• Imaging studies and radiology reports
• Referral correspondence
• Consent forms and authorizations

Hospital Medical Records Retention in South Carolina

Hospitals licensed by the South Carolina Department of Public Health (formerly DHEC) are subject to additional retention requirements under state licensing regulations.

State Licensing Standards

South Carolina Regulation 60-16, which establishes minimum standards for licensing hospitals and institutional general infirmaries, provides at Section 1107(A) that hospital medical records "shall not be disposed of before 10 years." For minor patients, Section 1107(A)(1) requires that records "must be retained until after the expiration of the period of election following achievement of majority as prescribed by statute," so the hospital rule tracks the statutory window a former minor patient still has to bring a claim rather than a fixed age-plus-years calculation.

This rule was previously numbered Regulation 61-16. It was transferred into Chapter 60 (Department of Public Health) by SCSR 49-5, Doc. No. 5352, effective May 23, 2025; Chapter 61 now holds the Department of Environmental Services regulations. The 10-year hospital baseline itself did not change.

These hospital-specific regulations are enforced through the state licensing process. Hospitals that fail to comply with record retention standards risk their operating licenses.

How Hospital and Physician Rules Differ

While both physicians and hospitals in South Carolina share a 10-year baseline retention period for adult patients, there are practical differences:

• Physician practices follow S.C. Code 44-115-120 (10 years from last treatment for adults, 13 years for minors)
• Hospitals follow Regulation 60-16, Section 1107 (records not disposed of before 10 years, with a minor patient's records kept until after the expiration of the statutory period of election following achievement of majority)
• Hospitals also face federal requirements if they participate in Medicare or Medicaid programs

For hospital-based physicians, both sets of rules may apply simultaneously. The best practice is to follow whichever requirement results in the longer retention period.

Federal Requirements: HIPAA and Medicare

South Carolina providers must also comply with federal record retention rules, which layer on top of state requirements.

HIPAA Does Not Set a Medical Records Retention Period

A common misconception is that HIPAA requires healthcare providers to keep patient medical records for a specific number of years. According to the U.S. Department of Health and Human Services (HHS), HIPAA does not include medical record retention requirements. State laws govern how long records must be kept.

However, HIPAA does require covered entities to retain HIPAA-related administrative documentation for 6 years. This includes:

• Privacy policies and procedures
• Privacy practices notices
• Complaint disposition records
• Training records
• Business associate agreements
• Risk assessments and security documentation

This 6-year requirement applies to compliance paperwork, not to the actual patient medical records themselves.

HIPAA Privacy Protections Still Apply

While HIPAA does not dictate retention periods, it does require that covered entities apply appropriate administrative, technical, and physical safeguards to protect the privacy of medical records for whatever period the information is maintained. This protection extends through the disposal process.

Medicare Conditions of Participation

Hospitals participating in Medicare must comply with 42 CFR 482.24, which requires medical records to be retained in their original or legally reproduced form for at least 5 years. Since South Carolina's 10-year state requirement is longer, South Carolina hospitals should follow the state standard to satisfy both requirements.

For Medicare providers generally, CMS recommends retaining records for at least 7 years to account for audit and investigation timelines. Providers who participate in both Medicare and Medicaid should follow the longest applicable retention period among federal and state requirements.

Patient Access Rights in South Carolina

South Carolina law provides patients with clear rights to access and obtain copies of their medical records.

Right to Copies and Transfers

Under S.C. Code Section 44-115-30, patients have the right to receive a copy of their medical record or have the record transferred to another physician. The patient must provide written authorization for the release.

Records must be provided in either printed or electronic format. If records are stored electronically and can be reproduced without additional cost, the provider must offer electronic copies.

Records Cannot Be Withheld for Unpaid Bills

S.C. Code Section 44-115-70 specifically prohibits physicians from withholding medical records due to unpaid bills. This is an important patient protection that ensures continuity of care regardless of a patient's financial situation with a former provider.

Copy Fees

S.C. Code Section 44-115-80 sets the base fee schedule a physician may charge for searching and duplicating a medical record, and Section 44-115-80(A)(3) requires that every fee allowed by that section, including the maximum, be adjusted annually for inflation (CPI-U, South Region) effective each July 1. The South Carolina Department of Public Health (DPH, formerly DHEC) calculates and publishes that adjustment. The unadjusted base figures written into the statute text are $0.65 per page for the first 30 pages, $0.50 per page after that, a $25 clerical/search fee, a $150 total cap for electronic copies, and a $200 total cap for paper copies, and both statutory caps are stated per request. As of the July 1, 2026 adjustment published by DPH, the figures actually in effect are:

• Per-page fee: $0.90 per page for the first 30 pages, $0.68 per page for each additional page
• Clerical/search fee: Capped at $34.76 (DPH's schedule allows a maximum $25 clerical fee where no records are found)
• Total maximum, electronic copies: $208.63 per request
• Total maximum, paper copies: $278.16 per request
• Postage and sales tax: Actual costs may be added on top of these caps

A separate statute, S.C. Code Section 44-7-325, governs health care facilities such as hospitals. Its dollar figures are the same and it carries its own materially identical annual CPI adjustment at Section 44-7-325(A)(1)(d), but the unit differs: the electronic cap applies per request regardless of how many times the patient was admitted, while under Section 44-7-325(A)(1)(b) the paper cap applies per admission (only one clerical fee may be charged even when multiple admissions exist, and multiple emergency room visits without an admission count as one admission).

Because DPH republishes these figures every July 1, providers and patients should check DPH's current fee table rather than the base statutory amounts above.

Additionally, when a physician refers a patient to another provider for continuation of treatment, the referring provider must transfer the medical records at no charge.

Suspended, terminated, or excluded Medicaid providers are also required to provide patient records at no charge.

Proper Destruction of Medical Records

Once the minimum retention period has passed, South Carolina providers may destroy medical records. However, the destruction process must comply with both state law and federal HIPAA requirements.

When Records Can Be Destroyed

Medical records for adult patients may be destroyed after the 10-year retention period has elapsed (measured from the last date of treatment). For minor patients, a physician may destroy the records after the applicable 13-year period under S.C. Code Section 44-115-120. A hospital must keep a minor patient's records until after the expiration of the period of election following that patient's achievement of majority, as prescribed by statute (Regulation 60-16, Section 1107(A)(1)).

HIPAA-Compliant Destruction Methods

The HHS Office for Civil Rights requires that covered entities use destruction methods that render protected health information unreadable and impossible to reconstruct.

For paper records, acceptable methods include:

• Cross-cut shredding
• Burning
• Pulping
• Pulverizing

For electronic records, acceptable methods include:

• Clearing (overwriting with non-sensitive data using certified software)
• Purging (degaussing or exposing media to a strong magnetic field)
• Physical destruction (disintegration, pulverization, melting, incinerating, or shredding the media)

Documentation and Business Associates

Providers should maintain certificates of destruction that document the date, method, and records destroyed. When using a third-party destruction company, HIPAA requires a Business Associate Agreement (BAA) with the vendor.

Records must never be disposed of in dumpsters, recycling bins, or other receptacles accessible to the public or unauthorized persons.

Practice Closure and Record Transfer Obligations

South Carolina has specific rules governing what happens to patient records when a physician retires, closes a practice, or becomes unable to practice.

Closing a Medical Practice

The South Carolina Board of Medical Examiners requires physicians closing a practice to:

• Notify patients at least 30 days before closure by letter or email
• If email notification bounces, use alternative contact methods
• Keep the practice phone number active for at least 30 days after closure with an informational voicemail message
• Inform patients of their right to obtain or transfer their records
• Publish a notice in a local newspaper on three or more occasions, giving patients reasonable time to retrieve their records

Even after a practice closes, the records must still be retained for the full minimum period required by S.C. Code 44-115-120.

Sale of Medical Records

Under S.C. Code Section 44-115-130, physicians cannot sell medical records to anyone other than a licensed physician, osteopath, or hospital without approval from the State Board of Medical Examiners. Before any sale, the physician must publish public notice in local newspapers at least three times within 90 days, allowing patients the opportunity to retrieve their records.

Physician Incapacity, Disappearance, or Death

South Carolina Regulation 81-1 addresses situations where a physician becomes incapacitated, disappears, or dies. Key requirements include:

• Every licensed physician must designate a responsible party (partner, personal representative, or other designee) to assume responsibility for patient records if the physician cannot continue practicing
• Physicians must affirm this designation upon initial licensure and each renewal
• If no responsible party exists, the Board of Medical Examiners may appoint another licensee to take custody of the records
• The appointed licensee must notify patients by first-class mail, post notice at the physician's last known business address, and publish notice in a newspaper for three consecutive weeks
• Appointment terms last up to 12 months, with extensions available as needed
• After one year, the appointed licensee may petition for permission to dispose of unclaimed records

Key Compliance Tips for South Carolina Providers

To stay in full compliance with South Carolina medical records retention laws:

1. Track retention periods carefully. Use the last date of treatment as the starting point, not the date the record was created.

2. Default to the longest applicable period. When federal and state requirements overlap, follow whichever requires the longer retention.

3. Maintain records for minors beyond the standard period. The 13-year physician requirement and hospital rules for minors extend well past the standard adult timeline.

4. Document your retention and destruction policies. Written policies protect your practice during audits and regulatory reviews.

5. Plan for practice transitions. Designate a responsible party for your records as required by Regulation 81-1, and update that designation at each license renewal.

6. Use HIPAA-compliant destruction methods. Keep certificates of destruction and maintain Business Associate Agreements with any third-party vendors.