How Long Do Hospitals Keep Medical Records? A PI Guide

Your client mentions it at the second meeting. They had neck pain years ago and saw a doctor a few times. The clinic has since closed. The carrier will find that history eventually, and you'd rather find it first. So the question is whether the records still exist.

This guide answers how long do hospitals keep medical records, and doctors' offices too, with the rules for the states we checked against the official text. It also covers what a PI firm should check before requesting old records, and what to do when they're gone.

How Long Do Hospitals Keep Medical Records?

It depends on the state and the type of provider. Hospitals in Medicare must keep records at least 5 years under federal rules, and states set their own periods on top. In the states we checked, hospital minimums run from 6 years in New York to 26 years in Washington. Doctors' offices usually have shorter minimums than hospitals.

Two words matter in every rule: "at least." These are minimums. Many providers keep records longer, especially electronic records. So a retention period tells you when a record may be gone, not that it is.

HIPAA Doesn't Set a Medical Record Retention Period

You'll often read that HIPAA requires providers to keep medical records for six years. It doesn't. HIPAA's six-year rule covers HIPAA documentation: the provider's policies, procedures and required records of actions. The Security Rule says to keep that documentation six years from creation or from when it was last in effect.

The federal floor for the medical record itself comes from Medicare's hospital rules. Under 42 CFR 482.24(b)(1), hospitals must keep medical records at least five years. Everything else is state law.

Medical Records Retention Laws by State

Here are the minimum periods for the states we checked, each read from the official statute or regulation in October 2026. States change these rules. Washington lengthened its hospital period in 2025, and Texas replaced its physician rule the same year. Check the current text before you rely on any of it.

State	Provider	Minimum retention	Minors	Source
Federal (Medicare hospitals)	Hospitals	5 years	No separate rule	42 CFR 482.24(b)(1)
California	General acute care hospitals	7 years after discharge	At least 1 year after age 18, never less than 7 years	22 CCR 70751(c)
Texas	Hospitals	May dispose 10 years after last treatment	Until age 20 or 10 years, whichever is later	Health & Safety Code 241.103
Texas	Physicians	7 years after last treatment	Until age 21 or 7 years, whichever is longer	22 TAC 163.2(c)
New York	Hospitals	6 years after discharge, or 6 years after death	3 years after age 18, if longer	10 NYCRR 405.10(a)(4)
Florida	Physicians	5 years after last patient contact	No separate rule	Fla. Admin. Code 64B8-10.002(2)
Washington	Hospitals	26 years from when the record was created	No separate rule	RCW 70.41.190(1)
Massachusetts	Hospitals and clinics licensed by DPH	May destroy 20 years after discharge or final treatment	No separate rule in this section	M.G.L. c. 111, § 70
Massachusetts	Physicians	7 years after the last encounter	7 years or until age 18, whichever is longer	243 CMR 2.07(13)(a)
Michigan	Licensed health professionals	7 years from the date of service (15 for certain services)	No separate rule	MCL 333.16213(2)

Some notes on reading the table. Washington's 26 years applies to records created on or after July 27, 2025, and to older records the hospital still held on that date. Texas hospitals can't dispose of records tied to litigation they know is unresolved. We left out rules we couldn't confirm in the official text, including physician rules in California and New York and a hospital period in Florida.

Which Records Disappear First?

Doctors' office records usually disappear first. In the states we checked, physician minimums run five to seven years from the last visit, while hospital minimums run six to twenty-six years. Small practices also close, merge and change systems more often than hospitals. Each change is a chance for old records to be archived badly or destroyed on schedule.

Watch the wording, too. Some rules say a provider "must keep" records for a period. Others say a provider "may dispose" of them after it. Either way, the end of the period is when the risk starts. It doesn't mean the records are already gone.

Record	Risk it's gone	Why
Solo or small practice, last visit over five years ago	High	Shorter minimums; practices close, retire or change systems
Chiropractor or therapist who retired	High	Records may sit with a custodian nobody told the patient about
Paper chart from before the provider's electronic system	Medium to high	Often archived offsite or destroyed when the period ends
Hospital in a long-retention state	Lower	Longer minimums and central record departments
Large health system on one electronic record	Lower	Old visits often stay in the same system
Records from when the client was a minor	Lower than you'd think	Several states extend retention past the age of majority

Records From When Your Client Was a Minor

Old pediatric records often outlive adult records from the same years. Several states tie retention for minors to the patient's age, not just the last visit. In California, hospital records of unemancipated minors are kept at least one year after the patient turns 18, and never less than seven years. Texas hospitals keep minors' records until age 20 or ten years after the last treatment, whichever is later.

That matters when a prior injury happened in childhood or the teen years. A sports injury at 15 may still be on file at 22 in some states, even though an adult visit from the same year would be gone. Ask for it anyway. Then let the attorney decide whether it's relevant to the claim.

Why Prior Records Matter in a PI Case

Prior records show your client's condition before the incident. That baseline is how you prove an aggravation of a preexisting condition. It's also the first thing a carrier looks for when it argues the injury wasn't new. Getting the records before the carrier does lets the attorney decide how to address them in the demand.

Our guide to the eggshell plaintiff rule in a demand letter covers how to use that baseline. Retention adds a clock to it. A record you didn't request in time may be a record nobody can produce, for either side.

Start with the client. Most of what you need to know about prior treatment is in their memory, and you only get it if you ask specific questions. Ask them in the first meeting, before records go out:

• Have you ever been treated for this part of your body before?
• Who did you see, roughly when, and for how long?
• Did you miss work, take medication or have imaging for it?
• Were you still having symptoms right before the incident?
• Do you still have any old bills, portal access or letters from that provider?

Write down the answers with dates. You'll use them to scope the request, and you'll compare them to the records when they come back. If the answers and the records don't match, you want to find that out before the carrier does.

Before You Request Old Records: A Checklist

Run these checks before the request goes out. Each one takes a phone call or a search, and each one can save weeks.

1. 1Pin down the dates. Ask the client for the last visit, not just the first. Retention usually runs from the last treatment or discharge.
2. 2Name the provider type and state. Hospital or office, and where. That tells you which rule applies.
3. 3Check whether the provider still exists. If the practice closed, find the records custodian. Former staff, the state medical board or a successor practice often know.
4. 4Request early. If the period is close to running out, send the request now, not when the demand is half written.
5. 5Keep it narrow. Ask for the same body parts and the period the case needs. A narrow request is faster and easier for the provider to fill.

The request itself follows the same rules as any records request. Our guide to medical record retrieval for lawyers covers the authorization, deadlines and follow-up.

Finding Records From a Closed Practice

When a practice closes, its records don't disappear on that day. They usually go to a custodian: a successor practice, a records storage company, or the physician who owned them. The hard part is finding out who that is.

Start with the client's old paperwork. A closing notice, a final bill or a letter about transferring records often names the custodian. Then try the former staff, the practice's last known address, or a successor practice at the same location. Some state medical boards also have information about where a closed practice's records went.

Once you find the custodian, the request is the same as any other. The retention period keeps running while you search, so start early.

What If the Records Were Destroyed?

If the provider says the records are gone, get that answer in writing, with the date range and the reason. A written "no records" response shows you asked. If the carrier later claims the history was hidden, you can show it never existed in a form anyone could get.

Then look for the same facts somewhere else.

• Health plan claims: the client's insurer may list past visits, dates and diagnosis codes.
• Pharmacy history: prescriptions show treatment even when the notes are gone.
• Imaging: a hospital or imaging center may still hold old studies and reports.
• Later records: a new provider's intake notes often summarize past treatment.
• The client: old patient portals, bills or letters they kept.

None of these replaces the original chart. Together, they can show what the baseline was. How to present a gap in the record is a decision for the attorney.

Where Lexyno Fits

Lexyno doesn't request or store records for providers. Once your firm has the records, Lexyno's medical chronology software extracts each visit with its provider, dates and source page. A visit table shows each provider's treatment period, so prior treatment and post-incident treatment are easy to tell apart.

Your team can review, correct or remove any event before the AI demand letter is drafted. Our medical chronology template shows the format, and our guide to medical record review covers reading prior records for conditions the carrier will raise.

Ask Before the Clock Runs Out

How long do hospitals keep medical records? Longer than most doctors' offices, and longer in some states than others. HIPAA doesn't set the period; state law does. Check the rule, ask early, and get a written answer when the records are gone.

The record you request this month may not exist next year. The one you never request can't help your client at all.

For the rest of the file, see our guides to the demand letter to the insurance company and HIPAA for PI firms, start from the PI demand letter template, or try Lexyno on one case from your own file, free.