North Dakota Medical Records Retention Requirements: What Healthcare Providers Need to Know

Mandatory Retention Periods for Medical Records

North Dakota’s retention period regulations vary by provider type. Hospitals must preserve each patient’s chart for at least 10 years after the date of last treatment; for minors, the later of age 21 or 10 years after last treatment applies. Hospitals that close must store records for 10 years and publish public notices so former patients can claim copies. Radiology images and duplicate reports are kept at least five years. These rules sit alongside North Dakota Century Code provisions recognizing electronic records. ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-01.1.pdf))

• Physicians and other Board of Medicine licensees: retain records at least seven years from the last date of service unless properly transferred. ([regulations.justia.com](https://regulations.justia.com/states/north-dakota/title-50/article-50-01/chapter-50-01-03/section-50-01-03-01/))
• Nursing facilities: preserve discharged residents’ records for 10 years (seven years if the resident is deceased); minors’ records are kept through the period of minority plus 10 years after live discharge (or plus seven years if deceased). ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-03.2.pdf))
• Extended stay centers: maintain patient records for not less than five years from the date of discharge. ([ndlegis.gov](https://ndlegis.gov/information/acdata/pdf/33-03-36.pdf?utm_source=openai))

Taken together, these administrative compliance requirements give you clear, facility‑specific timelines while allowing electronic formats to serve as legally valid originals under the North Dakota Century Code. ([codes.findlaw.com](https://codes.findlaw.com/nd/title-31-judicial-proof/nd-cent-code-sect-31-08-01-3/?utm_source=openai))

Appointment of Record Custodians

To ensure continuity of access, every licensed physician must designate a medical record custodian. Beginning January 1, 2024, a licensee must appoint another North Dakota licensee or an appropriate representative/entity to fulfill record‑keeping duties in the event of death or incapacitation, and must be able to show proof of this appointment to the Board on request. ([regulations.justia.com](https://regulations.justia.com/states/north-dakota/title-50/article-50-01/chapter-50-01-03/section-50-01-03-01/))

Procedures for Provider Transition

When a provider retires, sells a practice, departs a group, or dies, the rule requires three core actions: (1) transfer all charts to a licensee or entity that agrees to act as custodian and uphold patient confidentiality compliance; (2) notify all active patients that records will be transferred and that, with written request, their records will be sent to them or any provider they choose; and (3) notify the Board of Medicine of the custodian’s location and contact information for patient inquiries. These record transfer protocols keep care continuous and compliant. ([regulations.justia.com](https://regulations.justia.com/states/north-dakota/title-50/article-50-01/chapter-50-01-03/section-50-01-03-01/))

Patient Notification and Rights

Under the North Dakota Century Code, a patient (or authorized representative) may request copies of their medical records. For continuation of care, the provider must send a free copy directly to the new, designated provider. Otherwise, maximum copy charges apply: up to $20 for the first 25 pages and $0.75 per page thereafter for paper/fax, or $30 for the first 25 pages and $0.25 per page thereafter for electronic formats; these caps include any administration, retrieval, and postage fees. A signed authorization is required. ([ndlegis.gov](https://ndlegis.gov/cencode/t23c12.pdf?20130326163310=))

For hospitals that discontinue operations, North Dakota’s hospital rule requires public notice in at least two forms and secure off‑site storage with retrieval services for at least 10 years, ensuring patients can still obtain their information. ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-01.1.pdf))

Record Security and Confidentiality Standards

Confidentiality and security expectations are explicit. Hospitals must restrict access to authorized personnel, control disclosures, authenticate entries (including detailed electronic signature controls), and keep records retrievable and complete. Nursing facilities must maintain complete, confidential resident records and permit access and release according to policy, with robust authentication for paper and e‑signature workflows. Extended stay centers must ensure secure maintenance and storage of all patient records. ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-01.1.pdf))

The North Dakota Century Code also confirms that medical records created and maintained electronically are treated as “original” records for evidentiary purposes, supporting compliant use of EHR systems. ([codes.findlaw.com](https://codes.findlaw.com/nd/title-31-judicial-proof/nd-cent-code-sect-31-08-01-3/?utm_source=openai))

Specific Requirements for Nursing Homes

Nursing facilities have detailed retention period regulations and content rules. Discharged residents’ records must be preserved for 10 years; records of deceased residents are kept seven years. For minors, retain through the period of minority and then 10 additional years after live discharge (or seven years after death). Facilities must assign an employee to ensure records are maintained, completed, and preserved, and the governing body must extend retention for records with ongoing research, legal, or medical value. ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-03.2.pdf))

Compliance with North Dakota Administrative Code

• Map your provider type to the correct rule set (e.g., NDAC 33‑07‑01.1 for hospitals, 33‑07‑03.2 for nursing facilities, 33‑03‑36 for extended stay centers, and 50‑01‑03‑01 for physician record retention). ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-01.1.pdf))
• Adopt a written retention schedule that meets or exceeds state rules and reflects your healthcare provider responsibilities.
• Formally appoint a medical record custodian and document coverage for incapacitation, retirement, sale, or death. ([regulations.justia.com](https://regulations.justia.com/states/north-dakota/title-50/article-50-01/chapter-50-01-03/section-50-01-03-01/))
• Standardize record transfer protocols and patient notifications, including continuation‑of‑care requests and fee handling under the North Dakota Century Code. ([ndlegis.gov](https://ndlegis.gov/cencode/t23c12.pdf?20130326163310=))
• Harden security and authentication controls to demonstrate patient confidentiality compliance across paper and electronic records. ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-01.1.pdf))

In short, align your administrative compliance requirements with the North Dakota Administrative Code and the North Dakota Century Code: hospitals generally 10 years, physicians at least seven years, nursing facilities 10 years (with special rules for deceased residents and minors), and extended stay centers five years—backed by clear custodianship, notification, and security practices. ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-01.1.pdf))

FAQs.

What is the minimum retention period for medical records in North Dakota?

It depends on provider type. Physicians must retain records at least seven years from the last date of service. Hospitals must keep records at least 10 years after last treatment (longer for minors), while extended stay centers must retain records at least five years from discharge. Nursing facilities must keep records 10 years after discharge (seven years if the resident is deceased), with added time for minors. ([regulations.justia.com](https://regulations.justia.com/states/north-dakota/title-50/article-50-01/chapter-50-01-03/section-50-01-03-01/))

How must healthcare providers handle records after retirement or death?

Physicians must appoint a medical record custodian and, upon retirement, sale, departure, or death, ensure transfer of records to a custodian held to the same confidentiality standards. Active patients must be notified about the transfer and their option to direct records elsewhere, and the Board must be informed of the custodian’s location and contact information. ([regulations.justia.com](https://regulations.justia.com/states/north-dakota/title-50/article-50-01/chapter-50-01-03/section-50-01-03-01/))

What are the patient rights regarding medical record transfers?

For continuation of care, a patient (or authorized person) can direct a provider to send a free copy of their records to a designated new provider. For personal copies, state‑capped fees apply, and a signed authorization is required. These rights and fees are set in the North Dakota Century Code. ([ndlegis.gov](https://ndlegis.gov/cencode/t23c12.pdf?20130326163310=))

How long must nursing home records be retained?

Nursing facilities must preserve records for 10 years after discharge; if the resident is deceased, seven years. For minors, retain through the period of minority and then 10 additional years after live discharge (or seven years after death). ([legis.nd.gov](https://www.legis.nd.gov/information/acdata/pdf/33-07-03.2.pdf))