How Long Do Hospitals Keep Medical Records in California?

In California, hospitals must keep an adult patient’s medical records for at least seven years after discharge. For patients treated as minors, the hospital must hold the records until at least one year after the patient turns 18, and never for less than seven years. Those are the floors set by state regulation; some record types carry longer clocks, and federal rules add a second layer for Medicare-related documentation.

The Seven-Year Rule and When the Clock Starts

California’s hospital licensing regulations set the baseline. Under Title 22 of the California Code of Regulations, general acute care hospitals must preserve all patient health records for a minimum of seven years following the patient’s discharge date.¹ The clock starts on discharge, not on the date of a specific test, surgery, or note within the stay. A patient admitted for two weeks in March generates a single retention deadline tied to the day they went home.

Health and Safety Code section 123145 backs the regulation with a statute and closes an obvious loophole: if the facility shuts down, the seven-year obligation follows it. A hospital or clinic that stops operating still has to preserve records for the full period. Patients who lose access because a provider abandoned that duty can sue for damages, and where the provider was a dissolved corporation or partnership, the suit can name the principal officers as of the date of dissolution.²

Medicare-participating hospitals have a separate federal floor of five years under 42 CFR 482.24, but because California’s seven-year minimum is longer, the state rule controls for hospitals here.³ HIPAA, contrary to a common assumption, sets no retention period for the medical record itself. The Department of Health and Human Services has said so directly: “the HIPAA Privacy Rule does not include medical record retention requirements.”⁴

Records for Children and Teenagers

Records for minor patients get a longer window. A hospital must keep them for at least seven years, or until one year after the patient turns 18, whichever period is longer.¹

The two-part test matters for different ages. Records for a child treated at age two stay until the child turns 19 at the earliest, because the age-based endpoint runs longer than seven years. For a teenager treated at 16, the seven-year clock runs past the age endpoint, so the records stay until roughly age 23. Adult day health centers use the same formula.⁵

Some records you’ll want longer than any hospital is required to keep them. The CDC recommends parents and guardians establish a permanent vaccination record for each newborn and keep it themselves.⁶

X-Rays, Mammograms, and Laboratory Specimens

Imaging films aren’t on a shorter clock than the chart. California’s regulation is explicit that exposed X-ray film must be retained for seven years, the same as the rest of the patient record.¹

Mammograms run longer. Under Title 17, Section 30317.50, facilities that perform mammography must retain the images and their reports for at least seven years. If the facility doesn’t take any additional mammograms of that patient, the retention period stretches to ten years.⁷

Laboratory specimens follow separate federal timelines under CLIA, and these clocks apply to the physical material, not the record of the results:

Histopathology slides: at least 10 years from the date of examination.
Cytology slide preparations: at least 5 years from the date of examination.
Pathology specimen blocks: at least 2 years from the date of examination.
Remnants of tissue: preserved until a diagnosis is made on the specimen.⁸

If the Hospital Closes or Your Doctor Retires

A closure doesn’t erase the retention duty. Section 123145 requires a licensed provider that ceases operation to preserve records for the full seven-year minimum, longer for minors, and treats abandoning them as a violation that exposes the provider or its former officers to liability for resulting harm.²

An individual physician who retires operates under a parallel rule. Business and Professions Code section 2266 requires physicians to maintain adequate and accurate records for at least seven years after the last date of service, and failing to do so is unprofessional conduct under the Medical Practice Act.⁹ In practice, a retiring doctor transfers records to another provider or a custodial service and notifies patients. If you get a letter announcing a closure or retirement, act on it. Request your records or confirm where they will be stored before the transition finishes.

Records of Deceased Patients

The seven-year retention period runs from discharge regardless of whether the patient later died. After that period ends, the hospital can lawfully destroy the file. HIPAA separately protects the privacy of a deceased person’s health information for 50 years following death, but that privacy rule doesn’t force any provider to keep the records that long. It simply means that for as long as the provider does hold them, the privacy protections still apply.¹⁰

The personal representative of the estate, typically the executor, can exercise the same access rights the patient would have had, including requesting copies. A provider may also share limited information with family members who were involved in the patient’s care before death, so long as doing so doesn’t conflict with a preference the patient expressed while alive.¹⁰ Broader disclosures require a written HIPAA authorization from the representative.

How to Get Your Records Before They Are Destroyed

Requesting records while they still exist is straightforward, and California sets the deadlines and the fee ceilings.

Making the Request

Submit a written request to the provider, addressed to the Health Information Management department at a hospital or the medical records office at a physician’s practice. Expect to verify your identity and sign a release form before processing begins. You can ask for the whole record or a specific portion.¹¹

How Long the Provider Has to Respond

Health and Safety Code section 123110 sets two deadlines with a subtle but important difference. For in-person inspection, the provider must make records available within five working days of receiving the request. For copies, the provider must transmit them within 15 days. The inspection window counts working days; the copies window counts calendar days.¹²

What the Provider Can Charge

California caps copying fees. Paper copies run up to $0.25 per page, and records copied from microfilm up to $0.50 per page. The provider may add a reasonable clerical fee for the labor involved.¹³ For electronic copies of records that are maintained electronically, a federal guideline allows a flat fee of up to $6.50 per request covering labor, supplies, and postage.¹⁴ Diagnostic imaging films such as X-rays and MRIs are charged at the actual cost of duplication rather than the per-page rate.¹⁵

Once the Retention Period Ends

When the seven-year period runs out, the provider can destroy the record. California does not require any advance notice to individual patients before that happens. If you know you may need documentation later, for ongoing treatment, a legal claim, insurance, or family medical history, request copies before the deadline approaches. Records worth keeping for the long term, such as immunizations, surgical reports, and documentation of chronic conditions, are worth storing yourself. The provider’s duty to hold your record has an end date; your need for the information often does not.

1
Cornell Law School. California Code of Regulations Title 22, 72543 – Patients Health Records
2
California Legislative Information. California Health and Safety Code HSC 123145
3
eCFR. 42 CFR 482.24 – Condition of Participation Medical Record Services
4
U.S. Department of Health & Human Services. Does HIPAA Require Covered Entities to Keep Medical Records for Any Period
5
Cornell Law School. California Code of Regulations Title 22, 78435 – Retention of Records
6
Centers for Disease Control and Prevention. Vaccination Records
7
CDPH. X-Ray Image and Report (Medical Records) Retention
8
eCFR. 42 CFR 493.1105 – Standard Retention Requirements
9
California Legislative Information. California Business and Professions Code 2266
10
U.S. Department of Health & Human Services. Health Information of Deceased Individuals
11
Medical Board of California. Patient Access to Medical Records
12
California Legislative Information. California Health and Safety Code 123110
13
California Legislative Information. California Health and Safety Code HSC 123110
14
U.S. Department of Health & Human Services. Is 6.50 the Maximum Amount That Can Be Charged to Provide Individuals With a Copy of Their PHI
15
Medical Board of California. FAQs – Complaint Medical Records