Wrapping Up the Right Way: Handling Patients and Records When Closing a Dental Practice

Jordan Uditsky • October 12, 2022

When looking ahead towards retirement and the next chapter in life, many dentists will plan to sell their practice to another dentist or perhaps to a DSO. But plenty of dentists decide that closing-up shop and locking the door behind them is the better course of action when moving on. Nothing wrong with that, of course, so long as the practice owner does right by their patients, including providing them with proper notice and handling of their records in accordance with their legal and ethical obligations.

 

Closing a practice, especially after years or decades of serving patients and the community, is no small decision and no simple process. As such, a foundational step in wrapping up a practice is assembling a team of trusted professionals – attorneys, accountants, and financial professionals – who have experience in the dental space and can ensure that all issues are fully considered and addressed.

 

Sharing The News With Patients

 

Once an owner has decided to close their practice, one of the top priorities is breaking the news to their patients.

 

While sooner rather than later is always preferable, most state laws require that health care practitioners, including dentists, provide both their patients and the public at large with notice prior to closing their practice. For example, Illinois law (735 ILCS 5/8-2001(f)) requires at least 30 days prior notice of closure, and that the notice  include an explanation of how patients can access copies of their records. In addition to letters sent to active patients of record, the law allows notice to be given “by publication in a newspaper of general circulation in the area in which the health care facility or health care practitioner is located.”

 

The American Dental Association (ADA) has produced the following sample letter that practice owners can send to patients when announcing a closing:

 

Dear [Patient]:

 

Our records indicate that you are a patient of record at this dental office. Due to (give a reason, if possible) this office will be closing on (date). It has been our pleasure to serve your dental needs and we thank you for your patronage. You should begin looking for another dentist. Oftentimes, the recommendation of friends and relatives or contacting the local dental society, are ways of locating another dentist. With your permission, copies of the pertinent information from your record can be made available to a dentist of your choosing. Please do not hesitate to telephone us during normal business hours before the last scheduled day, if you have questions.

 

After the closing date, all inquiries about the records or other matters should be directed to (name of custodian) located at ____. Again, thank you for having been a part of this practice.

 

Sincerely,

DDS or agent of the dentist

 

The ADA also has a sample newspaper announcement that owners can use to provide notice to the public:

 

The dental office of Dr. _located at phone number is closing on (date) due to (give a reason, if possible). We thank you for your patronage. It has been our pleasure to serve your dental needs.

 

At your request, copies of the pertinent information from your record can be made available to a dentist of your choosing. If you wish to make a request regarding your patient record, please contact the office before the permanent closing day, as we shall need your written authorization to make your records available to another dentist. After that day, you will have to direct your inquiry about the record to (name of dentist or record custodian)__, located at _.

 

Patient Record Retention and Release

 

The other main obligation of practice owners to their patients when shutting down their practices is handling, transferring, and maintaining patient records and protected health information (PHI).

 

Again, in Illinois dentists must maintain patient records for ten years. When closing their practice, many owners retain third-party custodians to store their records and address patient requests. Any owner seeking to use such an outside custodian should ensure that the vendor specializes in medical records such that they understand and comply with HIPAA and other relevant laws and requirements regarding patient privacy.

 

Whether they hire an outside vendor or maintain the records themselves, practice owners are allowed to charge a reasonable reimbursement fee for reproducing and transferring records to another practice upon the patient’s request. As the ADA notes, however, “failure (or refusal) to release necessary information to another dentist for a patient’s continuing care may be illegal and may be viewed as an unethical practice… You should not refuse to release a patient’s treatment information or records due to an outstanding payment.”

 

Before transferring records to another practitioner, it is prudent to obtain the patient’s written consent. The patient can be provided with a simple release form for transfer of the records to either the patient or another health care provider. To be signed by the patient, this release form should specify:

 

  • Patient's name and identifying information
  • Address of the health care professional or institution directed to release the information
  • Description of the information to be released
  • Identity of the party to be furnished the information
  • Language authorizing the release of information
  • Signature of patient or authorized individual
  • The period for which release remains valid

 

Of course, patient notification and record retention and transfer issues are not the only matters that owners must address when closing their practice. It is a multifaceted and multistep process that practice owners should not undertake without experienced counsel on their team.

 

At Grogan, Hesse & Uditsky, P.C., we focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you.

 

If you are considering closing your dental practice, please call us at (630) 833-5533 or contact us online to arrange for your free initial consultation.

 

Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices, and this blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals. 


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This structure enables talented but liquidity-challenged associates to become owners without initial financial strain. It also incentivizes them to grow the practice and stay long-term. Shadow Account (a/k/a Phantom Equity) As I discussed in detail in this post , a shadow account (also known as a phantom equity plan) is an increasingly popular buy-in model, especially when the owner is not yet ready to transfer real equity but wants to reward the associate as if they were an owner. In this model, the associate receives the right to cash payments equal to the value of the shares at a specified later date or distribution event. That value can be established through an appraisal or an agreed-upon formula. The selected events that give an associate a right to a payout can include such things as achieving performance goals, termination, or retirement. There are two types of shadow account/phantom stock plans. In an "appreciation only” plan, the cash payout upon vesting does not include the value of the underlying shares, only the increase in value of that stock since it was granted. In a “full value” plan, the practice pays both the underlying value of the stock and the amount the stock has appreciated while held by the associate. Like actual stock, phantom stock has a defined value and tracks the practice’s performance, but an associate holding phantom stock typically does not have either minority shareholder rights or voting rights in the practice. This makes phantom stock plans attractive for owners who want to provide associates with a sense of equity ownership without giving up any actual control. The practice has broad discretion and flexibility in designing the plan, including valuation formulas and vesting conditions, and the administrative burdens are less than for traditional stock option plans. As noted, the “best” buy-in structure depends on the unique goals of both parties. No matter which model is ultimately adopted, well-crafted documentation, preceded by careful consideration and consultation with counsel, is essential. That is because these deals do more than just transfer ownership - they can lay the foundation for a stable, profitable partnership that preserves the practice’s legacy and rewards everyone’s investment, financial or otherwise. We Focus on You So You Can Focus on Your Patients At Grogan Hesse & Uditsky, P.C., we focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you. Please call us at (630) 833-5533 or contact us online to arrange for your free initial consultation. 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