(a) (1) An APRN licensed under this chapter shall provide notice under this section to all affected patients no less than 30 days before doing any of the following:
a. Discontinuing a medical practice in this State when the APRN is not transferring patient records to another health-care provider in this State.
b. Terminating a patient relationship.
(2) The notice required under paragraph (a)(1) of this section must include all of the following:
a. How the patient can obtain the patient’s records.
b. The name, phone number, and address of other health-care providers in the area who may be available to accept new patients who require that medical care.
c. The date the APRN will discontinue services.
(3) The notice required under paragraph (a)(1) of this section must be provided by all of the following:
a. If the patient is enrolled to receive messages through an electronic medical record system, an electronic message through that system.
b. A letter sent by first-class mail.
(4) When an APRN is closing a medical practice and patient medical records will no longer be available at the APRN’s place of business, the APRN shall provide to the Board of Nursing notice of how former patients may obtain the patient’s records.
(b) (1) If an APRN dies and has not transferred patient records to another health-care provider and has not made provisions for a transfer of patient records to occur upon the APRN’s death, a personal representative of the APRN’s estate shall provide notice to the deceased APRN’s patients of record by doing all of the following:
a. Publishing a notice to that effect in a newspaper of general circulation in the area where the deceased APRN practiced. The notice must be published at least 1 time per month in the 3-month period after the APRN’s death.
b. Providing notice to all patients of record who have not requested records 30 days after publication of the first notice under paragraph (b)(1)a. of this section by all of the following:
1. If the patient is enrolled to receive messages through an electronic medical record system, an electronic message through that system.
2. A letter sent by first-class mail.
(2) The notice required under paragraph (b)(1) of this section must include all of the following:
a. That the APRN has died.
b. How the patient can obtain the patient’s records.
(3) The personal representative of the person’s estate shall provide the Board of Nursing notice of how former patients may obtain the patient’s records.
(c) (1) If a patient changes from the care of an APRN to another health-care provider, the APRN shall transfer the patient’s records to the new health-care provider upon the request of the patient or the new health-care provider with the patient’s written consent.
(2) If the patient and APRN agree, the APRN may forward a summary of the patient’s record to the new health-care provider in lieu of transferring the entire record, at no charge to the patient.
(d) (1) Patients have the right to obtain a copy of their records from an APRN.
(2) Unless a patient is requesting a copy of their records under subsection (a) or (b) of this section or to make or complete an application for a disability benefits program, a patient who requests a copy of their records is subject to any of the following charges:
a. The reasonable expenses of copying the patient’s records, according to the payment schedule under paragraph (d)(3) of this section.
b. The actual cost of postage or shipping, if the records are mailed or shipped.
c. Charges for copies of records not susceptible to photostatic reproduction, such as radiology films, models, photographs, or fetal monitoring strips, may be the full cost of the reproduction.
(3) The Delaware Board of Nursing shall establish a payment schedule for copies of patient records under this section and must review this payment schedule annually.
(4) The APRN or their third-party release-of-information service may require payment of all costs under paragraph (d)(2) of this section before providing the copies of the records.
(e) This section does not apply to an APRN who has seen or treated a patient on referral from another health-care provider and who has provided a copy of the record of the diagnosis or treatment to at least 1 of the following:
(1) The referring health-care provider.
(2) A hospital or an agency that has provided treatment for the patient.
(f) An APRN has 45 days from the closure of the record or the assembly of a complete record to fulfill a request for records, unless a faster response is medically necessary.
(g) (1) An APRN may permanently dispose of a patient’s record in a manner that ensures confidentiality of the records 7 years after the following:
a. Discontinuing business in this State.
b. The last entry date in the patient’s record after terminating the patient relationship or the patient changes from the care of the APRN to another health-care provider.
(2) Seven years after the death of an APRN, the APRN’s personal representative may permanently dispose of patient records that have not been procured, in a manner that ensures confidentiality of the records.
(3) An APRN or the personal representative of the APRN who disposes of patient records in accordance with this section is not liable for any direct or indirect loss suffered as a result of the disposal of a patient’s records.
(h) The Delaware Board of Nursing may find that an APRN who violates this section has committed unprofessional conduct, and any aggrieved patient or the patient’s personal representative may bring a civil action for damages or injunctive relief, or both, against the violator.