For decades, Plain Old Telephone Service (POTS) lines have quietly underpinned some of the most critical functions in healthcare facilities—from faxing patient records to enabling elevator emergency calls and connecting fire alarms. But a seismic shift is underway: U.S. telecommunications carriers are rapidly retiring copper networks, spurred by Federal Communications Commission (FCC) deregulation and the relentless march of digital transformation.
This transition is not just a matter of swapping out phone lines; it’s a foundational change that impacts compliance, patient safety, operational resilience, and cost structures across the healthcare sector. As the “copper sunset” accelerates, healthcare leaders must understand both the risks of inaction and the opportunities of modernization.
The decline of POTS has been years in the making. Regulatory changes have steadily loosened requirements for carriers to maintain analog copper infrastructure. In March 2025, the FCC further relaxed regulations, waiving obligations for standalone voice service and costly notification periods when retiring copper. This has enabled carriers to accelerate network upgrades to fiber, wireless, and IP-based technologies.
The business case for this shift is clear: maintaining aging copper networks is expensive, environmentally vulnerable, and increasingly unreliable. For many facilities, this translates into skyrocketing monthly costs (often exceeding $1,000 per line), deteriorating service quality, and shrinking support from carriers. For healthcare organizations, the stakes are even higher due to the mission-critical nature of many POTS-dependent systems.
However, healthcare faces unique challenges compared to other industries when it comes to retiring copper networks. Compliance risks are at the forefront, as many healthcare communications—such as faxing patient records—must adhere to HIPAA and other privacy regulations. Outages or delays in these services can jeopardize both regulatory compliance and patient care. Life safety systems present another layer of complexity. Elevator phones, fire and burglar alarms, and emergency call boxes often still rely on analog lines. Failures in these systems are not merely inconvenient—they can be life-threatening and result in substantial fines for non-compliance. Operational disruption is also a significant concern, as legacy systems may not be easily migrated to digital alternatives, especially when device compatibility varies across locations and manufacturers.
Navigating the Transition: Risks, Rewards, and Readiness
Healthcare organizations that delay addressing the copper sunset face mounting risks that go far beyond rising costs. As carriers accelerate the retirement of POTS lines, monthly rates for remaining analog services continue to climb—sometimes by double digits each year. Meanwhile, service quality is declining as support contracts and Service Level Agreements (SLAs) disappear, leading to more frequent outages and longer repair times. For healthcare providers, these disruptions can have severe consequences. Non-functional alarm or emergency lines may result in immediate regulatory violations and fines that can quickly escalate into thousands of dollars per hour. With notice periods for disconnection now dropping to as little as 90 days, organizations that lack a transition plan risk being caught off guard, potentially leaving critical systems offline and jeopardizing patient safety and compliance.
Yet, this period of upheaval also presents an opportunity for meaningful modernization. Transitioning away from POTS is not just about cost reduction—though digital alternatives do offer significant savings. Modern solutions deliver enhanced reliability and redundancy, leveraging IP-based and wireless technologies with built-in failover, remote monitoring, and proactive maintenance. These features minimize downtime for mission-critical systems and provide peace of mind for healthcare leaders. Digital platforms are also better equipped to meet today’s stringent compliance requirements, offering encryption, audit trails, and access controls essential for HIPAA and other standards. Operational efficiency improves dramatically through centralized management, real-time reporting, and seamless integration with cloud-based applications, streamlining workflows and supporting higher-quality patient care. Importantly, digital infrastructure is scalable, enabling healthcare organizations to adapt quickly as they grow or consolidate—a flexibility that fixed copper lines simply cannot match.
To navigate this transition successfully, healthcare organizations should begin with a comprehensive audit of their dependencies. This means identifying every system—fax machines, alarms, elevators, point-of-sale terminals, and more—that still relies on analog lines, and determining which are mission-critical versus those that can be consolidated or retired. Collaboration across departments is key; facilities managers, IT professionals, compliance officers, and clinical leadership must work together to assess needs and set priorities. Evaluating available alternatives—including VoIP, cellular, fiber, and managed wireless solutions—requires careful attention to compatibility with existing devices and regulatory obligations. Planning for business continuity is essential, ensuring that any new solution incorporates redundancy, remote monitoring, and rapid support to prevent disruptions. Finally, investing in staff education and training will help ensure a smooth transition, as user adoption and awareness are crucial, especially among IT and facilities personnel.
Beyond addressing immediate risks, the end of POTS lines presents healthcare organizations with a valuable opportunity to modernize their communications infrastructure and enhance operational efficiency. By proactively assessing current dependencies and developing a thoughtful migration plan, organizations can leverage advanced digital solutions that not only safeguard critical services today but also lay the groundwork for greater resilience and adaptability in the future. Taking action now ensures continuity, supports compliance, and positions healthcare providers to meet evolving demands with confidence.
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About Max Silber
Max Silber is responsible for MetTel’s mobility operations, technology and business development initiatives across the private and public sectors. He is a member of the Forbes Technology Council, hosts the Techie & the Biz podcast and represents MetTel at industry events.
