Most practice owners I talk to assume Microsoft is quietly keeping a copy of their data somewhere. Microsoft's own documentation says otherwise.
When you delete a departed employee's account, their OneDrive is held for 30 days by default. After that it sits in a deleted state for another 93 days, where only an administrator can pull it back, and only through PowerShell. Once it's permanently deleted, Microsoft is blunt about it: you won't be able to restore it.
Here's the part that catches people. That clock starts when the account is deleted, not on the person's last day. Block their sign-in and nothing counts down. Delete the account months later to stop paying for the license, and a quiet 123-day timer starts on files nobody has opened in a year.
For a medical practice, that's referral letters, the credentialing folder, the scheduling spreadsheet your office manager built that nobody else knows how to rebuild. None of it feels urgent until the morning you need it.
Microsoft keeps the platform running and available. Keeping a recoverable copy of your practice's data is a separate job, and it belongs to you.
The real test isn't whether you have backup. It's whether anyone has ever restored from it. Pick a folder, ask for it back, and time how long it takes.
Worth sorting out before your next cyber renewal.
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