Massachusetts nursing home responsiveness requirements

Any paid caregiver (mandatory reporting individual) with reasonable cause to believe a resident has been abused, neglected, mistreated or had property misappropriated must immediately make an oral report to their supervisor or employer, who must then immediately notify the Department of Public Health by oral communication, electronic report or fax.

Any mandatory reporting individual, as defined in 105 CMR 155.003, shall immediately make an oral report of suspected patient or resident abuse, neglect, mistreatment or misappropriation of patient or resident property to his or her supervisor or employer ... Upon receiving such report, said supervisor or employer shall immediately notify the Department by oral communication, electronically transmitted report or facsimile.

Anyone who makes an oral abuse report to the Department must follow it with a written report containing all the information specified in 105 CMR 155.005 within 48 hours after the oral report.

Any person who makes an oral report of suspected patient or resident abuse, neglect, mistreatment or misappropriation of patient or resident property to the Department pursuant to 105 CMR 155.004(A) or (B) shall also send a written report containing all of the information specified in 105 CMR 155.005 to the Department within 48 hours after making the oral report.

Separate from the individual reporter duty, the facility itself must immediately report to DPH any suspected instance of resident abuse, neglect, mistreatment or misappropriation, must immediately report listed serious events (unanticipated death, full or partial evacuation, fire, suicide, serious criminal act, employee strike, and certain reportable illnesses/outbreaks), and must report within seven days any other incident that seriously affects resident health or safety.

Each facility shall immediately report to the Department any suspected instance(s) of resident abuse, neglect, mistreatment or misappropriation of a resident's personal property, as defined in 105 CMR 155.000 ... Within seven days of the date of occurrence of the event, each facility shall report to the Department any other incident or accident occurring on premises covered by the facility's license that seriously affects the health or safety of a resident(s) or causes serious physical injury to a resident(s).

The statutory basis for the regulation: an enumerated list of paid caregivers with reasonable cause to believe a patient or resident has been abused, mistreated, neglected or had property misappropriated must immediately report to the Department, and if the report is oral must file a written report within 48 hours, with a fine of up to $1,000 for failure and treble damages for retaliation against a reporter.

shall immediately report such abuse, mistreatment or neglect or misappropriation of patient or resident property to the department by electronically transmitted report, facsimile or oral communication and, if by oral communication, by making a written report within 48 hours after such oral communication. Any such person required to make such oral and written reports who fails to do so shall be punished by a fine of not more than $1,000.

Every long-term care facility must have written arrangements for emergency physician services, including a maintained list of names and telephone numbers of emergency physicians, for whenever the resident's own primary care provider is not immediately available, and must log the date, time and circumstances of every call to an emergency physician in the resident's clinical record.

All facilities shall have written arrangements for emergency physician services when the resident's own primary care provider is not immediately available. (1) A list of the names and telephone numbers of emergency physicians.

The address and telephone number of each resident's primary care provider must be recorded in the resident's record and kept readily available to on-duty personnel specifically so it can be used in an emergency.

The addresses and telephone numbers of the resident's primary care provider shall be recorded in the resident's record and be readily available to personnel on duty in case of emergencies.

Level I and Level II facilities must provide a licensed nurse (RN or LPN) on each unit 24 hours a day, seven days a week, plus a full-time director of nurses and a day-shift supervisor of nurses, and must deliver a minimum of 3.580 nursing hours of care per resident per day of which at least 0.508 hours must be provided by a registered nurse.

On and after April 1, 2021, sufficient staffing must include a minimum number of hours of care per resident per day of 3.580 hours, of which at least 0.508 hours must be care provided to each resident by a registered nurse. The facility must provide adequate nursing care to meet the needs of each resident, which may necessitate staffing that exceeds the minimum required PPD.

In Level III and Level IV facilities the nurse aide or responsible person on duty must be readily accessible so residents can easily report injuries, symptoms or emergencies, must ensure prompt action, and the facility must establish mechanisms for that person to summon assistance in an emergency.

The nurse aide or the responsible person on duty in facilities providing Level III or IV care shall be readily accessible so residents can easily report injuries, symptoms, or emergencies. Such person shall be responsible for ensuring appropriate action is taken promptly.

Each floor or unit must have at least one working, lock-free telephone available to staff at all times for emergency incoming and outgoing calls, and the facility must provide residents access to phone service to make calls in private.

(a) There shall be at least one functioning telephone available to staff at all times on each floor or in each unit where patients, residents or personnel reside. These telephones shall be free of locks and shall be available for use in emergency for both incoming and outgoing calls. (b) Facilities shall provide access to phone service to residents to make calls in private.

Facilities must make provision for privacy during residents' telephone conversations and during visits with clergy, relatives and other visitors.

Provisions shall be made for privacy during telephone conversations, during visits with clergymen, relatives or other such visitors.

Every facility must have a written fire and emergency plan developed with local and state fire and safety experts, posted at all nurses' and attendants' stations, specifying persons to be notified, alarm and extinguisher locations, evacuation routes and per-shift task assignments, drilled on all shifts at least twice a year, and must maintain an always-available reliable means of sending incident and emergency information to DPH and receiving information back from DPH and other authorities.

Each facility shall ensure a reliable means is available at all times, in accordance with Department guidelines; for: (a) sending information to the Department regarding incidents and emergencies occurring on the premises; and (b) receiving information from the Department and other state and local authorities in the event of an emergency.

Each facility must maintain, on the premises and current, schedules of names, telephone numbers, dates and alternates for all emergency or on-call personnel.

Schedules of names, telephone numbers, dates and alternates for all emergency or "on call" personnel

The name, address and phone number of each resident's emergency contact must be kept readily available in the resident's chart and that person contacted immediately in an emergency, and the administrator must establish procedures for notifying both the primary care provider and the emergency contact in an emergency.

The name, address and the phone number of the resident's emergency contact shall be kept readily available in the resident's chart. The designated individual shall be contacted immediately in an emergency involving the resident.

A nurse's and attendant's calling station is required at each resident bedside, in each resident toilet, bath and shower room, and in listed common areas; bathroom/shower calls must be emergency calls with a pull cord reachable by a resident lying on the floor; all calls must register at the nurses' station and light a visible corridor signal outside the originating room; and any wireless nurse call used in place of a wired system must comply with UL Standard 1069.

(A) A nurse's and attendant's calling station shall be installed at each resident bedside, in each resident's toilet, bath and shower room, and in the following additional areas: resident dining room, treatment room, physical therapy rooms, special care room, activity rooms, television rooms, and sitting rooms, consultation rooms and beauty parlor and barber shop. (B) The nurse's call in the toilet, bath and shower rooms shall be an emergency call. A nurse's call station pull cord shall be reachable by a resident lying on the floor near each toilet and each shower enclosure.

Level I and Level II facilities must review the services, quality of care and utilization of their facilities through a multidisciplinary utilization review committee (or a Department-approved outside committee) with no member holding a proprietary interest in the facility, and must keep at least one medical care evaluation study in progress at all times to determine the quality and necessity of care provided.

(A) Facilities providing Level I or II care shall review the services, quality of care and utilization of their facilities. ... Reviews shall be made on a continuing basis of all or a sample of residents to determine the quality and necessity of care and services provided and to promote efficient use of health facilities and services. Such studies shall be of appropriate type and duration, and at least one study shall be in progress at all times.