Contacts
Division of Health Care Facility Licensure and Certification
The Details of Apply for Primary Stroke Service Designation
What you need for Apply for Primary Stroke Service Designation
Hospitals that intend to apply for PSS designation should submit a notice of intent prior to completing an application. The notice of intent should include an estimated date that the hospital will be ready for an onsite survey. Following submission of the notice of intent, the hospital must submit a completed application to the Department.
Prior to submitting the Primary Stroke Service application, hospitals should ensure the all items listed in the Materials List (Doc) are readily available for onsite review, including written protocols that the hospital should develop to assure consistency in the implementation of the Primary Stroke Service.
To request voluntary designation as a provider of Primary Stroke Services, hospitals must:
Complete the Primary Stroke Service Licensure Application (PDF) | (DOCX) and attach comments on additional pages if necessary.
If Primary Stroke Services are to be provided at multiple campuses of the hospital, complete a separate application for each campus.
How to apply Apply for Primary Stroke Service Designation
Return the completed application to:
Department of Public Health
Division of Health Care Facility Licensure and Certification
67 Forest Street
Marlborough, MA 01752
Next steps for Apply for Primary Stroke Service Designation
Site visit
After review of the application, a Department staff member will call the hospital contact person identified on the application to discuss the application and arrange for a site visit. Documents identified on the Primary Stroke Service Licensure Application Materials List (Doc) must be readily available for onsite review by survey staff.