Report incidents at your Assisted Living Residence (ALR)

This method is only for submitting timely Incident Reports if QuickBase is unavailable. 

Reportable incidents must be reported to the Assisted Living Certification Unit (ELD-CU) within 24 hours of the incident.

If ALR staff cannot access QuickBase, for any reason, to make a timely report, ALR staff should take the following steps:

1. Record the information about the incident on the current version of the paper Incident Report Form (get form 1.2 Mar 1, 2013 as a PDF file). Be sure to include the reason that QuickBase was unavailable.

2. Send the form to ELD-CU via either

   • Email to alrincidentreport@state.ma.us, or

   • Fax to at (617) 222-7461

3. Leave a voice-mail notification at

   • (617) 222-7595 for Facility Incident Reports

   • (617) 222-7593 for Residence Incident Reports

After QuickBase is available, within 1 business day, ALR staff should record within QuickBase all Incident Reports sent to ELD-CU by alternate means during the outage.

For each report, indicate in the IR Narrative that the Incident was previously submitted, and the submission date/time.