Any report required under 651 CMR 12.04(11)(c) must be filed with the Assisted Living Certification Unit within 24 hours after the occurrence of the incident or accident via EOEA's online filing system (QuickBase).
In the event the online filing system is unavailable, the Residence must submit a temporary report by fax or email, and telephone and formally submit the official report via the online filing system as soon as the service becomes accessible.
The information submitted in the incident report must be accurate and include all details associated with the incident. This requirement is in addition to the requirements of M.G.L. c. 19A, § 15, and of any other applicable law.
Reporting facility wide situations
If any emergency or facility wide situations displaces Residences from their Units for 8 hours or more, the manager of the Residence or his or her designee must immediately submit a report to the EOEA Assisted Living Residence Certification Unit. This report should include at least:
- The name and location of the Residence;
- The nature of the problem;
- The number of Residents displaced;
- The number of Units rendered unusable due to the occurrence, and the anticipated length of time before the Residents may return to them;
- Remedial action taken by the Residence; and
- Other State or local agencies notified about the problem.
Reporting resident-specific emergencies
A Residence must report to EOEA the occurrence of an incident or accident that arises within a Residence or its property, that has or may have a Significant Negative Effect on a resident's health, safety or welfare, as defined by 651 CMR 12.02.
A Significant Negative Effect is assumed whenever, as a result of an incident or accident, any unplanned or unscheduled visit to a hospital or medical treatment is necessary.
What is Significant Negative Effect?
Significant Negative Effect is the consequence of a situation in which a Resident experienced a significant risk of death or serious physical or emotional harm.
The consequences of such situations include, but are not limited to:
- accidental injury
- Unanticipated Death
- suicide or suicide attempt
- a physical or sexual assault by or against a Resident
- a complaint of Resident abuse, suspected Resident abuse, or referral of a complaint of Resident abuse to a local or state authority
- a medication error requiring medical attention
- SAMM or LMA error with an adverse effect requiring medical attention
- elopement with an absence of greater than 30 minutes
- misuse of a Resident's funds by the Residence or its staff
- an outbreak of a serious communicable disease that is listed in 105 CMR 300.100: Diseases Reportable to Local Boards of Health
- pest infestation
- food poisoning as defined in 105 CMR 300.020: Definitions
- fire or structural damage to the Residence