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Long-Term Care Facilities Checklists

Compliance checklists for use with projects in long-term care facilities

These checklists are derived from long-term care licensure regulations 105 CMR 150.000, entitled "Licensing of Long Term Care Facilities," as well as relevant parts of Chapter 111 of Massachusetts General Laws (specific sections indicated in each checklist).

Applicants must verify project compliance with all licensure requirements when filling out these checklists, and must include the DPH affidavit when submitting project documents for self-certification or abbreviated review.

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Checklists - PDF version

LTC1. LTCF – Level II & Level III Nursing Unit, Open PDF file, 591.03 KB (English, PDF 591.03 KB)
LTC2. LTCF – Level IV Resident Care Unit, Open PDF file, 80.8 KB (English, PDF 80.8 KB)
LTC3. LTCF – Common Areas, Open PDF file, 90.51 KB (English, PDF 90.51 KB)
LTC4. LTCF – Hospital Based, Open PDF file, 92.59 KB (English, PDF 92.59 KB)

Checklists - Word Document version

LTC1. LTCF – Level II & Level III Nursing Unit, Open DOCX file, 73.93 KB (English, DOCX 73.93 KB)
LTC2. LTCF – Level IV Resident Care Unit, Open DOCX file, 64.74 KB (English, DOCX 64.74 KB)
LTC3. LTCF – Common Areas, Open DOCX file, 86.05 KB (English, DOCX 86.05 KB)
LTC4. LTCF – Hospital Based, Open DOCX file, 90.78 KB (English, DOCX 90.78 KB)

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