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Long Term Care Facility circular letters

See circular letters for Long Term Care Facilities, including nursing homes and rest homes.
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General Nursing Homes and Rest Homes circular letters

Memo Dated May 22, 2025: Number of Beds Per Resident Bedroom in Nursing Homes, Open DOCX file, 49.1 KB (English, DOCX 49.1 KB)
Waiver Attestation Form: Number of Beds Per Resident Bedroom in Nursing Homes, Open DOCX file, 90.02 KB (English, DOCX 90.02 KB)
Memo Dated August 14, 2025: Updated Admission of Residents on Medication for Opioid Use Disorder (MOUD) to Long-Term Care Facilities
Memo dated November 18, 2022: DPH Limits on Admissions for Outbreaks or Clusters in Long-Term Care Facilities
Memo dated October 29, 2021 – DPH Guidance to Nursing Homes on Good Faith Efforts to Meet Deadline for Compliance with Resident Bedroom 2-Bed Maximum Requirement
Nursing Home Good Faith Efforts Attestation, Open DOCX file, 73.81 KB (English, DOCX 73.81 KB)
Memo dated 10/13/2021 – Fines for Violations of State Long-term Care Facility Regulations
Memo: Tuberculosis Screening, Testing and Treatment of Healthcare Personnel – November 2019
Circular Letter: DHCQ 19-11-693 Clarification of the Meaning of “Ambulatory” in 105 CMR 150.000, Standards for Long-Term Care Facilities
Seasonal influenza vaccination of healthcare personnel
Circular Letter: #17-2-699 Revised Informed Consent for Use of Psychotropic Medications in LTCFs – 2/1/2017, Open DOCX file, 68.99 KB (English, DOCX 68.99 KB)

This letter describes revised and updated policies that replace the policies and guidance published in the February 1, 2016 Circular Letter: DHCQ 16-2-653

Circular Letter: DHCQ 17-1-668 Implementation of the STEP Law: Voluntary Non-Opioid Directive Form – 1/24/2017 - English, Open DOCX file, 78.13 KB (English, DOCX 78.13 KB)
#16-2-654 Dementia Training Requirements for Hospice Staff Providing Care in Nursing Homes 2/1/2016, Open DOC file, 68 KB (English, DOC 68 KB)
Circular Letter: #16-2-653 Informed Consent for Use of Psychotropic Medications in LTCFs 2/1/2016, Open DOC file, 97.5 KB (English, DOC 97.5 KB)
#15-9-641 Revocation and Suspension of Licensure based on Fraudulent Credentials, Open DOC file, 44.5 KB (English, DOC 44.5 KB)
#13-9-599 Compliance with web-based reporting of incidents and abuse using the Health Care Facility Reporting System (HCFRS) 9/17/2013, Open DOC file, 75.5 KB (English, DOC 75.5 KB)
#13-9-596 New Version of the Nursing Home Consumer Brochure 9/9/2013, Open DOC file, 48.5 KB (English, DOC 48.5 KB)
#13-9-595 Long Term Care Facility Respite Care Program 9/9/2013, Open DOC file, 54.5 KB (English, DOC 54.5 KB)
#13-7-592 Department of Public Health, MassHealth, and Department of Developmental Services Active Treatment Licensure Survey Process 7/17/2013, Open DOC file, 45 KB (English, DOC 45 KB)
Active Treatment Survey Document/Worksheet, Open DOC file, 855.5 KB (English, DOC 855.5 KB)
Active Treatment Survey Protocol, Open DOC file, 118 KB (English, DOC 118 KB)
#12-12-581 Informational Bulletin on the MA Collaborative for Resident-Centered Care and the Reduction in the use of unnecessary Antipsychotic medications for (LTC) residents - 12/10/2012, Open RTF file, 50 KB (English, RTF 50 KB)
#12-12-577 Electronic Submission of Plans of Correction - 12/10/2012, Open RTF file, 41 KB (English, RTF 41 KB)
#12-11-576 Transition to web-based reporting of incidents and abuse using the Health Care Facility Reporting System (HCFRS) - 11/5/2012, Open DOC file, 65.5 KB (English, DOC 65.5 KB)
#12-02-557 Fire Safety Requirements for Long Term Care Facilities, Mandatory Sprinkler Installation Requirement - 2/27/2012, Open RTF file, 41.5 KB (English, RTF 41.5 KB)
#12-01-556 Electronic Transmission of Correspondence - 1/25/2012, Open RTF file, 43.5 KB (English, RTF 43.5 KB)
#11-12-552 Use of Electronic Medical Records in Long Term Care Facilities - 12/27/2011, Open RTF file, 45.5 KB (English, RTF 45.5 KB)
DHCQ 11-01-545 - Care Transitions and Universal Transfer - 1/18/2011, Open RTF file, 250.46 KB (English, RTF 250.46 KB)
Universal Transfer Form and Instructions, Open RTF file, 25.4 MB (English, RTF 25.4 MB)
#11-01-543 Long Term Care Health Maintenance Guidelines - 1/18/2011, Open DOC file, 48 KB (English, DOC 48 KB)
Pediatric and Adolescent Resident, Open XLS file, 45.5 KB (English, XLS 45.5 KB)
Adult Residents Aged 19 to 69, Open XLS file, 38.5 KB (English, XLS 38.5 KB)
Elderly Residents Aged 70 or Older, Open XLS file, 38.5 KB (English, XLS 38.5 KB)
#10-11-540 Infection Prevention during Blood Glucose Monitoring and Insulin Administration - 11/24/2010, Open RTF file, 58 KB (English, RTF 58 KB)
#10-11-538 Massachusetts DPH Nursing Home Brochure (Revised) - 11/2/2010, Open RTF file, 39 KB (English, RTF 39 KB)
#09-11-524 Waiver or Modification of Federal Requirements Under Section 1135 of the Social Security Act - 11/3/2009, Open RTF file, 50 KB (English, RTF 50 KB)
Attachment A - waiver or modification of requirements, Open RTF file, 31 KB (English, RTF 31 KB)
Attachment B - EMTALA Fact Sheet, Open RTF file, 171.5 KB (English, RTF 171.5 KB)
Attachment C - Requesting an 1135 Waiver, Open RTF file, 47 KB (English, RTF 47 KB)
#09-04-509 Resident Transfer Agreements - 4/28/2009, Open RTF file, 38 KB (English, RTF 38 KB)
#08-04-485 LTCF Communications During an Emergency - 4/4/2008, Open RTF file, 952.5 KB (English, RTF 952.5 KB)
#06-6-464 Comfort Care for Residents in Long Term Care Facilities 8/15/2006, Open RTF file, 237.53 KB (English, RTF 237.53 KB)
#06-4-459 Attestation for Continuity of Operations Plans (COOPs), Open RTF file, 190.1 KB (English, RTF 190.1 KB)
#05-10-451 Revised Guidelines for Long Term Care Facility Emergency Ambulance Transport Policies 10/14/2005, Open RTF file, 135.19 KB (English, RTF 135.19 KB)
#05-09-452 Stock Medications - 9/30/2005, Open RTF file, 106.71 KB (English, RTF 106.71 KB)
#05-04-448 Do Not Resuscitate Orders - 4/8/2005, Open RTF file, 54.47 KB (English, RTF 54.47 KB)
#4-00-400 Unauthorized Use of DMH Form AA-1 -4/2002, Open RTF file, 214.93 KB (English, RTF 214.93 KB)
#02-04-424 Recall of Sprinkler Heads in Health Care Facilities 4/2/2002, Open RTF file, 221.77 KB (English, RTF 221.77 KB)
Circular Letter # DHCQ-12-97-373 - NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace - 12/1997, Open RTF file, 11.13 KB (English, RTF 11.13 KB)

Beds Out of Service

Permanent Reduction in LTCF Number of Beds and Enforcement of Requirements, Open DOCX file, 32.05 KB (English, DOCX 32.05 KB)
Circular Letter: DHCQ 18-12-682 Long-Term Care Facility Beds Out of Service – New Process, Open DOCX file, 32.56 KB (English, DOCX 32.56 KB)
FAQs about Beds at Open Long-term Care Facilities – Temporarily or Permanently Out of Service

Memorandums

Addition of Veteran Status Question for DPH Incident Reporting

Medical Orders for Life-Sustaining Treatment (MOLST) – for nursing homes and rest homes

Massachusetts will be transitioning away from the use of the current MOLST (Medical Orders for Life Sustaining Treatment) form to the National POLST model. The MOLST form is still valid and should be used to document patients’ wishes until further notice. Please see this website for more information: MOLST Transition to POLST

MOLST and Comfort Care DNR Verification

Additional circular letters for nursing homes only - General

#15-08-639 Dementia Special Care Unit Disclosure Statement Updated Instructions 08/21/2015, Open DOC file, 102.5 KB (English, DOC 102.5 KB)
#15-02-628 Dementia Special Care Unit Annual Disclosure Statement 2/12/2015, Open DOC file, 105.5 KB (English, DOC 105.5 KB)
#14-5-615 Guidelines for Dementia Special Care Unit Regulations 5/22/2014, Open DOC file, 143.5 KB (English, DOC 143.5 KB)
Updated Information Concerning Circular Letter: DHCQ 13-11-604 12/9/2013, Open DOC file, 44.5 KB (English, DOC 44.5 KB)
Frequently Asked Questions about the Nurse Aide Registry, Open DOC file, 36.76 KB (English, DOC 36.76 KB)
#13-11-604 Changes to the Nurse Aide Registry Verification Process and Statement of Deficiency/Plan of Correction Process - 11/20/2013, Open DOC file, 42.5 KB (English, DOC 42.5 KB)
#13-9-597 Additional Section S questions effective 10/1/2013: Unnecessary use of Antipsychotic Medications 9/9/2013, Open DOC file, 42.5 KB (English, DOC 42.5 KB)
MDS Section S Manual, Open DOC file, 113 KB (English, DOC 113 KB)
#13-01-584 MDS 3.0 Section Q: Return to the Community Nursing Home Responsibilities to refer to a Local Contact Agencies - 1/23/2013, Open RTF file, 58.5 KB (English, RTF 58.5 KB)
#08-12-503 Final Deadline for Broadband Conversion for MDS/OASIS Connectivity - 12/16/2008, Open PDF file, 29.04 KB (English, PDF 29.04 KB)
#08-05-488 Cardiopulmonary Resuscitation in LTCFs with 24 Hour Skilled Nursing Staff On Duty, Open RTF file, 138.15 KB (English, RTF 138.15 KB)
Advisory Ruling on the Initiation and Withholding of Cardiopulmonary Resuscitation in Massachusetts Long-term Care Facilities with 24-hour Skilled Nursing Staff on Duty, Open RTF file, 182.99 KB (English, RTF 182.99 KB)
Nursing Competencies Related to Advisory Ruling, Open RTF file, 66.28 KB (English, RTF 66.28 KB)
Task Force Final Report, Open RTF file, 452.77 KB (English, RTF 452.77 KB)
#08-04-487 Broadband Conversion for MDS/OASIS Submissions and CASPER Reporting Connectivity - 4/29/2008, Open RTF file, 145.28 KB (English, RTF 145.28 KB)
#08-03-484 Use of Cameras During the Survey Process - 3/25/2008, Open RTF file, 151.19 KB (English, RTF 151.19 KB)
CMS Memorandum S&C-06-33 (provided by CMS)
Consent to Photograph Form, Open RTF file, 17.49 KB (English, RTF 17.49 KB)
Survey Photo Log, Open RTF file, 70.83 KB (English, RTF 70.83 KB)
#08-01-480 Resident Empowerment Program& VIII - Request for Response - 1/2008, Open RTF file, 140.16 KB (English, RTF 140.16 KB)
Request for Response (RFR), Open RTF file, 81.03 KB (English, RTF 81.03 KB)
#07-02-473 Emergency Preparedness at Long Term Care Facilities - 2/7/2007, Open RTF file, 64.31 KB (English, RTF 64.31 KB)
LTC Facility Survey Guidance and Provider Attestation Tool, Open RTF file, 349.91 KB (English, RTF 349.91 KB)
#12-04-447 Family Councils in Nursing Homes - 1/4/2005, Open RTF file, 128.05 KB (English, RTF 128.05 KB)
#12-04-447 - Attachment A, Open RTF file, 7.84 KB (English, RTF 7.84 KB)
#03-12-437 Paid Assisted Feedings - 12/2003, Open RTF file, 111.04 KB (English, RTF 111.04 KB)
#01-06-412 Standing Orders - 6/2001, Open RTF file, 215.56 KB (English, RTF 215.56 KB)
#12-00-407 Nursing Home Residents with Mental Retardation or Developmental Disability - 12/2000, Open RTF file, 217.44 KB (English, RTF 217.44 KB)

Automated external defibrillators (Nursing Homes only)

#05-06-449 Automated External Defibrillators (AEDs) in Nursing Facilities 6/15/2005, Open RTF file, 79.64 KB (English, RTF 79.64 KB)

Dispute resolution (Nursing Homes only)

#11-12-554 Informal Dispute Resolution (IDR) and Independent Informal Dispute Resolution (IIDR) - 12/27/2011, Open RTF file, 98.5 KB (English, RTF 98.5 KB)
IDR and IIDR Request Cover Sheet, Open RTF file, 50 KB (English, RTF 50 KB)

Medications (Nursing Homes only)

#18-6-679 Controlled Substances in Schedule II-V Approved for Inclusion in Long Term Care Facilities Emergency Kits, Open DOC file, 54 KB (English, DOC 54 KB)
#03-04-433 Antipsychotic Medications - 4/2003, Open RTF file, 234.48 KB (English, RTF 234.48 KB)
#02-04-425 Medications - 4/16/2002, Open RTF file, 219.8 KB (English, RTF 219.8 KB)
#5-97-363 Management of Clostridium difficile - 5/15/1997, Open RTF file, 56 KB (English, RTF 56 KB)
#8-99-395 Methods to facilitate the appropriate administration of morphine sulfate - 8/9/1999, Open RTF file, 18.17 KB (English, RTF 18.17 KB)
#12-98-386 Assessment of the Medication Knowledge of Individuals Administering Medications - 12/21/1998, Open RTF file, 15.99 KB (English, RTF 15.99 KB)

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