offered by
Division of Health Care Facility Licensure and Certification
Bureau of Health Care Safety and Quality
Department of Public Health
related to
Nursing Home Provider Information
Information for Rest Homes

Long Term Care Facility circular letters

See circular letters for Long Term Care Facilities, including nursing homes and rest homes.
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Table of Contents

General Nursing Homes and Rest Homes circular letters

Seasonal influenza vaccination of healthcare personnel 
Circular Letter: DHCQ 18-12-682 Long-Term Care Facility Beds Out of Service – New Process (DOCX 32.56 KB)
Frequently asked questions about beds out of service at open long-term care facilities 
Circular Letter: #17-2-699 Revised Informed Consent for Use of Psychotropic Medications in LTCFs – 2/1/2017 (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 (DOCX 78.13 KB)
Circular Letter: DHCQ 16-11-662 - Admission of Residents on Medication Assisted Treatment for Opioid Use Disorder 
#16-2-654 Dementia Training Requirements for Hospice Staff Providing Care in Nursing Homes 2/1/2016 (DOC 68 KB)
Circular Letter: #16-2-653 Informed Consent for Use of Psychotropic Medications in LTCFs 2/1/2016 (DOC 97.5 KB)
#15-9-641 Revocation and Suspension of Licensure based on Fraudulent Credentials (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 (DOC 75.5 KB)
#13-9-596 New Version of the Nursing Home Consumer Brochure 9/9/2013 (DOC 48.5 KB)
#13-9-595 Long Term Care Facility Respite Care Program 9/9/2013 (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 (DOC 45 KB)
Active Treatment Survey Document/Worksheet (DOC 855.5 KB)
Active Treatment Survey Protocol (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 (RTF 50 KB)
#12-12-577 Electronic Submission of Plans of Correction - 12/10/2012 (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 (DOC 65.5 KB)
#12-02-557 Fire Safety Requirements for Long Term Care Facilities, Mandatory Sprinkler Installation Requirement - 2/27/2012 (RTF 41.5 KB)
#12-01-556 Electronic Transmission of Correspondence - 1/25/2012 (RTF 43.5 KB)
#11-12-552 Use of Electronic Medical Records in Long Term Care Facilities - 12/27/2011 (RTF 45.5 KB)
#11-02-547 Change in Process for Distributing BHCS Circular Letters - Request for Email Contact Information - 2/24/2011 (RTF 60.5 KB)
DHCQ 11-01-545 - Care Transitions and Universal Transfer - 1/18/2011 (RTF 250.46 KB)
Universal Transfer Form and Instructions (RTF 25.4 MB)
#11-01-543 Long Term Care Health Maintenance Guidelines - 1/18/2011 (DOC 48 KB)
Pediatric and Adolescent Resident (XLS 45.5 KB)
Adult Residents Aged 19 to 69 (XLS 38.5 KB)
Elderly Residents Aged 70 or Older (XLS 38.5 KB)
#10-11-540 Infection Prevention during Blood Glucose Monitoring and Insulin Administration - 11/24/2010 (RTF 58 KB)
#10-11-538 Massachusetts DPH Nursing Home Brochure (Revised) - 11/2/2010 (RTF 39 KB)
Control of Influenza and Pneumococcal Disease in Long-Term Care Facilities 2010 - 2011 (RTF 222.5 KB)
#09-11-524 Waiver or Modification of Federal Requirements Under Section 1135 of the Social Security Act - 11/3/2009 (RTF 50 KB)
Attachment A - waiver or modification of requirements (RTF 31 KB)
Attachment B - EMTALA Fact Sheet (RTF 171.5 KB)
Attachment C - Requesting an 1135 Waiver (RTF 47 KB)
#09-04-509 Resident Transfer Agreements - 4/28/2009 (RTF 38 KB)
#08-04-485 LTCF Communications During an Emergency - 4/4/2008 (RTF 952.5 KB)
#07-07-477 Tuberculosis Testing and Treatment for Nursing Homes and Rest Homes - 7/27/2007 (RTF 129.33 KB)
Policy: Tuberculosis Testing and Treatment for Nursing Homes and Rest Homes (RTF 49.05 KB)
Two Step Skin Testing: Nursing Home and Rest Home Residents (RTF 16.43 KB)
Targeted Testing and Treatment of Latent Tuberculosis Infection 
#06-6-464 Comfort Care for Residents in Long Term Care Facilities 8/15/2006 (RTF 237.53 KB)
#06-4-459 Attestation for Continuity of Operations Plans (COOPs) (RTF 190.1 KB)
#05-10-451 Revised Guidelines for Long Term Care Facility Emergency Ambulance Transport Policies 10/14/2005 (RTF 135.19 KB)
#05-09-452 Stock Medications - 9/30/2005 (RTF 106.71 KB)
#05-04-448 Do Not Resuscitate Orders - 4/8/2005 (RTF 54.47 KB)
#4-00-400 Unauthorized Use of DMH Form AA-1 -4/2002 (RTF 214.93 KB)
#02-04-424 Recall of Sprinkler Heads in Health Care Facilities 4/2/2002 (RTF 221.77 KB)
Circular Letter # DHCQ-12-97-373 - NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace - 12/1997 (RTF 11.13 KB)

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

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

Automated external defibrillators (Nursing Homes only)

#05-06-449 Automated External Defibrillators (AEDs) in Nursing Facilities 6/15/2005 (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 (RTF 98.5 KB)
IDR and IIDR Request Cover Sheet (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 (DOC 54 KB)
Oral Morphine Sulfate Conversion Chart - Long-Term Care Facilities - 2006 (RTF 12.2 KB)
#03-04-433 Antipsychotic Medications - 4/2003 (RTF 234.48 KB)
#02-04-425 Medications - 4/16/2002 (RTF 219.8 KB)
#5-97-363 Management of Clostridium difficile - 5/15/1997 (RTF 56 KB)
#8-99-395 Methods to facilitate the appropriate administration of morphine sulfate - 8/9/1999 (RTF 18.17 KB)
#12-98-386 Assessment of the Medication Knowledge of Individuals Administering Medications - 12/21/1998 (RTF 15.99 KB)

Memorandums

Addition of Veteran Status Question for DPH Incident Reporting 
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