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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 November 18, 2022: DPH Limits on Admissions for Outbreaks or Clusters in Long-Term Care Facilities 
Memo Dated September 12, 2022: Updated Admission of Residents on Medication for Opioid Use Disorder (MOUD) to 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 
Open DOCX file, 73.81 KB,  Nursing Home Good Faith Efforts Attestation (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 
Open DOCX file, 68.99 KB,  Circular Letter: #17-2-699 Revised Informed Consent for Use of Psychotropic Medications in LTCFs – 2/1/2017 (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

Open DOCX file, 78.13 KB,  Circular Letter: DHCQ 17-1-668 Implementation of the STEP Law: Voluntary Non-Opioid Directive Form – 1/24/2017 - English (English, DOCX 78.13 KB)
Open DOC file, 68 KB,  #16-2-654 Dementia Training Requirements for Hospice Staff Providing Care in Nursing Homes 2/1/2016 (English, DOC 68 KB)
Open DOC file, 97.5 KB,  Circular Letter: #16-2-653 Informed Consent for Use of Psychotropic Medications in LTCFs 2/1/2016 (English, DOC 97.5 KB)
Open DOC file, 44.5 KB,  #15-9-641 Revocation and Suspension of Licensure based on Fraudulent Credentials (English, DOC 44.5 KB)
Open DOC file, 75.5 KB,  #13-9-599 Compliance with web-based reporting of incidents and abuse using the Health Care Facility Reporting System (HCFRS) 9/17/2013 (English, DOC 75.5 KB)
Open DOC file, 48.5 KB,  #13-9-596 New Version of the Nursing Home Consumer Brochure 9/9/2013 (English, DOC 48.5 KB)
Open DOC file, 54.5 KB,  #13-9-595 Long Term Care Facility Respite Care Program 9/9/2013 (English, DOC 54.5 KB)
Open DOC file, 45 KB,  #13-7-592 Department of Public Health, MassHealth, and Department of Developmental Services Active Treatment Licensure Survey Process 7/17/2013 (English, DOC 45 KB)
Open DOC file, 855.5 KB,  Active Treatment Survey Document/Worksheet (English, DOC 855.5 KB)
Open DOC file, 118 KB,  Active Treatment Survey Protocol (English, DOC 118 KB)
Open RTF file, 50 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 (English, RTF 50 KB)
Open RTF file, 41 KB,  #12-12-577 Electronic Submission of Plans of Correction - 12/10/2012 (English, RTF 41 KB)
Open DOC file, 65.5 KB,  #12-11-576 Transition to web-based reporting of incidents and abuse using the Health Care Facility Reporting System (HCFRS) - 11/5/2012 (English, DOC 65.5 KB)
Open RTF file, 41.5 KB,  #12-02-557 Fire Safety Requirements for Long Term Care Facilities, Mandatory Sprinkler Installation Requirement - 2/27/2012 (English, RTF 41.5 KB)
Open RTF file, 43.5 KB,  #12-01-556 Electronic Transmission of Correspondence - 1/25/2012 (English, RTF 43.5 KB)
Open RTF file, 45.5 KB,  #11-12-552 Use of Electronic Medical Records in Long Term Care Facilities - 12/27/2011 (English, RTF 45.5 KB)
Open RTF file, 60.5 KB,  #11-02-547 Change in Process for Distributing BHCS Circular Letters - Request for Email Contact Information - 2/24/2011 (English, RTF 60.5 KB)
Open RTF file, 250.46 KB,  DHCQ 11-01-545 - Care Transitions and Universal Transfer - 1/18/2011 (English, RTF 250.46 KB)
Open RTF file, 25.4 MB,  Universal Transfer Form and Instructions (English, RTF 25.4 MB)
Open DOC file, 48 KB,  #11-01-543 Long Term Care Health Maintenance Guidelines - 1/18/2011 (English, DOC 48 KB)
Open XLS file, 45.5 KB,  Pediatric and Adolescent Resident (English, XLS 45.5 KB)
Open XLS file, 38.5 KB,  Adult Residents Aged 19 to 69 (English, XLS 38.5 KB)
Open XLS file, 38.5 KB,  Elderly Residents Aged 70 or Older (English, XLS 38.5 KB)
Open RTF file, 58 KB,  #10-11-540 Infection Prevention during Blood Glucose Monitoring and Insulin Administration - 11/24/2010 (English, RTF 58 KB)
Open RTF file, 39 KB,  #10-11-538 Massachusetts DPH Nursing Home Brochure (Revised) - 11/2/2010 (English, RTF 39 KB)
Open RTF file, 50 KB,  #09-11-524 Waiver or Modification of Federal Requirements Under Section 1135 of the Social Security Act - 11/3/2009 (English, RTF 50 KB)
Open RTF file, 31 KB,  Attachment A - waiver or modification of requirements (English, RTF 31 KB)
Open RTF file, 171.5 KB,  Attachment B - EMTALA Fact Sheet (English, RTF 171.5 KB)
Open RTF file, 47 KB,  Attachment C - Requesting an 1135 Waiver (English, RTF 47 KB)
Open RTF file, 38 KB,  #09-04-509 Resident Transfer Agreements - 4/28/2009 (English, RTF 38 KB)
Open RTF file, 952.5 KB,  #08-04-485 LTCF Communications During an Emergency - 4/4/2008 (English, RTF 952.5 KB)
Open RTF file, 237.53 KB,  #06-6-464 Comfort Care for Residents in Long Term Care Facilities 8/15/2006 (English, RTF 237.53 KB)
Open RTF file, 190.1 KB,  #06-4-459 Attestation for Continuity of Operations Plans (COOPs) (English, RTF 190.1 KB)
Open RTF file, 135.19 KB,  #05-10-451 Revised Guidelines for Long Term Care Facility Emergency Ambulance Transport Policies 10/14/2005 (English, RTF 135.19 KB)
Open RTF file, 106.71 KB,  #05-09-452 Stock Medications - 9/30/2005 (English, RTF 106.71 KB)
Open RTF file, 54.47 KB,  #05-04-448 Do Not Resuscitate Orders - 4/8/2005 (English, RTF 54.47 KB)
Open RTF file, 214.93 KB,  #4-00-400 Unauthorized Use of DMH Form AA-1 -4/2002 (English, RTF 214.93 KB)
Open RTF file, 221.77 KB,  #02-04-424 Recall of Sprinkler Heads in Health Care Facilities 4/2/2002 (English, RTF 221.77 KB)
Open RTF file, 11.13 KB,  Circular Letter # DHCQ-12-97-373 - NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace - 12/1997 (English, RTF 11.13 KB)

Beds Out of Service

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

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

Automated external defibrillators (Nursing Homes only)

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

Dispute resolution (Nursing Homes only)

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

Medications (Nursing Homes only)

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

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