Code of Massachusetts Regulations
105 CMR - DEPARTMENT OF PUBLIC HEALTH
Title 105 CMR 130.000 - Hospital Licensure
Subpart C - SUPPLEMENTARY STANDARDS: IN GENERAL
Section 130.331 - Serious Incident and Accident Reports

Universal Citation: 105 CMR 130.000 MA Code of Regs 130.331

Current through Register 1531, September 27, 2024

(A) Each hospital shall immediately report to the Department, pursuant to Department guidelines, any of the following occurring on premises covered by its license:

(1) Death that is unanticipated, not related to the natural course of the patient's illness or underlying condition, or that is the result of an error or other incident as specified in guidelines of the Department;

(2) Full or partial evacuation of the facility for any reason;

(3) Fire;

(4) Suicide;

(5) Serious criminal acts;

(6) Pending or actual strike action by its employees, and contingency plans for operation of the hospital; and

(7) Other serious incidents or accidents as specified in guidelines of the Department.

(B) Each hospital shall immediately report to the Department, for any patient treated at the hospital, any suspected instance(s) of abuse, neglect, mistreatment of that patient or misappropriation of that patient's property at or by a nursing home, rest home, home health, home maker or hospice.

(C) Each hospital shall report to the Department any other serious incident or accident occurring on premises covered by the hospital's license that seriously affects the health and safety of a patient(s) or that causes serious physical injury to a patient(s) within seven calendar days of the date of occurrence of the event.

(D) If a hospital makes a report of any incident pursuant to 105 CMR 130.331(A), (B) or (C), and the incident meets the definition of Serious Reportable Event or a Serious Adverse Drug Event in 105 CMR 130.332, the hospital also shall comply with the requirements of 105 CMR 130.332.

(E) The Department shall establish guidelines for the reporting of serious incidents and accidents pursuant to 105 CMR 130.331, including the means of reporting (for example, telephonic report or written report provided to the Department by facsimile, electronic means, delivery, or other means).

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