How to report abuse or neglect by another provider to the Department of Public Health

Instructions:

1. If the incident resulted in death, call DPH immediately and complete step 2 .

(See contact information)

If not, skip this step and go to step 2

2. Submit the form below by fax to 617-753-8165.

Tips:

• As a reminder, these instructions refer to instances of abuse, neglect, mistreatment or misappropriation of property that previously took place at a nursing home, rest home, home health, home maker or hospice facility

Resources:

Laws: 105 §§ CMR 130.331 (b), 140.307 (b)

Fax Form

Facility Reporting to Department of Public Health

Contact Information

Department of Public Health, Bureau of Health Care Safety and Quality

Business hours:
617-753-8150

Non-business hours:
617-363-0755 or 617-469-1111

Fax: 617-753-8165

www.mass.gov/dph/bhcsq

We hope these instructions helped you meet this reporting requirement. Be aware that this action may not fulfill all applicable reporting requirements associated with the event.

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