Immediately
1. Notify DPH Bureau of Health Care Safety and Quality at 1-800-462-5540.
2. Notify DPH Office of Preparedness and Emergency Management’s (OPEM) 24-hour on-call duty officer at pager number 617-339-8351.
3. Notify your region’s Central Medical Emergency Direction Center (CMED) by radio or phone. If an evacuation is needed, coordinate with CMED. See contact information.
Follow up
4. After the condition that prompted the Code Black is resolved:
a) Immediately notify your region’s CMED by radio or phone;
b) Immediately notify the OPEM on-call duty officer by page;
c) As soon as reasonably possible submit a Code Black incident report to DPH via the Virtual Gateway | Health Care Facility Reporting System (HCFRS); and,
d) Within 14 days of the event, add a written after-action report to your HCFRS submission describing the circumstances that prompted the Code Black and actions taken to resolve, recover and resume operations.
Tips:
Contact Information:
Massachusetts Department of Public Health, Bureau of Health Care Safety and Quality
1-800-462-5540
Massachusetts Department of Public Health, Office of Preparedness and Emergency Management
Pager: 617-339-8351
Regional Central Medical Emergency Direction Center (CMED):
Emergency Medical Service Regions Map
| Region | Phone Number |
|---|---|
| Region 1 CMED | 413-846-6226 |
| Region 2 CMED | 508-854-0100 |
| Region 3 CMED | 978-946-8130 |
| Region 4 CMED | 617-343-1499 |
| Region 5 CMED | 508-362-4335 (Barnstable) 508-747-1779 (Plymouth) 508-995-0520 (Bristol) |
Resources
Circular Letter #15-04-635 – 4/16/2015
Laws: 105 CMR § 130.331 (A)
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.
This document is intended for informational purposes only and does not constitute regulatory guidance or legal advice. Links and information in this document may be outdated. The Betsy Lehman Center does not represent or warrant that this information is accurate, complete, or current. For further terms and conditions, see the Terms of Use.