reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart D - DENTAL SERVICES › Section 140.403 - Dental Policies and Procedures

Current through Register 1525, July 5, 2024
(A) Each
				clinic offering dental services shall have a written policy providing for the
				referral of patients to other health care providers as necessary for services
				that are not part of the clinic's services.
(B) Each clinic shall have policies and
				procedures for recalling patients on a periodic basis as appropriate for the
				patient's needs for dental care maintenance procedures.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart D - DENTAL SERVICES › Section 140.404 - Anesthesia

Current through Register 1525, July 5, 2024
(A) Each clinic licensed for dental services
				may administer local anesthesia, nitrous oxide sedation and conscious
				intravenous sedation. General anesthesia may not be administered, unless the
				clinic is licensed under
				105 CMR
				140.600 through
				140.614
				to provide surgical services.
(B)
				Conscious intravenous sedation may only be performed by individuals with
				appropriate training as established separately by the Commissioner as
				administrative guidelines.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart D - DENTAL SERVICES › Section 140.405 - Dental Surgery

Current through Register 1525, July 5, 2024
A clinic that performs dental surgical procedures including,
				  but not limited to, procedures requiring general anesthesia, advanced oral
				  maxillofacial surgery, removal of a large tumor, or major surgery to the
				  mandible or maxilla such as reduction of a fractured jaw must be licensed to
				  provide surgical services pursuant to
				  105 CMR
				  140.600(B).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart D - DENTAL SERVICES › Section 140.450 - Applicability of 105 CMR 140.451 through 140.453

Current through Register 1525, July 5, 2024
The requirements of 105 CMR 140.451 through 140.453 are
				  applicable to clinics subject to Department licensure to provide mobile health
				  services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart D - DENTAL SERVICES › Section 140.451 - Host Sites for Mobile Services

Current through Register 1525, July 5, 2024
(A) Host sites for
				mobile services may include community environments including, but not limited
				to, long-term care facilities licensed pursuant to M.G.L. c. 111, § 71,
				assisted living facilities, corporate or business locations, community centers,
				social service agencies, or churches.
(B) Host sites shall not include commercial
				office space rented by the licensed clinic.
(C) If the site is leased, rented or
				otherwise under the control of the clinic, the clinic must obtain approval for
				the site as a satellite.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart D - DENTAL SERVICES › Section 140.452 - Medications for Mobile Services

Current through Register 1525, July 5, 2024
(A) The clinic may
				not store medications at any host site.
(B) The clinic may not store medications
				overnight in a mobile, portable or mobile/portable unit.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart D - DENTAL SERVICES › Section 140.453 - Signage for Mobile Services

Current through Register 1525, July 5, 2024
The clinic shall appropriately identify the mobile, portable
				  or mobile/portable unit, including, if applicable, signage identifying any
				  affiliation with the host site. All signage must clearly state that the unit
				  provides mobile services, and, if applicable, state that the service is
				  sponsored by a parent or host facility.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart E - MENTAL HEALTH SERVICES › Section 140.500 - Applicability of 105 CMR 140.510 through 140.560

Current through Register 1525, July 5, 2024
To provide Mental Health Services, as that term is defined in
				  105 CMR 140.020,
				  clinics must meet the requirements of
				  105 CMR
				  140.510 through
				  140.560.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart E - MENTAL HEALTH SERVICES › Section 140.510 - Mental Health Services

Current through Register 1525, July 5, 2024
For purposes of
				  105 CMR
				  140.500 through
				  140.560,
				  each clinic licensed to provide mental health services shall operate a mental
				  health program that provides, internally or by contract, in accordance with the
				  requirements of
				  105 CMR
				  140.520, the following services, as
				  appropriate to the patient's chief complaint or problem:
(1) intake services including, but not
				limited to, a substance use disorder screening;
(2) evaluation and diagnostic
				services;
(3) treatment planning
				services;
(4) treatment services
				that include:
(a) case consultation,
				psychotherapy and counseling; and
(b) pharmacotherapy;
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart E - MENTAL HEALTH SERVICES › Section 140.520 - Adequate Mental Health Services

Current through Register 1525, July 5, 2024
(A)
Intake Services
. During intake, the clinic licensed to
				provide mental health services must accumulate and record at least the
				minimally required patient information necessary to facilitate evaluation and
				diagnostic services and/or for referral to an appropriate professional person
				or agency. This intake must include screening for any co-occurring substance
				use disorder.
(B)
Evaluation and Diagnostic Services
.
(1) Evaluation and diagnostic services must
				be documented and shall include:
(a)
				Identification of the patients presenting complaint or problem at the time of
				evaluation;
(b) An assessment of
				the current status and history of the patient's physical and psychological
				health;
(c) Current and former
				substance use disorder treatment, or any other related treatment, including
				pharmacotherapy; and
(d) Current
				and former social, economic, developmental, and educational functioning,
				describing both strengths and needs.
The above assessment shall be conducted by health care
				  providers trained in completing such an evaluation, which includes
				  evidence-based, specialized training in the assessment of substance used
				  disorders, as appropriate to the patient's needs.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart E - MENTAL HEALTH SERVICES › Section 140.540 - Case Review

Current through Register 1525, July 5, 2024
(A) The clinic must
				establish a case review process that includes a review of each patient's
				treatment plan and progress including, but not limited to, a patient's
				prescribed medication.
(B) Case
				review shall be conducted by one or more members of the multidisciplinary staff
				as defined in
				105 CMR
				140.530(B).
(C) Case review shall not be completed by the
				mental health professional(s) responsible for implementing the patient's
				treatment plan.
(D) Case reviews
				must be conducted as necessary, but at least once a year or at discharge. The
				frequency of case reviews shall be based upon the patient's current problems,
				specific and concrete goals and treatment.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart E - MENTAL HEALTH SERVICES › Section 140.550 - Additional Recordkeeping Requirements

Current through Register 1525, July 5, 2024
In addition to the requirements at
				  105 CMR 140.302,
				  clinics with a licensed mental health service must comply with the
				  following:
(A) Documentation of the
				delivery of mental health services, which may include substance use disorder
				treatment, including progress notes or statements recorded by the mental health
				professionals who are responsible for implementing the patient's treatment
				plan. In the case of unlicensed clinicians recording progress notes or
				implementing treatment plans, a licensed clinician is responsible for clinical
				oversight of all clinical activities.
(B) Patient records must be created and
				maintained in accordance with all federal and state laws, regulations, and
				requirements applicable to the services provided.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart E - MENTAL HEALTH SERVICES › Section 140.560 - Mental Health Outreach Programs

Current through Register 1525, July 5, 2024
(A) A mental
				health outreach program must be operated by a clinic licensed to provide mental
				health services.
(B) Outreach
				programs shall be operated in conformance with the standards for mental health
				services contained in
				105 CMR
				140.500 through
				140.550.
(C) Outreach services may include diagnostic
				services and treatment services, including emergency services provided to
				patients in their homes or other community environments.
(D) Documentation of services delivered in
				settings other than the clinic must describe the place of service in which the
				care was delivered.
(E) When
				outreach services must be provided in buildings with community health or social
				service uses, the site will be maintained in a safe and sanitary
				manner.
(F) If the mental health
				outreach program site is leased, rented or otherwise under the control of the
				clinic, the clinic must obtain approval for the mental health outreach program
				as a satellite.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.600 - Applicability of 105 CMR 140.600 through 140.614

Current through Register 1525, July 5, 2024
(A) The requirements of 105 CMR 140.600
				through
				140.614
				are applicable to clinics subject to Department licensure to provide surgical
				services.
(B) A clinic may perform
				surgery, including those dental surgical procedures set forth in 105 CMR
				140.600(C), only if specifically licensed to do so by the Department, unless it
				performs only simple surgical procedures such as incision and drainage or
				suturing of simple lacerations.
(C)
				Dental surgical procedures for which a clinic must be licensed pursuant to 105
				CMR 140.600(B) include procedures requiring general anesthesia; advanced oral
				maxillofacial surgery; removal of a large tumor; or major surgery to the
				mandible or maxilla such as reduction of a fractured jaw.
(D) A clinic may perform surgical procedures
				under regional or general anesthesia only if licensed to provide surgical
				services.
(E) No clinic may perform
				cardiac catheterization services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.601 - Incorporation of Medicare Conditions of Participation for Ambulatory Surgical Services

Current through Register 1525, July 5, 2024
A clinic licensed to perform surgery must comply with the
				  standards of the Medicare Conditions of Participation for Ambulatory Surgical
				  Services set forth in
				  42 CFR
				  416.42(a)(I) relating to
				  anesthesia risk and evaluation;
				  42 CFR
				  416.44(a)(1) and (2)
				  relating to physical environment;
				  42 CFR
				  416.44(c) relating to
				  emergency equipment; and
				  42 CFR
				  416.44(d) relating to
				  emergency personnel. Clinics administering general anesthesia shall also comply
				  with
				  42 CFR
				  416.44(b) of the Medicare
				  Conditions of Participation relating to safety from fire.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.602 - Surgical and Anesthesia Privileges

Current through Register 1525, July 5, 2024
(A) Surgical
				staff shall be granted privileges to perform only those surgical procedures
				that they are legally and professionally qualified to perform.
(B) Anesthesia staff shall be granted
				privileges to administer anesthesia, including conscious intravenous sedation,
				only in accordance with their legal and professional qualifications.
(C) Surgical and anesthesia privileges shall
				be granted by the governing body based on the recommendation of the Surgery
				Director or Anesthesia Director.
(D) The clinic shall maintain a list of
				individuals granted surgical and/or anesthesia privileges including each
				individual's name, profession, specialty and the surgical procedures he or she
				is permitted to perform or the type of anesthesia he or she is permitted to
				administer.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.603 - Surgery Director

Current through Register 1525, July 5, 2024
(A) Each clinic
				licensed to perform surgery shall designate, as appropriate for the services
				offered, a physician, podiatrist or dentist with surgical privileges and
				certification by an appropriate specialty board, as the Surgery
				Director.
(B) The Surgery Director
				shall direct and observe surgical staff and is responsible for maintaining the
				quality of surgery.
(C) Clinics
				performing only dental surgery shall designate a dentist who is board certified
				by the American Board of Oral and Maxillofacial Surgery as the Surgery
				Director.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.604 - Procedures

Current through Register 1525, July 5, 2024
Each clinic licensed to perform surgery shall determine, with
				  the advice of its surgery director, the types of surgical procedures it may
				  perform. The clinic shall maintain a current list of these
				  procedures.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.605 - Preoperative Evaluation

Current through Register 1525, July 5, 2024
(A) A physician
				shall perform a physical examination, review the patient's medical history, and
				review the results of pertinent preoperative diagnostic studies prior to
				surgery.
(B) Prior to the
				performance of a dental surgical procedure where there is no known medical
				problem, a dentist may perform a physical examination, review the patient
				medical history, and review the results of pertinent preoperative diagnostic
				studies prior to surgery in
lieu
of a physician upon:
(1) successful completion of a physical
				evaluation program or course at an accredited hospital or teaching institution,
				and
(2) board certification or
				eligibility by the American Board of Oral and Maxillofacial Surgery or by the
				American Board of Pedodontics.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.606 - Anesthesia Director

Current through Register 1525, July 5, 2024
(A) Each clinic
				administering regional or general anesthesia shall designate an
				anesthesiologist to be responsible for the anesthesia services. For the
				purposes of
				105 CMR
				140.600 through
				140.614,
				an anesthesiologist is a physician who is certified by the American Board in
				Anesthesiology.
(B) The Anesthesia
				Director is responsible for the supervision of all persons administering
				anesthesia in the clinic, the review of all anesthesia complications and the
				development of policies and procedures related to preoperative and
				postoperative anesthesia care.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.607 - Adequate Assistance

Current through Register 1525, July 5, 2024
No surgical procedure shall be initiated without adequate
				  assistance present in the operating room:
(A) The operating room circulator shall meet
				the definition and functions set out in
				105 CMR
				140.620 and
				105 CMR
				140.621; and
(B) The person administering general
				anesthesia, functioning within his or her scope of practice, shall be someone
				other than the primary operating surgeon.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.608 - Surgical Area

Current through Register 1525, July 5, 2024
(A) Acceptable
				aseptic techniques shall be used by all persons in the surgical area.
(B) Each clinic licensed to perform surgery
				shall designate a receiving area appropriately designed and equipped for
				preoperative preparation, examination, holding and observation of
				patients.
(C) Each clinic licensed
				to perform surgery shall have at least one operating room.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.609 - Specimens

Current through Register 1525, July 5, 2024
(A) Except as provided in 105 CMR 140.609(B),
				all specimens of tissue removed during a surgical procedure shall be submitted
				to a pathologist for microscopic examination.
(B) An exception to the requirements of 105
				CMR 140.609(A) may be made in the case of dental surgery involving tooth
				removal where no soft tooth tissue pathology is suspected. The number of teeth,
				including fragments, shall be recorded in the patient's record.
(C) Each clinic licensed to perform surgery
				shall have written policies and procedures governing microscopic examination of
				tissue and the verification of removal of non-tissue specimens, such as foreign
				bodies.
(D) The results of all
				tissue examinations shall be entered in the patient's medical record. Each
				clinic shall provide treatment, or referral for treatment of any diagnosed
				pathological condition.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.610 - Recovery Procedures

Current through Register 1525, July 5, 2024
(A) Each
				postoperative patient shall be supervised constantly while recovering from
				surgery and anesthesia by a registered nurse trained to recognize complications
				until released from the recovery area.
(B) Patients shall be sufficiently recovered
				from surgery and anesthesia prior to discharge. The individual who performed
				the surgical procedure shall be responsible for a postoperative evaluation and
				shall enter his or her report and discharge order into the patient's record
				prior to the patient's discharge. Patients recovering from general or regional
				anesthesia shall have a post anesthesia evaluation performed by a physician or,
				in the case of a patient without medical problems admitted for dental
				procedures, a dentist with anesthesia privileges.
(C) The clinic shall provide each patient
				with written instructions including possible complications arising from the
				surgery, how to recognize these complications, whom to contact for follow-up
				care with questions if the clinic is closed and in the event of an
				emergency.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.612 - Physical Environment and Safety Provisions

Current through Register 1525, July 5, 2024
In addition to the physical environment requirements set
				  forth in
				  105 CMR
				  140.201 through
				  140.208 and
				  105
				  CMR 140.601, each clinic licensed to perform
				  surgery shall meet the physical environment and safety requirements of 105 CMR
				  140.612.
(A) Each clinic licensed to
				perform surgery using regional or general anesthesia shall inspect the
				condition of electrical and mechanical medical equipment used in each operating
				room when such equipment is obtained and regularly thereafter. A licensed
				electrician or biomedical technician shall routinely test and maintain
				electrical equipment. Written records must be kept of such
				inspections.
(B) Each clinic must
				have an adequate sterilizing area, instrument storage area, change area, scrub
				area, pack area, and clean-up area. Clean work areas shall be physically
				separate from soiled work areas.
(C) Emergency power shall be available in the
				surgical and recovery areas.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.613 - Evaluation of Quality

Current through Register 1525, July 5, 2024
(A) In addition to
				the requirements set forth in
				105 CMR
				140.370, the quality assurance program
				established by each clinic licensed to perform surgery shall include reviews of
				at least the following:
(1) medical necessity
				of procedures performed, including the review of tissue removed at surgery to
				determine agreement or disagreement among the preoperative, postoperative and
				pathological diagnoses;
(2) whether
				adequate pre and postoperative services and procedures met patient needs; and
				(3) all complications.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.614 - Limitation on Transfusions

Current through Register 1525, July 5, 2024
(A) Surgical
				services shall not do procedures that generally result in extensive blood loss
				or for which the need for blood replacement is anticipated.
(B) Transfusions shall be permitted as part
				of the clinic's surgical services in accordance with
				105 CMR
				135.410:
Transfusion Outside of a
				Licensed Hospital
that allow such transfusions outside a transfusion
				service in rare and unusual circumstances as deemed necessary by the blood bank
				director, provided that blood or blood product is released to the requesting
				physician and that physician is responsible for the transfusion.
(C) Surgical services that administer whole
				blood and/or its components and/or derivatives in transfusion as authorized by
				105 CMR 140.614(B) shall meet the requirements set forth in
				105 CMR
				140.380(A) through
				(C).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.620 - Surgical Technology Definitions

Current through Register 1525, July 5, 2024
For the purposes of
				  105 CMR
				  140.621, the following terms have the
				  following meanings:
Operating Room Circulator
. A
				  licensed registered nurse who is educated, trained and experienced in
				  perioperative nursing, who is immediately available to physically intervene in
				  providing care to a surgical patient.
Surgical Technologist
. Any person
				  who provides surgical technology services who is not licensed or registered
				  under M.G.L. c. 112, §§ 2, 16, 74 or 74A, or who is not an intern,
				  resident, fellow or medical officer who conducts or assists with the
				  performance of surgery.
Surgical Technology
. Surgical
				  patient care including, but not limited to, one or more of the
				  following:
(1) collaboration with an
				operating room circulator prior to a surgical procedure to carry out the plan
				of care by preparing the operating room, gathering and preparing sterile
				supplies, instruments and equipment, preparing and maintaining the sterile
				field using sterile and aseptic technique and ensuring surgical equipment is
				functioning properly and safely;
(2) intraoperative anticipation and response
				to the needs of a surgeon and other team members by monitoring the sterile
				field and providing the required instruments or supplies;
(3) performance of tasks at the sterile
				field, as directed in an operating room setting, including:
(a) passing supplies, equipment or
				instruments;
(b) sponging or
				suctioning an operative site;
(c)
				preparing and cutting suture material;
(d) transferring and irrigating with
				fluids;
(e) transferring, but not
				administering, drugs within the sterile field;
(f) handling specimens;
(g) holding retractors; and
(h) assisting in counting sponges, needles,
				supplies and instruments with an operating room circulator.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart F - SURGICAL SERVICES › Section 140.621 - Surgical Technology

Current through Register 1525, July 5, 2024
(A) Each clinic
				licensed to provide surgical services shall adopt policies and procedures
				addressing the following requirements set forth in M.G.L. c. 111, § 229.
(1) The clinic may not employ or otherwise
				retain the services of any person to perform surgical technology tasks or
				functions, unless such person:
(a) has
				successfully completed an accredited educational program for surgical
				technologists and holds and maintains a certified surgical technologist
				credential administered by a nationally recognized surgical technologist
				certifying body accredited by the National Commission for Certifying Agencies
				and recognized by the American College of Surgeons and the Association of
				Surgical Technologists; or
(b) has
				successfully completed an accredited school of surgical technology, but has
				not, as of the date of hire, obtained the certified surgical technologist
				certification required in 105 CMR 140.621(A)(1)(a); provided, however, such
				certification shall be obtained within 12 months of the graduation date;
				or
(c) was employed as a surgical
				technologist in a surgical facility on or before July 1, 2013; or
(d) has successfully completed a training
				program for surgical technology in the Army, Navy, Air Force, Marine Corps or
				Coast Guard of the United States or in the United States Public Health Service
				deemed appropriate by the commissioner; or
(e) is performing surgical technology tasks
				or functions in the service of the federal government, but only to the extent
				the person is performing duties related to that service.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart G - PHYSICAL REHABILITATION SERVICES › Section 140.700 - Applicability of 105 CMR 140.701 through 140.702

Current through Register 1525, July 5, 2024
For the purpose of
				  105 CMR
				  140.701 through
				  140.702, the
				  term "physical rehabilitation services" shall mean physical therapy,
				  occupational therapy or speech therapy services.
The requirements of
				  105 CMR
				  140.701 through
				  140.702 are
				  applicable to clinics subject to Department licensure licensed to provide
				  physical rehabilitation services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart G - PHYSICAL REHABILITATION SERVICES › Section 140.701 - Physician's Direction and Plan of Care

Current through Register 1525, July 5, 2024
(A)
				Each clinic providing physical rehabilitation services shall retain, at least
				on a consulting basis, one physician to, at a minimum, assist in establishing
				and implementing patient care policies and to provide medical consultation as
				needed.
(B) A clinic shall accept a
				patient for rehabilitation services only on the order of a clinic physician or
				referring physician who indicates the diagnosis and anticipated goals, and who
				is responsible for the general medical direction of such services as part of
				the total care of the patient.
(C)
				For each patient there shall be written plan of care approved by the physician.
				The plan of care must specify the type, amount, frequency and duration of the
				services to be provided. The plan of care and results of treatment shall be
				reviewed by the physician at least every 60 days or more often if
				required.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart G - PHYSICAL REHABILITATION SERVICES › Section 140.702 - Rehabilitation Staff

Current through Register 1525, July 5, 2024
If a clinic provides rehabilitation services, the clinic
				  shall retain on at least a part-time basis qualified therapists to provide
				  directly or to supervise the provision of the service.
For the purposes of
				  105 CMR
				  140.700 through 140.702, a "qualified
				  physical therapist" shall be a physical therapist who meets the requirements of
				  M.G.L. c. 112, § 23I. A "physical therapist assistant" shall be a person
				  who meets the requirements of M.G.L. c. 112, § 23J.
For the purpose of
				  105 CMR
				  140.700 through 140.702, a "qualified speech
				  pathologist" shall be a person who meets the requirements of M.G.L. c. 112,
				  § 144.
For the purposes of
				  105 CMR
				  140.700 through 140.702, a "qualified
				  occupational therapist" shall be a person who meets the requirements of M.G.L.
				  c. 112, § 23G. An "occupational therapy assistant" shall be a person who
				  meets the requirements of M.G.L. c. 112, § 23H.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart H - SUBSTANCE ABUSE › Section 140.801 - Substance Use Disorder Treatment Services

Current through Register 1525, July 5, 2024
To provide Substance Use Disorder Treatment Services, as that
				  term is defined in
				  105 CMR 140.020, a
				  clinic must meet the applicable programmatic and staffing requirements set
				  forth in
				  105 CMR 164.000:
Licensure of Substance Abuse Treatment
				  Programs
.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.901 - Birth Center Written Policies and Procedures

Current through Register 1525, July 5, 2024
An applicant to add a birth center to its license shall
				  develop, through an interdisciplinary team, written policies and procedures to
				  ensure the safe operation of the birth center prior to submitting an
				  application for approval. A birth center shall implement, review and revise,
				  through an interdisciplinary team as needed, but not less than once a year, its
				  written policies and procedures. A birth center shall ensure all staff,
				  including any temporary staff and volunteers, are trained and determined to be
				  competent as needed for their duties under the policies and procedures
				  developed by the facility. A birth center's policies shall include at a
				  minimum, but not be limited to:
(A)
				Patient admission criteria including specific information by which a woman's
				risk status will be established.
(B) Off-hour coverage.
(C) Consultation and referral for obstetric
				and pediatric care.
(D) Specific
				patient transfer criteria.
(E)
				Emergency procedures, including adult and neonatal intubation and
				resuscitation.
(F) Standards for
				medication procurement, storage and administration.
(G) Protocols for screening newborns for
				critical congenital heart disease with pulse oximetry or another test approved
				by the Department in accordance with Department guidelines.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.902 - Staffing

Current through Register 1525, July 5, 2024
A birth center shall have adequate, trained staff who are
				  licensed as required are available at all times to meet the needs of its
				  patients including, but not limited to:
(A)
Director of the Birth
				Center
.
(1) A birth center shall
				have a director who shall be responsible to the facility administrator for the
				operation and maintenance of the center.
(2) The director must be a certified
				nurse-midwife, or an obstetrician or family practitioner with obstetrical
				privileges in a nearby hospital licensed in Massachusetts or operated by the
				Commonwealth.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.903 - Equipment and Supplies

Current through Register 1525, July 5, 2024
Each birth center shall have safe and adequate equipment is
				  available to meet the needs of its patients, including those with disabilities,
				  to include at a minimum:
(A) A standard
				neonatal warming device and a transfer incubator.
(B) A microscope for routine office
				examination of vaginal smears.
(C)
				A sufficient number of sphygmomanometers and auscultation equipment.
(D) Equipment and supplies for administration
				of intravenous fluids, and full adult and infant resuscitation as required by
				procedures outlined in the birth center's protocols.
(E) A supply of oxygen, including portable
				oxygen available for emergency use.
(F) Portable suction available for both the
				mother and the infant.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.904 - Patient Records

Current through Register 1525, July 5, 2024
A birth center shall maintain accurate and complete records
				  on all of its patients that include at a minimum the following information with
				  respect to each newborn:
(A) The
				condition of the infant at birth to include Apgar Score (or its equivalent) at
				one minute and five minutes, time of sustained respiration, details of physical
				abnormalities and pathological states.
(B) Date and hour of birth, birth weight and
				period of gestation.
(C) Number of
				cord vessels and any abnormalities of the placenta.
(D) Verification of eye
				prophylaxis.
(E) Metabolic
				screening.
(F) Treatments,
				medications and special procedures.
(G) Condition at discharge or
				transfer.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.905 - Care and Services

Current through Register 1525, July 5, 2024
(A) The birth center
				shall provide a program of care, which includes at least the following:
(1) A personal and family history;
(2) A physical examination and appropriate
				laboratory tests;
(3) A program of
				prenatal care that shall include components of self-help, self-care, and fetal
				assessment;
(4) A program of
				prenatal education that shall include the importance of nutrition, preparation
				for birth and breast feeding, and information on adverse effects of smoking,
				alcohol and other drugs;
(5)
				Intrapartum and postpartum services that foster parental control and
				responsibility for the birth experience and infant parental bonding;
(6) Labor support for the mother and her
				family;
(7) Immediate postpartum
				care and newborn assessment;
(8)
				Required eye prophylaxis;
(9)
				Postpartum laboratory examination and program for prevention of Rh
				immunization;
(10) Newborn
				metabolic screening and other such tests as may be required;
(11) A postpartum examination and family
				planning; and
(12) A plan for well
				woman routine gynecologic health care.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.906 - Prohibited Practices

Current through Register 1525, July 5, 2024
(A) Surgical
				procedures shall be limited to those normally accomplished during uncomplicated
				childbirth, such as episiotomy and repair.
(B) The following practices are prohibited in
				a birth center:
(1) Surgical procedures such
				as forceps delivery, tubal ligation, abortion, or Cesarean section.
(2) The use of any analgesics subject to
				regulation under M.G.L. c. 94C for pain control during labor.
(3) Inhibition, stimulation or augmentation
				of the first or second stage of labor with controlled substances.
(4) The use of general or regional
				anesthesia. Local anesthesia for the infiltration of the perineum for
				episiotomy repair may be administered in accordance with patient specific
				orders written by the physician or certified nurse-midwife.
(5) The provision of controlled substances
				for self-administration outside of the birth center.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.907 - Off-hour Coverage

Current through Register 1525, July 5, 2024
Each birth center shall make arrangements for the provision
				  of services 24 hours per day. These requirements can be met through on call
				  coverage by a certified nurse-midwife or physician on the staff of the birth
				  center. These arrangements shall be reflected in a written policy available to
				  all the birth center's patients.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.908 - System for Referral

Current through Register 1525, July 5, 2024
(A) The
				free-standing birth center shall have a written agreement with a
				board-certified obstetrician/gynecologist, and a pediatrician or neonatologist
				for the provision of 24-hour consultation, referral and transfer to appropriate
				hospital facilities for obstetric/newborn care.
(B) Each hospital-affiliated birth center
				shall develop written agreements or policies for the provision of 24-hour
				consultation with an obstetrician/gynecologist and a pediatrician or
				neonatologist with clinical privileges at the parent hospital. If the parent
				hospital does not provide obstetrics and newborn services, the birth center
				must meet the requirements set forth in
				105 CMR
				142.506(A).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart I - BIRTH CENTER SERVICES › Section 140.909 - Reporting Requirements

Current through Register 1525, July 5, 2024
(A) Birth centers
				shall report all births to the Department, and to registrars and city or town
				clerks, in accordance with M.G.L c. 46.
(B) Birth centers shall report any child with
				low birth weight, congenital abnormalities, and other high risk infants in
				accordance with guidelines as may be established by the Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart J - LITHOTRIPSY SERVICES › Section 140.911 - Lithotripsy

Current through Register 1525, July 5, 2024
(A) In addition to the facilities and
				equipment specifically required in other applicable sections of
				105 CMR
				140.000, clinics offering lithotripsy shall provide at
				least the following in or easily accessible to the lithotripter unit:
(1) induction/patient preparation
				room;
(2) recovery area;
(3) oxygen and suction within the
				unit;
(4) emergency power within
				the unit;
(5) accessibility to
				emergency response on-site;
(6)
				accessibility to intensive care unit services on-site if host location is a
				licensed hospital; and
(7)
				radiology services including cystoscopy facilities.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart K - LIMITED SERVICES › Section 140.1000 - Applicability of 105 CMR 140.1001 and 140.1002

Current through Register 1525, July 5, 2024
The requirements of
				  105 CMR
				  140.1001 and
				  140.1002
				  are applicable to clinics licensed to provide limited
				  services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart K - LIMITED SERVICES › Section 140.1001 - Policies and Procedures for Limited Services Clinics

Current through Register 1525, July 5, 2024
(A) Each limited services clinic shall
				develop policies and procedures identifying the limited services the clinic
				will provide. No limited services clinic may serve as a patient's primary care
				provider. No limited services clinic may provide treatment to a patient younger
				than 18 months old.
(B) Each
				limited services clinic shall develop and utilize clinical practice guidelines
				for diagnosing and treating patients. Each limited services clinic shall
				utilize clinical practice guidelines for determining when patient needs are
				beyond the scope of the services it provides or beyond the scope of practice of
				its practitioners.
(C) Each limited
				services clinic shall develop policies and procedures specifying its staffing
				pattern as required by
				105 CMR
				140.310 through
				140.315.
(D) Each limited services clinic shall
				develop policies and procedures for referring patients whose needs exceed the
				clinic's services, including those circumstances in which a telephone referral
				may be appropriate; each limited services clinic shall develop policies and
				procedures for practitioner consultation on unclear cases.
(E) Each limited services clinic shall
				maintain a roster of primary care practitioners, including community health
				centers, in the clinic's geographic area who are currently accepting new
				patients, and who are willing to accept a referral from the limited services
				clinic to serve as a primary care provider.
(1) The limited services clinic shall provide
				each patient who does not have a primary care provider with a referral from the
				list maintained pursuant to 105 CMR 140.1001(E).
(2) If the purpose of the visit is for a
				childhood immunization other than the influenza vaccine, the limited services
				clinic shall counsel the parent or guardian on the importance of establishing
				and maintaining a relationship with a pediatric or family practice for ongoing
				medical and well-child care.
(3)105
				CMR 140.1001(E)(2) shall not apply to a limited services clinic that is a
				satellite of, or is otherwise affiliated with, a health care facility licensed
				pursuant to M.G.L. c. 111, § 51, an accountable care organization or
				provider organization subject to M.G.L. c. 6D, or other licensed
				practitioners.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart K - LIMITED SERVICES › Section 140.1002 - Physical Plant Environment Requirements in Limited Services Clinics

Current through Register 1525, July 5, 2024
(A) Notwithstanding general access
				requirements from the Facility Guidelines Institute's
Guidelines for
				Design and Construction of Health Care Facilities
, a limited services
				clinic located on the premises of another entity is not required to provide
				separate exterior entrances or designated parking or to provide a patient
				waiting area or reception area separate from the public area of the host
				entity.
(B) Notwithstanding general
				space requirements from the Facility Guidelines Institute's
Guidelines
				for Design and Construction of Health Care Facilities
, each limited
				services clinic shall have a minimum floor area of 56 square feet for each
				examination room, exclusive of fixed casework.
(C) Those provisions of the Facility
				Guidelines
Institute's Guidelines for Design and Construction of Health
				Care Facilities
that pertain to services a particular limited services
				clinic does not provide (
e.g.
, venipuncture) shall not apply
				to the limited services clinic.
(D)
				Each limited services clinic shall provide a hand sanitizer dispenser outside
				each treatment room.
(E) In
				accordance with
				105 CMR
				140.203, each limited services clinic must
				provide consultation, examination, treatment and dressing areas appropriate to
				the services provided by the clinic. Any limited services clinic intending to
				substantially alter or expand the scope of services provided at a clinic
				location must notify the Department and conform with appropriate physical plant
				requirements prior to implementation of any such change.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart L - ELECTRONIC HEALTH RECORDS › Section 140.1200 - Definitions Applicable to 105 CMR140.1201

Current through Register 1525, July 5, 2024
The following definitions apply to
				  105
				  CMR 140.1201:
Appropriate Patient
. A patient whose
				  attending health care practitioner has:
(1) diagnosed a terminal illness or condition
				reasonably expected to cause the patient's death within six months, whether or
				not treatment is provided, provided the attending health care practitioner
				determines discussion of the palliative care services is not contraindicated;
				or
(2) determined that discussion
				of palliative care services is consistent with the patient's clinical and other
				circumstances and the patient's reasonably known wishes and beliefs.
Attending Health Care Practitioner
.
				  A physician, nurse practitioner, or physician assistant who has primary
				  responsibility for the care and treatment of the patient within or on behalf of
				  the clinic; provided if more than one physician, nurse practitioner, or
				  physician assistant share that responsibility, each of them shall have a
				  responsibility under
				  105
				  CMR 140.1201, unless there is an agreement to
				  assign that responsibility to one such person.
Hospice Care Services
. Care provided
				  by an entity licensed pursuant to
				  105 CMR 141.000.
Palliative Care
. The attempt to
				  prevent or relieve pain and suffering and to enhance the patient's quality of
				  life and may include, but is not limited to, interdisciplinary end-of-life care
				  and consultation with patients and family members.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart L - ELECTRONIC HEALTH RECORDS › Section 140.1201 - Provision of Information on Palliative Care and End-of-life Options

Current through Register 1525, July 5, 2024
(A) Each clinic shall distribute to
				appropriate patients in its care, directly or through professionally qualified
				individuals, culturally and linguistically suitable information regarding the
				availability of palliative care and end-of-life options. This obligation shall
				be fulfilled by providing the patient with:
(1) A Department-issued informational
				pamphlet; or
(2) A similar
				informational pamphlet that meets the specifications in 105 CMR
				140.1201(B).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 140.000 - Licensure Of Clinics › Subpart L - ELECTRONIC HEALTH RECORDS › Section 140.1300 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				  105 CMR
				  140.000 are severable. If any provision of
				  105 CMR
				  140.000 is declared unconstitutional or invalid by a
				  court of competent jurisdiction, the validity of the remaining portions shall
				  not be so affected.