General Requirements

(1) Official Business or Mailing Address. The operator of a MDF or PDO shall maintain a phone number and official address of record which shall be filed with the Board. The operator of a MDF or PDO who does not maintain an office in Massachusetts shall also file the name, address, and telephone number of the entity's resident agent as filed with the Massachusetts Secretary of the Commonwealth. (2) The Board shall be notified within 30 days of any change in the address or telephone number of record, or director of the MDF or PDO. (3) All written or electronic publications and documents issued by the MDF or PDO shall include the name of the MDF or PDO director and official telephone number and the address of record for the MDF or PDO. (4) Patient Records. Patient records shall be maintained in accordance with 234 CMR 5.14 and 5.15. In addition, the MDF or PDO shall also comply with the following: (a) Treatment in a School Setting. Where consent has been granted by the patient or legal representative, a copy of the patient's information sheet or other written summary of the screening, examination or treatment shall be provided to the official designated by the school. (b) Treatment in a Nursing Home or Residential Treatment Facility. A copy of the patient's information sheet or other written summary of the screening, examination or treatment shall be provided to the official designated by the nursing home or residential treatment facility and shall become part of the patient's record. (5) Informed Consent. The MDF or PDO shall obtain a signed written consent from the patient or legal representative which conforms to the requirements of 234 CMR 5.15(3)(f). (6) Discharge and Referral. (a) Information Sheet. At the conclusion of the patient's visit to the MDF or PDO, the patient or institutional facility, as may be appropriate shall be given a written report that shall include the following: 1. Results of the dental and/or dental hygiene examination; 2. The name(s) of the licensed dentist and dental auxiliaries who provided services; 3. A description of the treatment rendered, including billed service codes and fees associated with treatment, and tooth numbers when appropriate; 4. Information on how to contact the MDF or PDO; 5. A timely written referral to a dentist in order to address emergent needs and achieve positive oral health outcomes for the patient; 6. Names of dentists or other organizations providing dental services located within a reasonable geographic distance from the patient's home and with whom the MDF or PDO has communicated regarding acceptance of referrals; and 7. The signature of the dentist or dental hygienist. (b) If the patient has given consent for an institutional facility (school, nursing home, residential facility, etc.) to access the patient's dental health records, the MDF or PDO shall provide the institution with a copy of the Information Sheet. (7) Emergency or Other Follow-up Treatment. The MDF or PDO shall: (a) Have a written procedure for referral of patients for emergency or other follow-up treatment; (b) Provide necessary follow-up treatment or make a timely referral for follow-up examina­ tion and treatment by the patient's dentist or by another dentist with whom the MDF or PDO has communicated regarding acceptance of referrals; (c) Provide the patient with the names of dentists, community health centers or dental school clinics located within a reasonable geographic distance from the patient's home and with whom the MDF or PDO has communicated with regarding the acceptance of referrals; and (d) Where consent has been granted, provide the subsequent provider with treatment information, including a copy of radiographs, within a reasonable period of time. 7.04: continued (8) Emergency Protocol. The MDF and PDO shall: (a) Have a written protocol for managing medical or dental emergencies; (b) Have communication equipment that ensures rapid access to emergency responders and others as necessary; and (c) Ensure that all staff are trained when hired, and at least annually thereafter, to implement the emergency protocols. (9) Identification of Personnel. Any person providing dental service(s) on behalf of a MDF or PDO shall wear a name tag that states his/her name, professional title, and function. (10) The MDF or PDO shall maintain a log that includes the dates, locations where services were provided, and names of all individuals providing services on behalf of the MDF or PDO. (11) Display of License(s). An original or copy of all licenses and permits issued by the Board shall be displayed at the location where services are being provided in an area where they may be viewed by patients. (12) Background Checks for Personnel. The MDF or PDO shall comply with any rules, regulations or statutory requirements for performance of Criminal Offender Record Information (CORI) and background checks of personnel serving vulnerable populations e.g. children, elderly or disabled person(s).