Massachusetts law requires every licensed or public hospital to report conduct by a health care provider that indicates incompetency in his specialty or conduct that is harmful to good patient care or safety.1  Health care facilities are required to adopt a Qualified Patient Care Assessment Program, which calls for the implementation of an incident reporting system within health care facilities.2  A Patient Care Coordinator is responsible for investigating such incidents, and notifying the facility’s board.3  The state also requires all health care facilities to report health care associated infections and preventable, adverse patient outcomes to the Department of Public Health.  Facilities that do not comply may be fined daily as well as the facility’s license being suspended and/or revoked.4  The law imposes an additional requirement on hospitals to report serious incidents or accidents to the Department of Public Health,5 as well as serious reportable events, which are preventable adverse patient outcomes.6  To further improve patient safety, Massachusetts has established the Betsy Lehman Center for patient safety and medical error reduction.  The Center was established in order to help identify and disseminate information about the best practices to reduce medical errors and enhance patient safety, develop best practices, and increase awareness of error prevention strategies through public and professional education.7