Laura’s Law in Massachusetts is the Act Ensuring Safe Patient Access to Emergency Care, signed as Chapter 384 of the Acts of 2020, which requires every hospital in the state that operates an emergency department to meet specific standards for signage, lighting, staffing, and monitoring at its ED entrances.1General Court of Massachusetts. Acts of 2020 Chapter 384 The implementing regulations, codified at 105 CMR 130.127 and 130.128, took effect on January 1, 2024.2Cornell Law Institute. Massachusetts Code 105 CMR 130.127 – Emergency Department Wayfinding, Signage, Lighting and Security Requirements If a hospital’s emergency entrance is hard to find, poorly lit, or unmarked, you can file a complaint with the state Department of Public Health.
What Signs and Lighting a Hospital Must Have
Signs identifying the emergency department must read “EMERGENCY” in all capital letters, in red on white or white on red.2Cornell Law Institute. Massachusetts Code 105 CMR 130.127 – Emergency Department Wayfinding, Signage, Lighting and Security Requirements Public entrances to the ED must be clearly marked from exterior approaches and visible from public roads. Wayfinding has to trace a clear path from the nearest public thoroughfare all the way to both the hospital’s main entrance and the ED entrance.
Identification and directional signs must be lit well enough for drivers and pedestrians to see them after dark and in bad weather. Patient drop-off areas and entry points must be lit so they are visually distinct from other entrances. That distinction is the point: the emergency entrance should stand out from everything around it, not blend in with a brighter but locked side door.
Perimeter doors that lock at night, including main entrance doors, emergency department doors, ambulance entrances, and any other door a patient might use, must be well lit and must include directions to the emergency department.3Department of Public Health. 105 CMR 130 – Hospital Licensure The law does not prohibit locked doors. It prohibits a locked door with no information about where to go instead. If you arrive at a dark hospital at 3 a.m. and the first door you try is locked, there should be a lit sign telling you where the open emergency entrance is.
Who Should Be Watching the Entrance
Hospitals must staff their security desks and emergency department front desks 24 hours a day, seven days a week. A hospital that does not keep those desks staffed around the clock must post a phone number at the desk that connects a patient directly to hospital personnel who can provide immediate help.2Cornell Law Institute. Massachusetts Code 105 CMR 130.127 – Emergency Department Wayfinding, Signage, Lighting and Security Requirements
Hospitals must also maintain written policies for 24-hour video and audio monitoring of exterior entrances and emergency department drop-off and entry areas.3Department of Public Health. 105 CMR 130 – Hospital Licensure Recorded footage is not enough on its own. The requirement is monitoring, meaning someone or something is actually watching for a person in trouble near an entrance.
The Annual Review Every Hospital Must Do
Compliance is ongoing. Under 105 CMR 130.128, every hospital with an emergency department must conduct an annual review of its security, wayfinding, signage, and lighting. The review has to happen during both daytime and nighttime conditions, because a sign that reads clearly at noon can disappear after dark.4Cornell Law Institute. Massachusetts Code 105 CMR 130.128 – Annual Review
At a minimum, the review must address:
- Plans to keep lighting, footpaths, and signs clear of debris, overgrown vegetation, and snow
- The effectiveness of surveillance systems and security patrol routes
- Whether signs and symbols work for patients who do not speak English as a first language
Personnel from security, facilities maintenance, risk management, and the emergency department must all participate.4Cornell Law Institute. Massachusetts Code 105 CMR 130.128 – Annual Review Policies must be updated each year and made available to the Department of Public Health on request. DPH does not have to wait for an inspection cycle; it can ask to see the current documentation at any time.
How to File a Complaint
If you encounter a barrier to emergency care at a Massachusetts hospital, you can file a complaint with the Division of Health Care Facility Licensure and Certification. The state asks that you put the complaint in writing and include specifics: the hospital name, the location, the date, and the names of any staff involved.5Mass.gov. File a Complaint Regarding a Hospital
You’ll need the Consumer/Resident/Patient Complaint Form, plus a HIPAA authorization if the complaint involves medical records. Three ways to submit:
- Mail: Division of Health Care Facility Licensure and Certification, Complaint Intake Unit, 67 Forest Street, Marlborough, MA 01752
- Fax: (617) 753-8165
- Phone, if you cannot put the complaint in writing: the 24-hour consumer complaint line at (800) 462-5540 or (617) 753-8150
There is no online submission portal.5Mass.gov. File a Complaint Regarding a Hospital Investigation timelines vary with the complexity of the case and whether medical records have to be obtained. Some complaints resolve within a month; others, especially those involving disciplinary action, take longer.6Mass.gov. File a Complaint Against a Health Care Professional or Facility The most useful complaints include the exact time you arrived, which entrance you tried, what signage you saw or didn’t see, and whether any staff member helped you. Photographs taken on the spot are valuable because they capture conditions a hospital may fix before an investigator visits.
What DPH Can Do About It
The Department of Public Health oversees hospital licensure and has authority to revoke a hospital’s license for cause under M.G.L. Chapter 111, Section 51.7General Court of Massachusetts. Massachusetts General Laws Chapter 111 Section 51 – Hospitals, Institutions for Care of Unwed Mothers, or Clinics; Licensing Revocation is rare and reserved for the most serious failures. More often, DPH issues deficiency findings after an inspection and requires the hospital to submit a corrective action plan. Because the department can ask for annual review documentation at any time, a hospital that cannot produce current wayfinding policies on request has an obvious compliance problem without a full on-site inspection.
Where the Law Came From
Laura’s Law is named for Laura Levis, who died from an asthma attack outside the emergency department of Somerville Hospital in September 2016. She walked to the hospital around 4 a.m., but neither entrance was clearly marked. The brightly lit door she chose was locked, and the actual emergency entrance had no sign above it. She collapsed on a bench about 100 feet away and called 911 to say she was at a locked door and felt she was dying. A nurse briefly stepped outside but only went about an arm’s length from the door before going back in. Her cellphone pinged inaccurately, sending first responders to the wrong entrance. A firefighter found her on the bench at 4:33 a.m. The whole sequence took roughly twelve minutes. Her husband, Peter DeMarco, spent years pushing for the legislation that now carries her name.
What Laura’s Law Does Not Cover
Laura’s Law governs the physical path to the emergency department. What happens once you’re inside is governed by a separate federal law, the Emergency Medical Treatment and Labor Act. EMTALA requires every hospital that accepts Medicare funds to provide a medical screening exam to anyone who comes to the emergency department, regardless of insurance status or ability to pay, and to stabilize a patient with an emergency medical condition before discharge or transfer.8Office of the Law Revision Counsel. 42 USC 1395dd – Examination and Treatment for Emergency Medical Conditions and Women in Labor If your concern is about treatment or billing after you reached the ED, EMTALA is the law to look to, not Laura’s Law.