The Health Care Professional Responsibility and Reporting Enhancement Act requires New Jersey health care entities licensed pursuant to pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a health maintenance organization authorized to operate pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), a carrier which offers a managed care plan regulated pursuant to P.L.1997, c.192 (C.26:2S-1 et seq.), a State or county psychiatric hospital, a State developmental center, a staffing registry, and a home care services agency as defined in section 1 of P.L.1947, c.262 (C.45:11-23) to report health care professionals licensed or certified by the New Jersey Division of Consumer Affairs or are certified by the Department of Health and Senior Services who are employed by, under contract to render professional services to, or have clinical privileges granted by that health care entity, or who provides such services pursuant to an agreement with a health care services firm or staffing registry to notify the New Jersey Division of Consumer Affairs, Health Care Professional Information Clearing House Coordinator regarding the health care professional’s conduct relating to impairment, incompetence or professional misconduct which relates to patient safety and the health care entity has taken action against them.
A health care professional shall file a report with the Health Care Professional Information Clearing House Coordinator if that health care professional is in possession of information which reasonably indicates that another health care professional has demonstrated an impairment, gross incompetence or unprofessional conduct which would present an imminent danger to an individual patient or to the public health, safety or welfare of the patient.
All reporting forms must be submitted via fax at (973) 792-4270 or via email at
New Jersey Department of Health Facility Disclosure Forms
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