Legislature Passes Oversight Reforms for Long-Term Care Facilities

BOSTON—State Senator Jason Lewis and State Representative Michael Day joined their colleagues in the Massachusetts Legislature to pass sweeping reforms to the long-term care and assisted living sectors, in order to improve the quality and safety of care for older and disabled residents across the Commonwealth.

An Act to improve quality and oversight of long-term care strengthens the state’s oversight of nursing homes, enables assisted living residences to offer basic health services, and provides anti-discrimination protections for LGBTQ+ residents of long-term care facilities, among other provisions.

“We should do everything possible to ensure that seniors and individuals with disabilities who reside in nursing homes and other long-term care facilities are getting high-quality care at all times,” said State Senator Jason Lewis. “I’m proud that the Legislature has passed this important and comprehensive legislation.”

“I was proud to support and help pass legislation that takes a comprehensive approach to reforming the long-term care industry,” said State Representative Michael S. Day. “This law will support and expand the long-term care workforce, enhance oversight of facilities and ensure greater access to these services, all while prioritizing quality of care.”

Key provisions of this new law include:

• Strengthening Department of Public Health (DPH) oversight of long-term care facilities by requiring annual inspections to assess quality of services and compliance; requiring reviews of the financial capacity and litigation history of facility applicants; and allowing DPH to limit, restrict, or revoke a long-term care facility license for cause, such as failure to provide adequate care, failure to comply with laws or regulations, or lack of financial capacity.
• Enhancing state oversight and compliance by enacting several reforms, including a lower threshold for ownership interest disclosure, whistleblower protections for staff and residents, powers to penalize non-compliance from assisted living residences (ALRs), and new authority for the Attorney General to file civil action against people who commit elder abuse or neglect.
• Expanding access to basic health services by making it easier for ALRs to offer basic health services such as helping a resident administer drops, manage their oxygen, or take a home diagnostic test. It also requires ALRs to create plans to ensure safe and effective delivery of basic health services.
• Promoting inclusion for LGBTQ+ residents by increasing protections from discrimination and requiring long-term care facilities to provide staff training on the rights and care of LGBTQ+ older adults and older adults living with HIV.
• Building the long-term care workforce by establishing the Long-Term Care Workforce and Capital Fund that will support initiatives to recruit and retain a dedicated workforce.
• Limiting MassHealth estate recovery to only federally mandated recovery and removing estate recovery for residents receiving assistance under CommonHealth.
• Streamlining licensure for small house nursing homes that are alternatives to traditional long-term care facilities with a growing body of evidence demonstrating superior clinical outcomes in addition to higher resident and staff satisfaction levels.
• Requiring long-term care facilities to create emergency outbreak response plans, and directing DPH to establish and implement training and education programs to prevent the spread of disease and keep residents and staff safe.
• Directing MassHealth to study the cost and feasibility of changes to its eligibility requirements with the goal of reducing the time applicants spend at acute-care hospitals awaiting long-term care eligibility determinations.

After final passage in both the House of Representatives and the Senate, Governor Maura Healey signed the bill into law on September 6, 2024.