Last week, the Massachusetts state senate passed a bill, S. 2889, An Act relative to long term care and assisted living, aimed at improving care in Massachusetts nursing homes and assisted living facilities. It would increase the powers and obligations of the Executive Office of Elder Affairs (EOEA) in regulating assisted living facilities and those of the Department of Public Health (DPH) in regulating nursing homes.
Here are some of the changes in the bill:
Assisted Living Facilities
- The bill would expand the ability of assisted living facilities to provide basic health services, including administering drops, managing oxygen and administering home diagnostic tests.
- It would expand required disclosures about owners by lowering the reporting threshold for disclosure from 25 percent ownership interest to 5 percent and requiring that all such owners demonstrate that any other facilities they currently own or owned in the past have met all licensing and certification requirements.
- It would strengthen EOEA enforcement powers and add whistleblower protections for staff members who report any threats to the health or safety of residents and staff.
Nursing Homes
- The bill would require the DPH to inspect every nursing home every nine to 15 months and to expand its review to include lawsuits against facilities related to quality of care, patient safety, labor issues, and deceptive business practices.
- It would give the DPH the power to appoint a temporary manager for facilities that fail to provide adequate care or comply with laws or regulations, or run into financial difficulties.
- In response to the difficulties nursing homes faced during the Covid-19 pandemic, the new bill would require all facilities to submit outbreak response plans with protocols for resident isolation, testing, visitor screening, and notification of residents, families and staff in the event of a contagious diseases outbreak.
- The bill also would prohibit discrimination against LGBTQ+ resident and require staff training on preserving LGBTQ+ rights and care.
What Next?
Before it can become law, this bill must be reconciled with the House version, House Bill No. 4178 – An Act To Improve Quality And Oversight Of Long-Term Care, passed in November 2023. House Speaker Ron Mariano has said that the bill is a priority for him.
The Massachusetts Senior Care Association criticized the Senate bill for not including “vital workforce initiatives including the establishment of medication aides in nursing facilities and the House’s Workforce Investment Fund. Instead, the Senate’s proposal unlike the House, added new language to permanently expand skilled nursing services in assisted living residences.”
It also called for better funding of nursing homes. Mass Senior Care President Tara Gregorio said:
While we support many of these provisions and have been advocating for these types of reforms, we are concerned that the Commonwealth continues to severely underfund nursing facility care by 47 dollars per resident per day, totaling more than $300 million annually, according to the federal government. 70% of the state’s more than 33,000 nursing facility residents have their care paid for by the Commonwealth and therefore a nursing facility’s ability to provide quality resident care, invest in our dedicated workforce and comply with thousands of government regulations is dependent on state funding.
(See my interview with Tara Gregorio here.)