Boston - On September 26, 2024, Governor Maura Healey, Lieutenant Governor Kim Driscoll, House Speaker Ronald J. Mariano, Senate President Karen E. Spilka, elected officials and advocates came together for a ceremonial signing of An Act to improve quality and oversight of long-term care, which improves oversight and standards at Long Term Care (LTC) and assisted living facilities to ensure that older adults are receiving high quality care delivered by qualified providers. The bill also takes steps to protect the rights of individuals with disabilities. 

“In Massachusetts, we are committed to making sure our aging residents and their loved ones can trust that they are receiving the highest quality of care from qualified staff at their long-term care or assisted living facilities,” said Governor Healey. “This bill helps to provide them with that peace of mind, while also ensuring our hardworking providers have the resources and support they need to succeed in this important career. We are also proud to be enhancing protections for older LGBTQ+ residents to ensure they receive the specialized care they need free from discrimination and to be taking steps to protect the rights of people with disabilities. I’m grateful to the Legislature for their leadership in making sure Massachusetts continues to be a national leader in health care and a great place for older adults.”

“This bill makes sure that no matter where you choose to age – at home, at an assisted living facility or at a long term care facility – you can know that you will receive the care that you deserve,” said Lieutenant Governor Kim Driscoll. “That includes having your civil rights protected, no matter who you are or how you identify. This is yet another example of the ways in which Massachusetts is lead the way in protecting freedoms and improving quality of life.” 

“This bill gives residents the opportunity to receive the services that best suit their individual needs at the most appropriate location,” said Health and Human Services Secretary Kate Walsh. “Through enhanced oversight, our agencies will be able to provide better support to address concerns and improve the safety of residents and staff.”

“Many MassHealth members, including older adults and people living with disabilities, rely on a strong ecosystem of providers and community supports to get the care they need,” said Assistant Secretary for MassHealth Mike Levine. “This important legislation will further strengthen the safety net for our members and ensure that Massachusetts continues to lead the nation in helping its residents live and age safely in the setting of their choice.”

Governor Healey signed the bill on September 6th. Some key provisions of the bill include:

- Limits MassHealth estate recovery to the minimum required by federal law and removes estate recovery for residents receiving assistance under CommonHealth and Personal Care Attendant (PCA) services.
- Requires the Department of Public Health (DPH) to inspect LTCs annually.
- Requires MassHealth to review nursing facility rates every two years and provide additional funding for bariatric nursing facilities and 1-on-1 staffing for nursing facility residents requiring 24-hour monitoring and supervision.
- Establishes a new fund to support grants to develop new Certified Nursing Assistants and Licensed Practical Nurses, along with leadership and supervisory training for nursing home leaders. The fund also establishes a no interest or forgivable capital loan program to off-set certain capital costs, including the development of specialized care units.  
- Requires LTCs to develop individualized outbreak response plans and DPH to establish and implement training and education programs on topics such as infection prevention and control, resident care plans, and staff safety programs.
- Requires staff training on the rights and care of LGBTQ+ older adults and older adults living with HIV and forbidding LTCs from discriminating based on a person’s sexual orientation, gender identity, or HIV status.
- Requires DPH to promulgate regulations related to “small house nursing homes,” which are facilities for no more than 14 residents that are designed to look and feel like a home.  
- Requires MassHealth to study the cost and feasibility of changes to the eligibility requirements for Medicaid long-term care services with the goal of reducing the time applicants spend awaiting discharge from acute care

“This legislation reflects Massachusetts’ values. It will improve quality of care for older adults, protect their civil rights, and support the workforce that cares for them,” said Senate President Karen E. Spilka (D-Ashland). “With the Governor’s signature today, we give peace of mind to families with loved ones in long-term care facilities and give the Commonwealth new tools to weed out bad actors in the industry. I’m grateful to the Governor for her signature, Senator Jehlen for her leadership, each member of the Senate, and our partners in the House. Together, our work will make a positive difference in so many lives.”

“The nursing home sector has long faced workforce and financial challenges that were only exacerbated by the pandemic. Addressing persistent challenges within this important sector will not only improve the quality of care that residents receive, it will increase capacity and help acute care hospitals more efficiently discharge patients to the appropriate post-acute care settings,” said House Speaker Ronald J. Mariano (D-Quincy). “Building on key investments in the industry in recent budgets, this comprehensive legislation takes the necessary steps to ensure that the Commonwealth’s nursing homes, and the patients that they care for, are supported. I want to thank Governor Healey for signing this critical legislation into law, as well as Chairman Stanley and my colleagues in the House, along with our partners in the Senate, for working diligently to get this done.”

“Thank you to Governor Healey, Speaker Mariano, Senate President Spilka, Elder Affairs Committee Chairs Stanley and Jehlen, and their fellow conferees for their efforts on this significant and comprehensive legislation to protect residents of long-term care facilities,” said Attorney General Andrea Joy Campbell. “This bill includes legislation I was proud to co-sponsor with Representative Balser and Senator Lewis on as one of my first acts as Attorney General, and I thank them for their partnership. By allowing my office to seek greater penalties against those who abuse or neglect our long-term care patients and extending the time period in which we can bring these cases, this law sends a clear and resounding message that protecting older adults is a priority in Massachusetts.”

Statements of Support

Brian Doherty, President and CEO, Massachusetts Assisted Living Association (Mass-ALA):

“This bill increases the opportunity for the Commonwealth’s citizens to select assisted living, giving residents expanded access to basic health services. It continues to advance the goals of regulators, advocacy groups, and providers in delivering high-quality assisted living care across the state. We thank Gov. Healey and Joint Committee on Elder Affairs Committee Chairs State Sen. Pat Jehlen and State Rep. Tom Stanley for their leadership on improving the lives of assisted living residents.”

Tara Gregorio, President, Massachusetts Senior Care Association:

“The Massachusetts Senior Care Association extends its strong gratitude to Governor Maura Healey, House Speaker Ron Mariano, Senate President Karen Spilka, Chairman Michael Rodrigues, Chairman Tom Stanley and the entire legislature for their unwavering dedication to nursing home residents and their caregivers. This comprehensive and historic legislation represents a profound commitment to the well-being of our seniors and the dedicated professionals who care for them, and it will have a lasting impact on the provision of care for individuals who can no longer live safely at home. We are deeply appreciative of the Governor and legislature’s efforts to safeguard the dignity and quality of life for our most vulnerable citizens by reforming the state’s licensure and suitability process to improve transparency and accountability, modernizing our Medicaid rate system to better reflect current resident care costs, and establishing a workforce and capital trust fund to help implement programs to expand our workforce.”

Clarence Richardson, Executive Director of MassNAELA, the National Academy of Elder Law Attorneys MA Chapter:

“I applaud the efforts of Governor Maura Healey and the Massachusetts Legislature on signing the Long-Term Care Bill (Chapter 197), into law.  This legislation is a significant step toward addressing the urgent needs of the Commonwealth's most vulnerable residents. In addition to addressing issues of inequality, this bill creates new rights and protections for individuals as they age in the community as well as residential facilities.”

Tim Foley, Executive Vice President, 1199SEIU:

“The nursing home oversight bill will start the important work of addressing the safety and staffing issues that our state’s nursing homes face, so we can lower costs, improve health care access, and reduce health inequities. The bill’s creation of a new Long-Term Care Workforce and Capital Fund will provide much-needed state support for infrastructure investments and new workforce training programs for nurses, CNAs, home health aides, homemakers and other direct care workers. The oversight provisions will also help ensure that long-term care facility owners are truly committed to the communities they serve, and prevent private equity funds and hedge fund financiers from exploiting vulnerable patients and workers for profit. 1199ers are grateful to the Healey administration and House and Senate leaders for their commitment helping address staffing shortages and improve the quality of care for our nursing home residents."

Colin Killick, Executive Director, Disability Policy Consortium:

“The Massachusetts disability community is thrilled to see this Long Term Care legislation signed into law. This bill would have several major benefits, including strengthening infection control standards in nursing homes to hopefully prevent the horrific scenes that played out in many facilities at the height of the pandemic. Above all, we are proud to support the provisions reforming Estate Recovery, which will allow individuals with disabilities to leave more to their families when they pass away, helping to break the cycle of poverty faced by too many in our community.”

Leo Sarkissian, Executive Director, The Arc of Massachusetts:

“We applaud “Chapter 197 of the Acts of 2024”, passed by our legislature, and signed by Gov. Healey on September 6. While the law improves the quality of long-term care, it also should increase the availability of residential living options such as small nursing or green homes and assisted living.”