Legislation aiming to improve quality and oversight of senior living communities and nursing homes in Massachusetts being seen as a mixed bag by one assisted living association.
Eight months after the state House passed its version of the bill, the Massachusetts Senate Ways and Means Committee advanced S 2889, a package to reform the long-term care sector in the wake of the COVID-19 pandemic, which shone a spotlight on the sector’s shortfalls.
State Senate President Karen E. Spilka (D) said the bill would ensure access to high-quality care.
“It seeks to build confidence in management of facilities by strengthening oversight and creating provisions to help ensure that facilities do not sacrifice quality of care because of financial difficulties,” Spilka said in a fact sheet.
The Senate version of the bill package aims to strengthen the licensure process for assisted living communities and nursing homes under the Department of Public Health, requiring communities and facilities to be inspected once every nine to 15 months.
The legislation also would add basic health service requirements — including the administration of drops, oxygen management and home diagnostic testing — into the certification process for assisted living communities, along with annual reviews of communities certified to provide those services by the state Executive Office of Elder Affairs.
An executive order issued during the pandemic allowed nurses in assisted living to temporarily provide basic care. Those services would become permanent under this bill, something the Massachusetts Assisted Living Association has supported.
“Older adults living in residences across Massachusetts will benefit from these services being made permanent,” Mass-ALA President and CEO Brian Doherty told McKnight’s Senior Living. “As the bill moves forward, we will advocate for a handful of changes to increase access to these services to more residents.”
Specifically, Doherty said, Mass-ALA will be supporting an amendment to limit the scope of fines in the bill, as he said that unlimited fines could be a “major change” for assisted living providers.
Another change Doherty said Mass-ALA supports involves the ownership disclosure threshold. In the package, owners and management companies with at least 5% controlling interest in a community — a change from the current 25% — would be required to disclose information including their criminal and civil litigation history and financial history. Doherty, however, said the association supports a 15% threshold rather than a 5% one.
“At a time when more assisted living is needed for our aging population, we also hope the ownership disclosure threshold for assisted living residences will be increased to 15%, as the current 5% would disincentivize critical investments,” Doherty said.
Other reforms in the bill introduce a frail elder waiver to assisted living that would allow Massachusetts to permit eligible older adults to choose to live in certified assisted living residences rather than nursing homes and address Medicaid rates for skilled nurses working in long-term care, uniform prior authorization admission forms and increased penalties for operating a facility without a license.
