Long Term Care Summary
On August 29th, 2024 the Legislature enacted H.5033 - An Act to improve quality and oversight of long-term care, which is now pending before the Governor for her signature. The Governor has 10 calendar days (from the bill’s passage) to sign the legislation. If she does not sign the bill within 10 days, it automatically becomes law.
This bill delivers major legislative reforms to our continuum of care system and assisted living industries in the Commonwealth. Regarding nursing homes, the bill takes a comprehensive approach towards supporting and expanding the workforce, enhancing oversight of facilities, prioritizing quality of care, and increasing access.
The bill seeks to further improve the quality of long-term care by:
facilitating the establishment of small house nursing homes
mandating new infection outbreak response plans, and providing for new training and education programs
Increasing accountability for underperforming nursing facilities by raising the civil penalties sought by the Attorney General in instances of abuse or neglect
Increasing fines sought by DPH if a facility is operating without a valid license
The bill also expands financial reporting which will give DPH, policymakers and the public, a better understanding of the complicated ownership arrangements of nursing homes and allow stakeholders to gain a deeper understanding of the financial strength of the nursing home industry in the Commonwealth.
Additionally, the bill looks to alleviate key chokepoints in the continuum of care by:
Launching a two-year pilot program requiring insurance carriers to respond to a prior authorization (PA) request to post-acute care facilities by the next business day, or to waive the PA altogether if a patient can be admitted into a facility over the weekend
Easing the administration of PA policies by partnering the Division of Insurance with MassHealth to create a standardized PA form to improve the efficiency of PA requests
Studying improvements to the MassHealth long-term care eligibility process and assembling a task force to make recommendation on addressing lingering hospital throughput challenges
Directing DPH to study and make recommendations on how to address the current shortage of professional guardians and their impact on delayed discharges in the state
This legislation also requires each long-term care facility to provide staff training on the rights and care of LGBTQ+ older adults and older adults living with HIV. It also forbids any long-term care facility and long-term care 2 facility staff from discriminating based in whole or in part on a person’s sexual orientation, gender identity, gender expression, intersex status or HIV status, whether through the denial of admission, medical or nonmedical care, access to restrooms, or through room assignments.
Additionally, this legislation responds to several of the recommendations made by the 2020 Nursing Facility Task Force report, by:
Providing the Department of Public Health (DPH) with additional tools to monitor and take punitive action against facilities including new abilities to limit, restrict, suspend or revoke a license for cause and appoint temporary managers;
Strengthening DPH’s licensure suitability standards to include a more comprehensive review of the background and legal record of applicants and expanding the scope of review to include any entity with at least 5 percent ownership interest in a nursing facility; and
Creating new initiatives to support and grow the workforce such workforce training grants to develop new Certified Nursing Assistants (CNAs), career ladder program grants for direct care workers to become Licensed Practical Nurses (LPNs), and leadership and supervisory training
The bill also establishes new commissions oriented around improving the Commonwealth's continuum of care, including:
Task Force to evaluate the state of residential care homes (Rest Homes) in the Commonwealth
Special legislative commission to study the oversight of continuing care retirement communities
Task Force to review the viability and sustainability of long-term care facilities in the Commonwealth
Assisted Living Residences Commission to study and recommend policies ensure that ALRs continue to meet the health and safety needs of their residents.
A comprehensive and patient-focused long-term care system is essential to the functioning of the Commonwealth’s continuum of care. I’m proud of my colleagues in the Legislature for making major strides towards this outcome with the passage of this bill.
If you are further interested in the specifics of the legislation, please see the detailed summary of the bill attached below.
As always, please do not hesitate to contact my office if you have any questions or concerns.
Best Regards,
Jay
