The Joint Committee on Elder Affairs Holds Hearing on Long-Term Care

The Joint Committee on Elder Affairs Holds Hearing on Nursing Facilities and Rest Homes

(BOSTON) – The Joint Committee on Elder Affairs, chaired by Representative Thomas M. Stanley (D-Waltham) and Senator Patricia Jehlen (D-Somerville), held a hearing on proposals to improve nursing facilities and rest homes.

The Committee received testimony on the following bills:
S375/H626; S377/H633; S381/H637; S384/H616; S395/H653; S389; S393; S378; H615; H623; H625; H628; H652; H655

“The bills heard by the committee today stress the importance of ensuring residents receive top-notch quality-of-care in nursing facilities and rest homes.” Representative Thomas Stanley said. “We appreciate the experts and constituents who testified in support of these important bills, as we work to improve conditions for seniors.”

“Most of us are in a state of denial about getting old, and about needing or paying for long term care. Most families aren’t able to pay for nursing facility care and end up on Medicaid.” Senator Patricia Jehlen said. “The legislation the Committee heard today highlights necessary steps for the Commonwealth to take in responding to these realities many are facing now, and we will all face one day.”

“As Vice Chair of the Joint Committee on Elder Affairs, today’s hearing was another opportunity to be informed by experts and stakeholders on issues relating to nursing care facilities and rest homes,” said Representative Lipper-Garabedian (D- Melrose). “In keeping with themes present throughout testimony today, we will continue to look for ways to prioritize dignity for our seniors as we review these legislative proposals.”

Advocates drew attention to ensuring that seniors in all settings are treated with dignity and respect. Themes included preventing discrimination against LGBTQI seniors, ensuring the Attorney General has the power to hold bad actors accountable, and increasing the amount of care and attention each resident receives through the Hours Per Patient Per Day (HPPD) requirement.

S375/H626: An Act increasing the personal needs allowance for residents of long-term care facilities increases the personal needs allowance to $100 a month for residents of a licensed nursing facility, a licensed chronic hospital, a licensed rest home, an approved public medical institution, or a public psychiatric institution.

S377/H633: An Act relative to transparency and accountability in nursing homes requires that nursing homes prepare and file an annual consolidated financial report annually, beginning with the fiscal year ending December 31, 2025. The State Auditor will have full access to all reports filed and the Auditor will periodically prepare reports concerning the quality of care, financial practices, and statewide oversight of Massachusetts skilled nursing facilities.

S381/H637: An Act establishing an LGBTQI long-term care facility bill of rights creates a bill of rights for LGBTQI residents of long-term care facilities. It prohibits discrimination and wrongful action based in whole or in part on a person’s actual or perceived sexual orientation, gender identity, gender expression, intersex status, or HIV status. The bill also requires that all long-term care facility staff will receive biennial training of the care of LGBTQI older adults and requires that transgender residents shall be provided access to such transition-related assessments, therapy, and treatments as have been recommended by the resident’s health care provider.

S384/H616: An Act strengthening the Attorney General’s tools to protect nursing home residents and other patients from abuse and neglect increases the civil penalties the attorney general can seek to a new maximum of; $25,000 if no bodily injury results; $50,000 if bodily injury results; $100,000 if sexual assault or serious bodily injury results; and $250,000 if death results. The attorney general may file a civil action within four years after an offense is committed.

S395/H653: An Act relative to rest home rate adjustments requires that the Secretary of Health and Human Services create regulations that will allow for rate adjustment and reimbursement within 90 days of implementing plans of correction or hiring new licensed nursing staff at rest homes.

S393: An Act relative to reserving beds in nursing homes during certain leaves of absence creates medical leave for residents of nursing homes. If a resident is a MassHealth recipient and enters a hospital, the division shall pay to preserve their bed in the nursing facility for a period of up to 20 days and reimburse the nursing facility. If a resident wants to take a nonmedical leave of absence, the division shall pay to preserve their bed in the nursing facility for a period of up to 10 day and reimburse the nursing facility.

S378: An Act relative to small house nursing homes establishes regulations for small house nursing homes. The model is designed to be a small house (with a kitchen and living area) where no more than 14 individuals live. Resident rooms will have up to 2 residents per room and include a fully accessible bathroom attached.

H615: An Act to ensure the quality of care in nursing homes increases the hours per patient per day to 4.1 hours, requires that nursing facilities implement anti-social isolation policies, and requires that nursing facilities provide technology to residents to prevent social isolation.

H623: An Act to improve quality and safety in nursing homes increases the hours per patient per day to 4.1 hours and requires that new nursing facilities or new renovations to existing facilities create rooms that can accommodate no more than 2 residents. The bill also creates a Human Rights Committee, which will have the authority to receive and investigate, or investigate on its own motion, any complaints affecting the rights of residents.

H625: An Act relative to stabilizing nursing home facilities proposes several financial changes. The bill requires that the base year used for rate determination purposes the reported costs of the calendar year not more than 2 years prior to the current rate year, requires that the so-called Nursing Cost Per Diem be the statewide average plus 10%, and that facilities with a disproportionately high number of Medicaid residents receive of upward adjustment of 5% in their rate.

H628: An Act relative to certified medical directors at skilled nursing facilities requires that each skilled nursing facility must contract with a certified medical director as a condition of licensure and establishes department oversight of said position.

H652: An Act establishing a special commission on a statewide long-term care insurance program creates a special commission to study and make recommendations to establish a statewide long-term care insurance program in the Commonwealth. Long-term care is often financially inaccessible to many families; most must spend down their savings to qualify for Medicare. The commission would study various policy options for implementing such a program.

H655: An Act requiring dignity, privacy, and safety for residents in nursing homes and rest home creates several provisions for residents including guaranteeing single occupancy rooms by July 1st, 2024, giving residents the option of in-room dining, and requiring that facilities submit a plan to the department demonstrating how said facility shall treat all residents with dignity at all times.

The May 15th hearing was Chaired by Sen. Jehlen and Co-Chaired by Rep. Stanley. A full recording of the event is available on Public Hearings on additional legislation will continue this spring and through the summer.