Bill H.3927

HOUSE DOCKET, NO. 4386 FILED ON: 6/6/2023

HOUSE . . . . . . . . . . . . . . . No. 3927

By Representative Lipper-Garabedian of Melrose, a petition (accompanied by bill, House, No. 3927) of Kate Lipper-Garabedian relative to assisted living facilities. Elder Affairs.

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Third General Court
(2023-2024)

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An Act relative to assisted living facilities.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Section 3 of chapter 19D of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by striking the section in its entirety and inserting in place thereof the following:-

Section 3. (a) No person shall advertise, operate or maintain an assisted living residence without the certification required under this chapter; provided, however, that the provisions of this chapter shall not apply to such entities for the original facilities and services for which said entities were originally licensed or organized to provide. Assisted living residences may be sponsored by the following entities:

(1) convalescent homes, licensed nursing homes, licensed rest homes, charitable homes for the aged or intermediate care facilities for persons with an intellectual disability licensed pursuant to section seventy-one of chapter one hundred and eleven:

(2) hospices licensed pursuant to the provisions of section fifty-seven D of chapter one hundred and eleven;

(3) facilities providing continuing care to residents as defined by section seventy-six of chapter ninety-three;

(4) congregate housing authorized by section thirty-nine of chapter one hundred and twenty-one B or participants in the department’s congregate housing program;

(5) group homes or supported living programs operating under contract with the department of mental health, the rehabilitation commission or the department of developmental services or

(6) housing operated for only those duly ordained priests, or for the of the religious orders of the Roman Catholic church in their own locations, buildings, residences or headquarters to provide care, shelter, treatment and medical assistance for any of the said duly ordained priests or members of the said religious order.

(b) The provisions of this chapter shall not apply to any residential

premises available for lease by elderly or disabled individuals which is financed or subsidized in whole or in part by local, state or federal housing programs established primarily to develop or operate housing or both rather than to provide housing and personal services in combination, provided that such premises are not currently licensed under chapter one hundred and eleven.

SECTION 2. Section 4 of chapter 19D of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by striking the section in its entirety and inserting in place thereof the following:-

Section 4. (a) The department shall issue for a term of two years, and shall renew for like terms, a certification, subject to corrective action, modification, suspension or revocation by it for cause, to any person whom it reasonably determines to meet the regulatory requirements promulgated by the department in accordance with this chapter. Such certification shall not be transferable or assignable and shall be issued only to the person and for the premises named in the application. The department shall issue a certificate which shall be posted by the assisted living residence in a conspicuous place on the approved premises.

(b) Upon applying for initial certification or certification renewal, an applicant shall pay the department a fee based on the number of units at the assisted living residence. Said fee shall be established by the secretary of administration and finance pursuant to the provisions of section three B of chapter seven of the General Laws; provided, however, that a minimum fee shall be established notwithstanding the number of units at the residence; and provided further, that said fees shall be sufficient to support the entire cost of the department's administration of this chapter. Monies collected from said fee may be appropriated for the purpose of supporting said administration.

(c) Notwithstanding the previous paragraph, no fees, including minimum fees, for initial certification or certification renewal shall be due from any provider for assisted living units created under the HUD Assisted Living Conversion Program.

(d) If an application for renewal is filed at least thirty days before the stated expiration date of the certification, such certification shall not expire on such date, and the assisted living residence shall be deemed to be certified until such time as the department may notify the sponsor that the application for renewal has been denied.

(e) Each applicant for initial certification shall file with the department an operating plan which includes the following information:

(1) the number of units for which certification is sought and the number of residents per unit;

(2) the location of resident units, common spaces and egresses by floor;

(3) the base fee to be charged for each such unit;

(4) the services to be offered, and arrangements for providing such services, including linkages with hospital and nursing facilities if any;

(5) the number of staff to be employed in the operation of said residence and

(6) such other information as the department may reasonably require or the applicant may choose to provide as affirmative evidence of ability to comply with the regulations and provisions of this chapter.

(f) Applicants and sponsors shall file notice of any material change to the assisted living residence’s operating plans prior to the change’s effective date and as may otherwise be required by the department. A sponsor shall file annually on a date established by and on a form prescribed by the department a statement and a professional opinion prepared by a certified public account or comparable reviewer indicating whether the assisted living residence is in sound fiscal condition and is maintaining sufficient cash flow and reserves to meet the requirements of the service plans established for its residents.

(g) Each applicant for initial certification and each sponsor applying for renewal of certification shall disclose the name and address of each officer, director and trustee and the names and addresses of limited partners or shareholders with more than five percent interest in the assisted living residence. The applicant or the sponsor shall furnish assurances that none of such individuals has ever been found in violation of any local, state or federal statute, regulation, ordinance or other law by reason of that individual's relationship to an assisted living residence, and the applicant shall list, for each such individual, all multifamily housing or health care facilities or providers in the commonwealth or in other states in which she or he has been or is an officer, director, trustee, or general partner.

(h) With respect to an applicant or sponsor who has or has had within the previous five years before the date of such application an interest in an entity licensed under chapter one hundred and eleven of the General Laws, or a medical provider licensed under other applicable state statutes, or a home health agency certified under Title XVIII of the Social Security Act, as amended, the applicant shall furnish evidence from the department of public health that such facility or agency has substantially met applicable criteria for licensure or certification and, if applicable, has corrected all cited deficiencies without delicensure or decertification being imposed. The department may in its discretion deny certification to any applicant hereunder who has directly or indirectly had an ownership interest in an entity licensed under chapter one hundred and eleven, or a medical provider licensed under other applicable state statutes, or a home health agency certified under Title XVIII of the Social Security Act, as amended, that (i) has been the subject of a patient care receivership action; (ii) has ceased to operate such an entity as a result of (a) a settlement agreement arising from a decertification action, (b) a settlement agreement in lieu of a patient care receivership or (c) a delicensure action or involuntary termination of participation in either the medical assistance program or the medicare program; (iii) has been the subject of a substantiated case of patient abuse or neglect involving material failure to provide adequate protection or services for the resident in order to prevent such abuse or neglect or (iv) has over the course of its operation been cited for repeated, serious and willful violations of rules and regulations governing the operation of said health care facility that indicate a disregard for resident safety and an inability to responsibly operate an assisted living residence.

SECTION 3. Section 6 of chapter 19D of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by striking the section in its entirety and inserting in place thereof the following:-

Section 6. (a) If the department determines a sponsor or applicant has failed or refused to comply with requirements established under this chapter or the regulations promulgated thereunder, the department may

(1)deny an application for recertification;

(2)modify, suspend or revoke a certification or

(3)issue a fine of not more than $500 for each day of such failure or refusal to comply.

(b) Notice of denial, revocation, suspension or modification and the sponsor's or applicant's right to an adjudicatory proceeding shall be governed by the provisions of chapter thirty A.

SECTION 4. Section 8 of chapter 19D of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by inserting in subsection (b) after the words “assisted living residence.” the following:-

; provided that, making such a referral shall be a violation of chapter 93A.

SECTION 5. Section 15 of chapter 19D of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by inserting after subsection (c) the following:-

(d) No assisted living residence shall discharge, discipline, discriminate or otherwise retaliate against an employee of such residence who, in good faith, files a complaint with or provides information to the department. No assisted living residence shall discriminate or retaliate against a resident, party or entity who, in good faith, files a complaint with or provides information to the department. Any assisted living residence in violation of this section shall be liable to the person so retaliated against by a civil action for up to treble damages, costs and attorney’s fees.

Name:	District/Address:	Date Added:
Kate Lipper-Garabedian	32nd Middlesex	6/6/2023