The controversial practice of allowing nurses in assisted living communities in Massachusetts to provide skilled nursing care has received another extension with the adoption of a new law.
Gov. Maura Healey (D) signed a $388.6 million supplemental budget last month extending staffing flexibilities adopted during the COVID-19 pandemic, including keeping “commonsense” policies that allow limited skilled care to be provided in assisted living settings. The pandemic-era provision was set to expire March 31 but was extended for another year after the governor signed the legislation.
Massachusetts state law historically prohibited nurses in assisted living communities from providing skilled care to residents, requiring family members to provide that care or to pay an outside provider.
The Massachusetts Assisted Living Association first introduced a bill in 2017 — An Act Authorizing Common Sense Health Services in Assisted Living — that permitted assisted living nurses to provide simple, noninvasive treatments.
A state emergency order during the pandemic put that bill into a pilot program, allowing assisted living nurses to deliver a handful of additional health services, including blood glucose monitoring for residents living with diabetes, simple wound care for skin tears or other minor injuries, and assistance with oxygen.
Mass-ALA President and CEO Brian Doherty told McKnight’s Senior Living that the state delivered a “win” for the state’s assisted living residents and their families.
“Our experience during the pandemic has shown that assisted living nurses have been able to deliver this care safely and effectively, providing continuity of care and easing burdens on families,” Doherty said. “We hope our leaders go one step further and make this permanent by passing an act authorizing common sense health services in assisted living. More assisted living residents would have access to these health services if the authorization is made permanent, as some providers are waiting for that clarity before offering them.”
A report from LeadingAge LTSS Center @UMass Boston, Collective Insight and the Gerontology Institute evaluated the policy and released a report in January 2022 on the positive effects that the policy had on assisted living staff members, residents and their families.
Former Massachusetts Gov. Charlie Baker (R) extended the pandemic-era policy several times. LeadingAge Massachusetts had voiced its support for the legislation.
Other industry advocates, however, were not as supportive of the move, including the Massachusetts Senior Care Association, which called the legislation “unnecessary, redundant and inconsistent” with the intent of Massachusetts law that promotes assisted living as a “social” housing model.The budget also includes provisions related to the end of the public health emergency and support for vulnerable populations, including addressing food insecurity, housing instability, the state’s long-term COVID-19 response, economic development, essential support services for incoming immigrants and refugees, and more.
