3 long-term care facilities placed in receivership

THREE LONG-TERM care facilities were placed under temporary receivership as lawmakers on Beacon Hill scrambled to act on legislation that would strengthen state oversight of nursing homes and other long-term care facilities.

Facilities owned by Blupoint Healthcare in South Hadley, Whitinsville, and Amesbury were experiencing financial difficulties, with workers complaining they weren’t being paid and even when they were paid the checks bounced.

State officials became alarmed at what Attorney General Andrea Campbell called “dangerous understaffing and poor quality of care,” so they filed an emergency petition in Suffolk Superior Court seeking a temporary receiver who could assess the situation and possibly shut the facilities down and transfer residents elsewhere.

“Receivership will help stabilize the situation by taking control of finances and supporting daily operations, while protecting the welfare of residents and staff,” Campbell said in a statement. .A court hearing is scheduled for Thursday.

The situation at Blupoint is increasingly common. The number of nursing homes is falling faster in New England than any other region of the country, according to a May report from the Federal Reserve Bank of Boston. The area has seen a net loss of more than 150 nursing facilities between 2011 and 2024.

Blupoint officials, who oversee Pioneer Valley Health and Rehabilitation in South Hadley, Blackstone Valley Health and Rehabilitation in Whitinsville, and Mill Town Health and Rehabilitation in Amesbury, could not be reached for comment.

Legislation focused on long-term care facilities is coming up for debate in the Senate on Thursday, eight after the House passed its version of the bill. The Senate bill is meant to reform the long-term care sector — an idea whose roots predate the COVID-19 pandemic that cast a harsh spotlight on lackluster infection controls, staffing shortages, and other pitfalls in the senior care system.

House Speaker Ron Mariano has identified the bill as one of his priorities for the session. Elder Affairs Committee Co-chair Rep. Thomas Stanley said earlier this month that the legislation could thwart the spate of nursing home closures seen in recent years, which have sent families scrambling to find new care options for their loved ones.

The Senate Ways and Means bill would create a “stronger” licensure process for long-term care facilities under the Department of Public Health, per Senate Ways and Means spokesman Sean Fitzgerald, and require every long-term care center to be inspected at least once every nine to 15 months, according to a bill summary.

Fitzgerald said that, under the bill, owners or management companies with at least 5 percent controlling interest in a facility would be required to disclose information to the Department of Public Health, which could review their criminal and civil litigation history and financial capacity, including filing for bankruptcy, any default under a lending agreement, the appointment of a receiver, or the recording of any lien.

The Massachusetts Assisted Living Association issued a statement encouraging the Senate to ease up on the requirement. “At a time when more assisted living is needed for our aging population, we also hope the ownership disclosure threshold will be increased to 15 percent, as the current 5 percent would disincentivize critical investments,” said Brian Doherty, president and CEO of the association.

The bill would also add providing basic health services into the certification process for assisted living facilities and have the Executive Office of Elder Affairs annually review all of the residences certified to provide such services.

Nurses could not provide certain services, such as administering insulin injections or basic wound care, in assisted living facilities under state law. The arrival of the COVID pandemic temporarily changed that, with an emergency order that allowed nurses to temporarily provide this basic care.

The COVID-era temporary health services, staffing and training flexibilities in assisted living were extended through March 31, 2024, as part of a supplemental budget approved earlier this year, and this bill would allow for some of those changes to become permanent.

“We applaud the Senate Ways and Means Committee for advancing basic health services in assisted living … It is important that the health services be made permanent so that more older adults have access to care from their nurses in assisted living,” Doherty’s statement said.

Along with the House, the Senate Ways and Means bill would require all long-term care facilities to develop individualized infection outbreak response plans.

High numbers of COVID deaths were reported across the country during the early days of the pandemic, and many facilities lacked resources and response plans to stop the spread of the highly contagious virus between elderly residents.

Like other sectors, the industry has long been grappling with staffing shortages, particularly during and after the pandemic. Last year, the Massachusetts Senior Care Association published results of a survey that found most facilities were near capacity with an average occupancy rate of 93 percent, coupled with thousands of job vacancies.

To address some workers’ concerns, the Senate Ways and Means bill creates some protections for employees. It forbids assisted living residences from discharging and disciplining employees who file a complaint with the Executive Office of Elder Affairs.

It also creates long-term facilities transfer requirements, including that a facility provide notice to its staff and to any union representing their employees at the time of the notice of intent to acquire.

The DPH would also have to issue regulations for the operation of small house nursing homes, facilities designed as residential homes that include a living room, kitchen, dining area, and outdoor space. The House bill limited newly constructed small house nursing homes to no more than 14 individuals per unit, with resident rooms accommodating only one person except in the cases of spouses, family members, or friends; the Senate Ways and Means summary did not include details about the committee’s preferred model.

To give state enforcement more teeth, the bill would quintuple penalties the attorney general can seek for abuse and neglect of patients, to $25,000 if the resident is not hurt, $50,000 if someone is hurt, $100,000 if an employee sexually assaults or seriously injures a resident, and $250,000 if a resident dies. This language matches the House bill.

Doherty said the Massachusetts Assisted Living Association will be supporting an amendment to limit the scopes of fines in the bill “as unlimited fines could be a major challenge for providers.”

One section of the Senate bill that was not included in what the House passed last fall is building-specific protections for older adults who are members of the LGBTQ+ community.

It would require that every long-term care facility provide staff training on the care of LGBTQ+ adults who have HIV. It would also explicitly forbid centers to discriminate against residents based on their sexual orientation, gender identity, or HIV status.

Centers would also be required to provide transgender residents with access to therapy and treatments recommended by their health care providers, and “ensure that resident records, including records generated at the time of admission, include the resident’s gender and the name and pronouns by which the resident would like to be identified, as indicated by the resident,” according to the bill summary.

The Senate bill includes another major provision of the House legislation — allowing for the Department of Public Health to institute a hand-picked “temporary manager” at a long-term care facility if the center isn’t in compliance with state and federal laws.

That mechanism could have staunched financial and payroll challenges at the Edgar P. Benjamin Healthcare Center, a Mission Hill nursing home that a court ultimately placed into state receivership, said Tara Gregorio, president of the Massachusetts Senior Care Association.

“If the bill does not pass, I worry that we’ll have missed an opportunity to really improve patient care and safety, address our workforce issues, and ensure that we have greater accountability and transparency in the sector, which I think is what everybody wants,” Gregorio said earlier this month. 

Other reforms in the bill have to do with reforming Medicaid rates for skilled nurses working at these facilities, requiring the Department of Insurance to develop a uniform prior-authorization form for admission to a post-acute care facility, and increasing penalties for those who advertise or run a long-term care center without a license.

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