Mass. Gen. Laws ch. 111, sec. 72 — MA Code / Part I / Title XVI / Chapter 111 / Section 72
Classification of long-term care facilities; rules and regulations; inspections; records of violations; jurisdiction; construction standards for small house nursing homes
Status: in_force

Section 72. (a)(1) The department shall classify long-term care facilities and shall, after a public hearing, promulgate rules and regulations for the conduct of such facilities. Rules and regulations for long-term care facilities shall include, but not be limited to, minimum requirements for medical and nursing care, the keeping of proper medical and nursing records, uniform requirements for the handling of patient funds, minimum requirements relative to the prevention and reparation of lost or damaged patient possessions, including personal clothing and minimum requirements relative to facility sanitation. (2) Regulations for intermediate care facilities for persons with an intellectual disability shall, in addition to the requirements pursuant to paragraph (1), include minimum requirements for social services, psychological services and other services appropriate for the care of persons with an intellectual disability and shall limit the size of such facilities to not more than 15 beds. (3) The department in promulgating rules and regulations for long-term care facilities shall consider the ability of long-term care facilities to provide service under rates set pursuant to section 13C of chapter 118E. No such rule or regulation shall apply to a long-term care facility licensed at the time of promulgation of such rule or regulation, or a long-term care facility being constructed at the time of such promulgation under plans approved by the department, unless such rule or regulation has a direct and material relation to patient diet, cleanliness, nursing care or health, or to habilitative services and active treatment for persons with an intellectual disability or persons with related conditions; provided, however, that nothing herein contained shall be interpreted to prevent the department from adopting or interpreting rules and regulations more favorable toward existing long-term care facilities. (4) The department may authorize specialized care units serving persons requiring treatment for infectious diseases, isolation, strokes, degenerative neurological conditions, traumatic brain injuries, in-house dialysis treatments, behavioral health treatments, substance use disorder treatments, bariatric patient care and conditions requiring 24–hour or 1–on–1 patient supervision. The department may promulgate rules and regulations to regulate the conduct of any such specialized care units. (b)(1) The department or its agents and the board of health or its agents of the city or town wherein any portion of such long-term care facility is located may visit and inspect such institution at any time; provided, that a board of health or its agents conducting an inspection of a long-term care facility located within its city or town shall notify the department of the results of any inspection conducted pursuant to this paragraph. (2) Any person making an inspection pursuant to paragraph (1) shall record in writing every violation of the applicable rules and regulations of the department that they discover during the course of their inspection. Every record of inspection shall be treated as a public record except to such extent the record or a portion thereof is expressly exempt from such treatment pursuant to clause Twenty-sixth of section 7 of chapter 4. A record of inspection containing violations shall be made public by the department at the same time that a written plan of correction is submitted. If a written plan of correction is not submitted within the allowable time, said violations shall be made public at the expiration of the allowable time. Inspections hereunder shall be unannounced and made at such intervals as the department shall specify in its rules and regulations; provided, that, each long-term care facility shall be subject to not less than 1 periodic, resident-centered inspection per year pursuant to subsection (b) of section 71. A visit made to a facility for the purpose of providing consultation shall not be considered to be an inspection. (c) The superior court shall have jurisdiction in equity to enforce the rules and regulations promulgated pursuant to this section. (d)(1) The department shall promulgate regulations for the construction, physical plant standards and operation of small house nursing homes. Newly constructed small house nursing homes shall house no more than 14 individuals per unit, in resident rooms that accommodate not more than 1 resident per room; provided, however, that if a resident requests to share a room with another resident to accommodate a spouse, partner, family member or friend, such resident room shall have sufficient space and equipment, as established by the department, for 2 residents; provided, further, that determinations to grant such requests shall be determined based on space and availability of rooms. All resident rooms shall contain a full private and accessible bathroom. (2) The department shall promulgate regulations for construction and physical plant standards for small house nursing homes that shall consider environmental standards and sustainability. (3) The department may promulgate additional regulations for small house nursing homes for a staffing model that: (i) allows for a universal worker approach to resident care that is organized to support and empower all staff to respond to the needs and desires of residents, including, but not limited to, cooking and meal preparation, without exceeding the lawful scope of practice of said employee; and (ii) provides for consistent staff in each small house nursing home. (4) The regulations promulgated pursuant to this subsection shall ensure the convalescent or nursing home meets the requirements necessary to be eligible to participate in both the Medicare and Medicaid programs.

Section 72. (a)(1) The department shall classify long-term care facilities and shall, after a public hearing, promulgate rules and regulations for the conduct of such facilities. Rules and regulations for long-term care facilities shall include, but not be limited to, minimum requirements for medical and nursing care, the keeping of proper medical and nursing records, uniform requirements for the handling of patient funds, minimum requirements relative to the prevention and reparation of lost or damaged patient possessions, including personal clothing and minimum requirements relative to facility sanitation.

(2) Regulations for intermediate care facilities for persons with an intellectual disability shall, in addition to the requirements pursuant to paragraph (1), include minimum requirements for social services, psychological services and other services appropriate for the care of persons with an intellectual disability and shall limit the size of such facilities to not more than 15 beds.

(3) The department in promulgating rules and regulations for long-term care facilities shall consider the ability of long-term care facilities to provide service under rates set pursuant to section 13C of chapter 118E. No such rule or regulation shall apply to a long-term care facility licensed at the time of promulgation of such rule or regulation, or a long-term care facility being constructed at the time of such promulgation under plans approved by the department, unless such rule or regulation has a direct and material relation to patient diet, cleanliness, nursing care or health, or to habilitative services and active treatment for persons with an intellectual disability or persons with related conditions; provided, however, that nothing herein contained shall be interpreted to prevent the department from adopting or interpreting rules and regulations more favorable toward existing long-term care facilities.

(4) The department may authorize specialized care units serving persons requiring treatment for infectious diseases, isolation, strokes, degenerative neurological conditions, traumatic brain injuries, in-house dialysis treatments, behavioral health treatments, substance use disorder treatments, bariatric patient care and conditions requiring 24–hour or 1–on–1 patient supervision. The department may promulgate rules and regulations to regulate the conduct of any such specialized care units.

(b)(1) The department or its agents and the board of health or its agents of the city or town wherein any portion of such long-term care facility is located may visit and inspect such institution at any time; provided, that a board of health or its agents conducting an inspection of a long-term care facility located within its city or town shall notify the department of the results of any inspection conducted pursuant to this paragraph.

(2) Any person making an inspection pursuant to paragraph (1) shall record in writing every violation of the applicable rules and regulations of the department that they discover during the course of their inspection. Every record of inspection shall be treated as a public record except to such extent the record or a portion thereof is expressly exempt from such treatment pursuant to clause Twenty-sixth of section 7 of chapter 4. A record of inspection containing violations shall be made public by the department at the same time that a written plan of correction is submitted. If a written plan of correction is not submitted within the allowable time, said violations shall be made public at the expiration of the allowable time. Inspections hereunder shall be unannounced and made at such intervals as the department shall specify in its rules and regulations; provided, that, each long-term care facility shall be subject to not less than 1 periodic, resident-centered inspection per year pursuant to subsection (b) of section 71. A visit made to a facility for the purpose of providing consultation shall not be considered to be an inspection.

(c) The superior court shall have jurisdiction in equity to enforce the rules and regulations promulgated pursuant to this section.

(d)(1) The department shall promulgate regulations for the construction, physical plant standards and operation of small house nursing homes. Newly constructed small house nursing homes shall house no more than 14 individuals per unit, in resident rooms that accommodate not more than 1 resident per room; provided, however, that if a resident requests to share a room with another resident to accommodate a spouse, partner, family member or friend, such resident room shall have sufficient space and equipment, as established by the department, for 2 residents; provided, further, that determinations to grant such requests shall be determined based on space and availability of rooms. All resident rooms shall contain a full private and accessible bathroom.

(2) The department shall promulgate regulations for construction and physical plant standards for small house nursing homes that shall consider environmental standards and sustainability.

(3) The department may promulgate additional regulations for small house nursing homes for a staffing model that: (i) allows for a universal worker approach to resident care that is organized to support and empower all staff to respond to the needs and desires of residents, including, but not limited to, cooking and meal preparation, without exceeding the lawful scope of practice of said employee; and (ii) provides for consistent staff in each small house nursing home.

(4) The regulations promulgated pursuant to this subsection shall ensure the convalescent or nursing home meets the requirements necessary to be eligible to participate in both the Medicare and Medicaid programs.