To:Assisted Living Residences and Other Interested Parties
From:Jennifer Davis Carey
Date:August 23, 2006
Re:Implementation of Amendments to Assisted Living Regulations, 651 CMR 12.00

One of the most rapidly growing forms of residential long-term care in Massachusetts is Assisted Living. Since the passage of Chapter 354 of the Acts of 1994, An Act Establishing Assisted Living Residences, the number of assisted living residences has grown to almost two hundred, and they collectively serve thousands of residents. The goal of assisted living residence programs is to provide the resident with the maximum amount of independence, in a residential setting, with personalized assistance. By offering a combination of housing and individualized personal care services, assisted living residences provide an essential option in the continuum of care that allows elders to age in their communities.

However, as this industry has matured, its services have been utilized by residents who require greater levels of assistance, including special care for dementia and related conditions. The regulatory framework had not kept pace with the changes in this industry. Informed by the work of its own consultant and the legislatively-established Special Commission to analyze the regulation of assisted living facilities - which included members of the Administration, members of the General Court, advocates, and representatives of the industry - Elder Affairs drafted, and, in March 2006, filed proposed amendments to its regulations. The public hearing was held in April and, after careful review, Elder Affairs revised the proposed regulations to reflect the many comments that were received from consumers, the industry, and advocacy groups. Final regulations were filed on August 23, 2006. The regulations take effect upon publication in the Massachusetts Register, which is expected to be issued on September 8, 2006.

In order to permit Assisted Living Residences a reasonable opportunity to develop, document, and implement policies and procedures which meet the requirements of the regulations, we are issuing this bulletin to outline a schedule for phasing in the new requirements. The schedule will be as follows:

  • Assisted Living Residences are expected to immediately begin to develop and implement policies and procedures which meet the requirements of the regulations, and to train their staff on those policies. They must be in full compliance with the revised regulations as soon as reasonably possible and, in any event, by December 10, 2006.

  • Any new forms or documentation required by these regulations must be submitted to the Elder Affairs Assisted Living Certification Unit by December 10, 2006.

  • Provided an Assisted Living Residence is making a good faith effort to develop and implement policies which comply with the revised regulations, the Elder Affairs Assisted Living Certification Unit will not make any adverse findings against it for failure to comply immediately with the requirements of the amended regulation on any compliance review or inspection conducted prior to December 10, 2006.

  • In the interim, adverse findings may be made against any Assisted Living Residence that has failed to comply with the regulatory requirements in effect prior to the filing of the final amendments, except to the extent the revised regulation imposes a lesser burden on an Assisted Living Residence. For example, in accordance with 651 CMR 12.07 (3), an Assisted Living Residence may treat as portable, in-service training received at another residence, and an adverse finding will not be made against it on that basis even if it has not yet met all other requirements of the revised regulations.

A copy of the final regulations and a red-lined version of them is available at Elder Affairs' portal at under the heading "Regulations and Statistics." If you do not have access to the Internet and need a hard copy sent to you, please contact a member of the Assisted Living Certification Program at 617-727-7750.