President and CEO’s Update – Brian Doherty, CAE

Advocacy Updates: An Active Year Serving as the Voice of Assisted Living

March 2026, Q1

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Dear Members,

So much of the work we do in advocacy for assisted living is nuanced and has mixed outcomes as policy changes involve so much compromise and assisted living regulations evolve as resident profiles change.

It’s within that context that we can enjoy a uniquely positive outcome. I am delighted to highlight a major victory for assisted living that your membership and our ongoing advocacy made possible. The highest court in Massachusetts affirmed our position on community fees in a decision that saved a member ALR $2.6 million dollars and will save many ALRs millions as well. We filed a detailed brief advocating for our position that community fees can be charged, and the outcome was a huge success. You can read more details in our member update.

As we navigate more nuanced advocacy on the new proposed assisted living regulations, assisted living communities remain guided by a simple and enduring purpose: helping older adults live with dignity, independence, and connection in a place they truly call home. That purpose is exactly what drives Mass-ALA’s ongoing engagement with regulators, policymakers, and other stakeholders on proposed updates to the assisted living regulations.

Mass-ALA also provided verbal testimony at the public hearing for proposed amendments to 651 CMR 12.00: Certification procedures and standards for assisted living residences on February 26 and submitted written testimony.  Our goal is to strengthen safety and quality while preserving what makes assisted living distinct: a home-like, resident-centered model built on choice and autonomy. People move into our communities because they want to maintain their independence and relationships but need support with activities of daily living. Regulations that reflect those values help providers keep communities vibrant, flexible, and person-focused. Overall, we support the direction of many of the proposed changes, especially those that clarify expectations, strengthen oversight, and promote resident safety, while offering practical recommendations to ensure the regulations align with current assisted living operations and staffing models. We also invite members to join us at our Regulations Symposium on June 17, 2026, where we’ll walk through key proposed changes and what they could mean for assisted living providers.

This work builds on years of advocacy. Thanks to the collective efforts of Mass-ALA members, legislators, and partners across the Commonwealth, we secured passage of the Assisted Living and Basic Health Services bill, landmark legislation that affirmed the essential role of licensed practical nurses (LPNs) in delivering health services within their scope of practice. Our comments to AGE build directly on that foundation.

In our comments to AGE, we expressed support for updates that strengthen transparency and accountability while recommending targeted refinements to keep the framework fair, efficient, and grounded in how care actually works. We advocated for enforcement practices that include clear guidance on when fines are issued and how they accrue, along with reasonable caps and consistent standards, so communities can focus resources on residents rather than administrative uncertainty. We reaffirmed the essential role of licensed practical nurses (LPNs) in assessments and service planning, recommended aligning on-site nursing coverage hours with residents’ real daily needs, and urged flexibility so qualified licensed clinicians can oversee AED policies and training. We also encouraged clearer, more workable standards for emergency response (for example, an average response-time measure rather than a strict per-call maximum), more focused reportable-injury language tied to actual injuries and serious incidents, and practical clarity around lifts and mobility/transfer devices that aligns with manufacturer instructions and appropriate clinical scopes of practice. Finally, we suggested several technical edits to improve consistency and implementation, including refining definitions (such as “serious incident”), clarifying operating plan expectations, and aligning ownership-change thresholds.

At the heart of every recommendation is one conviction: good regulation should make good care easier and this setting more accessible, not harder or more challenging. Our communities thrive when oversight is fair, transparent, and grounded in the real work of assisted living, focused on safety, respect, and the people who call our communities’ home.

We also remain engaged on detail-oriented advocacy that is happening as a follow-up to the work of the ALR Commission. We are currently reviewing a proposed disclosure form that AGE shared with us for comment, and we will be suggesting changes to that by March 31.

None of this work happens without the dedication you bring every single day. The credibility Mass-ALA carries in these conversations with state leaders is a direct reflection of the care, integrity, and professionalism you demonstrate in your communities. Thank you for being the foundation of everything we advocate for together.