There are currently 226 Assisted Living Residences in Massachusetts which must be certified every two years and must comply with the regulations. The Executive Office of Elder Affairs Assisted Living Certification program oversees the certification process.
Recognizing the rapidly expanding senior population and the increase in Assisted Living Residences, particularly those offering Special Care Units for people with dementia, Alzheimer's Disease and other cognitive impairment, the Executive Office of Elder Affairs initiated a review of its Assisted Living Residence certification regulation. Last reviewed in 2006, the new regulations were reviewed by a working group who submitted suggested revisions. Proposed changes were then subjected to public comment as well as a public hearing. The final certification regulations reflect public input.
Notable changes include:
- Increased activities for residents with dementia: Under the new "Special Care" provisions, providers that market specific dementia-related services must have a multipurpose activity space. They must have structured activities offered three times in a 24-hour period, as opposed to simply "on a daily basis," as previously stated. All Special Care residents that begin an initial certification process after October 1, 2015, must have a secure outdoor space.
- More intensive resident screening: A nurse now will be required to conduct a screening of prospective residents that includes an assessment of functional abilities based on cognitive status. The nurse should evaluate whether the person is capable of self-administering medication.
- Upgraded disaster and emergency planning: Plan now must include specific evacuation strategies for different types of events, as well as protocols for participating in the Silver Alert system for locating missing people who have dementia.
- Tighter management of controlled substances: Providers now must document and implement policies to prevent theft or diversion of prescription medications taken by certain residents, including safe storage and disposal methods for the controlled substances.
- Distribution of end-of-life information: Facilities now are called on to furnish "culturally and linguistically suitable" information on end-of-life options, such as hospice and palliative care, to certain residents, including those who have a terminal diagnosis.