Issue
Nursing home ownership changes and facility closures are often carried out with limited transparency and minimal opportunity for public input, despite their profound impact on residents, families, and staff. Greater transparency and oversight are essential to protect residents, families, and staff. Urge lawmakers to strengthen disclosure, review, and transition requirements to ensure safe, resident-centered outcomes.
DignityMA’s priority recommendation: Require the Massachusetts Department of Public Health (DPH) to hold mandatory, accessible public hearings whenever a nursing home is sold or closes.
What’s needed:
- In-person and virtual hearings must be required—not optional
- Hearings should be fully accessible, not limited to conference calls
- Residents, families, and staff must have a meaningful opportunity to be heard before decisions are finalized
Why it matters:
- Protect resident rights: Ensure individuals have a real voice in decisions affecting their lives
- Safer transitions: Provide time and oversight to plan appropriate relocations
- Community-based options: Guarantee residents are informed of and can choose home and community-based services when appropriate
- Accountability: Increase transparency around ownership changes and closure decisions
Legislative Action Needed:
- Ask legislators to support budget language requiring DPH hearings for all nursing home ownership transfers and closures
- Ensure hearings are robust, accessible, and resident-centered
Amendment: Section XX. Department of Public Health — Public Hearing Transparency
Amendment Language
SECTION XX. Section 20 of chapter 30A of the General Laws, as most recently appearing in the 2024 Official Edition, is hereby amended by inserting after section 1D the following section: –
Section 1E. The Department of Public Health shall hold a public hearing at the request of one or more citizens relative to the application, sale, transfer, closure, or receivership of a licensee to operate a skilled nursing facility or nursing home licensed under section 71 of chapter 111.
The hearing shall be advertised on the website of the department and on the website of the facility or facilities not less than fourteen (14) days prior to the date set for the public hearing.
Every hearing conducted pursuant to this section shall be conducted in a hybrid manner, both in-person and through virtual means accessible to the public.
The licensee shall make a good faith effort to notify any current resident, the resident’s authorized representative or caregiver, and family representative, if any, in advance of the hearing.
Explanation of the Amendment
This amendment strengthens transparency and public accountability in licensing actions involving skilled nursing facilities and nursing homes regulated by the Massachusetts Department of Public Health under section 71 of chapter 111.
Currently, a telephonic hearing is permitted at the discretion of the department after a request signed by ten registered voters.
significant transactions — including sales, transfers of ownership, closures, and receiverships — may proceed with limited public visibility and without a guaranteed opportunity for residents, families, staff, or community members to provide input.
This amendment:
- Requires a public hearing upon request of one or more citizens.
- Mandates at least 14 days’ public notice on both the Department and facility websites.
- Requires hearings to be conducted in hybrid format (in-person and virtual).
- Ensures residents and their authorized representatives are notified in advance.
The amendment creates a clear statutory right to public engagement before major changes affecting resident care and facility operations occur.
Fiscal Note – Estimated Fiscal Impact: Minimal
- Administrative costs associated with scheduling and conducting hearings are expected to be modest and absorbable within existing departmental resources.
- Hybrid hearing platforms are already widely used by state agencies, limiting additional technology costs.
- Notice requirements rely on existing agency and facility websites.
No new programmatic spending or personnel line items are required.
Why It Matters
Nursing home residents are among the Commonwealth’s most medically vulnerable citizens. Decisions involving facility ownership transfers, closures, or receivership can directly impact:
- Continuity of care
- Staffing levels
- Quality and safety outcomes
- Financial stability of the facility
- Resident displacement risks
Ownership changes, particularly involving private equity or complex corporate structures, can materially alter how facilities are operated. Without structured public input, residents and families often learn of changes after key decisions have already been made.
This amendment ensures:
- Transparency before irreversible decisions occur.
- Meaningful participation by residents and families
- Public accountability in transactions affecting publicly funded care
- Early identification of community concerns
- Greater trust in the regulatory process
By guaranteeing an accessible public forum, the Commonwealth affirms that nursing home residents are not passive occupants of licensed facilities, but individuals whose homes, health, and dignity are directly affected by these decisions.
This is a low-cost reform with high public value, reinforcing the Commonwealth’s commitment to transparency, accountability, and resident-centered long-term care governance.