Massachusetts legislators are demanding to know why state health regulators kept approving nursing home buyers with troubled records. The questions come less than two weeks before the Public Health Council is scheduled to vote on October 14 on tougher ownership rules. The rules would carry out a 2024 law that lets the Department of Public Health (DPH) consider an operator's out-of-state track record before granting a license.
For families, the stakes are practical. Few relatives can easily tell when a loved one's nursing home changes hands, and the new rules are meant to give regulators more power to say no before quality slips. The rules are not yet in effect.
Lawmakers Question Seven Years Without a Denial
The pressure follows a Boston Globe Spotlight investigation published in late September. It found that nine chains from New York and New Jersey owned 12 Massachusetts nursing homes in 2019 and now control 61, nearly one in five nursing homes in the state. Eight of the nine saw quality ratings at their Massachusetts homes decline after they arrived, according to the Globe's summary of its findings.
DPH Commissioner Robbie Goldstein acknowledged to the Globe that the department has not outright denied any application for a nursing home license since 2019. He said state law did not clearly allow regulators to consider applicants' records in other states.
The case drawing the most attention involves RegalCare, a New Jersey chain led by Eli Mirlis that acquired 12 Massachusetts nursing homes. Its homes in Quincy and Taunton fell from five federal stars to one. Mirlis acknowledged a role in a Medicare and Medicaid fraud scheme and settled with state and federal prosecutors, WBUR reported. The $1 million settlement, announced in September, resolved allegations that RegalCare billed for therapy services that were not medically necessary. Mirlis also reported on Massachusetts applications that he had never had a license revoked, although New Jersey revoked his license in 2018.
Rep. Marjorie Decker, who chairs the Joint Committee on Public Health, is sending Goldstein a letter asking why the department has not used its legal tools to vet operators more closely, according to the Boston Globe. Rep. Thomas Stanley, a co-sponsor of the 2024 law, put it bluntly: "We are providing DPH and the regulators all sorts of tools to take care of these problems that are identified, yet we still have a sense of a lack of urgency in implementing them."Sen. Julian Cyr and Sen. Patricia Jehlen also criticized the department's oversight.
Inside the Rules Headed to the Public Health Council
Gov. Maura Healey has defended Goldstein and said she put forward the strongest regulations. According to NBC Boston, Healey said the regulations "will bring the kind of accountability to the nursing home community across Massachusetts."
The law, signed in September 2024, directs DPH to weigh an operator's in-state and out-of-state quality history, criminal history, civil lawsuits, financial capacity, ownership, management companies, and private equity involvement. Management companies must also disclose major financial changes, such as bankruptcy, receivership, or liens.
DPH released proposed changes to its long-term care licensing rules, known as 105 CMR 153.000, and held a public hearing on the proposed changes on February 13, 2026. The draft added suitability reviews for management companies that run homes on an owner's behalf, as well as annual inspections of all long-term care facilities and reviews of outbreak response plans.
That timeline is at the center of lawmakers' concerns. The law has been on the books for about two years, and the rules needed to carry it out still await a final vote.
Families Weighing a Nursing Home Can Check Records Now
Families do not have to wait for the vote to do their own homework. The federal five-star quality rating system, shown on Medicare's Care Compare website, gives each nursing home an overall rating of one to five stars, with separate ratings for health inspections, staffing, and quality measures.
The Globe's findings suggest one useful habit: look at how a home's ratings have changed over time, not just its current score, and ask whether the facility has a new owner or management company.
Relatives of current residents can watch for problems the Globe documented, including unanswered call bells and medication errors, and raise concerns with the administrator or DPH.
These steps have limits. The federal government itself says no rating system can capture everything that matters, and many families have few nearby choices. Moving a frail relative carries its own risks, so decisions are best made with the resident's clinicians.
What Happens at the October 14 Meeting
The Public Health Council meets at 9 a.m. on October 14 at DPH headquarters, 250 Washington St. in Boston, according to the state's meeting schedule. Regular meetings are open to public observation, though the state advises checking the monthly docket because dates and times can change.
If the council approves the rules, DPH would gain clearer authority to weigh an applicant's full history. It is not yet clear when the rules would take effect or whether past approvals would be revisited. The new rules cannot undo earlier approvals on their own, so families should keep checking ratings and asking who runs a loved one's care.
Key Questions Answered
What is happening on October 14?
The Public Health Council is scheduled to vote on rules carrying out a 2024 nursing home oversight law. The rules are not yet in effect.
Why are lawmakers upset?
A Boston Globe investigation found DPH had not outright denied a nursing home license application since 2019, even as out-of-state chains with declining ratings expanded. Legislators say regulators have moved too slowly to use the 2024 law.
What does the Healey administration say?
Gov. Healey defended Commissioner Goldstein and said she put forward the strongest regulations. Goldstein said state law did not clearly allow the department to consider applicants' out-of-state records.
How can families check a nursing home's quality?
Use Medicare's Care Compare website to view star ratings for health inspections, staffing, and quality measures. Compare ratings over time, and ask whether ownership or management has recently changed.
Who is most affected?
Residents of homes bought by out-of-state chains, and families with few local options, face the most uncertainty. Talk with a resident's care team before considering a move.
Published by Medicaldaily.com
