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Allison Kuznitz | SHNS
People considering assisted living residences would gain new clarity into costs and the availability of medical care, under a set of newly proposed state regulations.
Assisted living residences would be required to produce "straightforward service agreements" specifying the costs of care and when those costs may increase, under draft regulations released by Attorney General Andrea Campbell's office. Facilities must disclose the scope of available nursing care, and residents must have "transparent information" about whether they need advanced care beyond what's offered in their current ALR.
Residents would also gain rights similar to other tenants, including protections around fees and evictions.
"When our elders move into assisted living residences, they and their loved ones deserve safe accommodations and clear information about the costs they will pay and services offered," said Campbell. "These regulations will strengthen accountability to ensure that these facilities are fulfilling their commitments and help ensure older adults live with dignity and respect."
ALRs allow adults to live largely independently while receiving help with daily tasks, but the facilities came under heightened scrutiny following the July 2025 blaze at the Gabriel House in Fall River that claimed 10 lives. More than 17,000 people are living in more than 270 certified ALRs in Massachusetts, according to the Executive Office of Aging & Independence (AGE).
The executive office says assisted living residences offer help to residents with activities like housekeeping, meal preparation, bathing, dressing and medication assistance, but do not provide medical or nursing services and are "not designed for people who need serious medical care." Most fees are paid privately and the cost to live in assisted living varies from $3,655 to $8,036 per month, with residents who need additional care due to memory impairment facing median monthly costs ranging from $6,334 to $9,525.
Campbell's office said the draft regulations are based on feedback from stakeholders, such as elder law attorneys. They also align with recommendations issued in January by the state's ALR Commission, which called for standardized disclosure forms.
The commission found that existing information about ALRs can be "confusing," and that families can struggle to compare facilities across cost and service criteria. Under the draft regulations, ALRs would violate consumer protection law by not itemizing all costs for housing, resident services, personal care services, medical services and other care; imposing a charge for a service that the resident did not request or agree to; or increasing a service charge without first providing 60 days' notice.
Campbell's office plans to hold a public hearing on the proposed regulations on April 29 and accept written comments through May 1.
In late February, the state executive office held its own hearing on a slate of proposed regulations for bolstering emergency preparedness at ALRs. The facility nurse and resident care coordinator must develop individualized service plans that detail the type of help that residents need in emergencies or evacuations.
ALRs must also have comprehensive disaster and emergency preparedness plans, developed with local and state safety experts. The plans should outline specific responsibilities for staff, address the physical and cognitive needs of residents, and indicate evacuation routes and procedures to evacuate residents, according to the proposed regulations.
Alison Kuznitz is a reporter for State House News Service and State Affairs Pro Massachusetts.
