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SD 2135

An Act clarifying responsibility for policy and budgetary decision-making in nursing homes

194th Legislature (2025-2026) Introduced by John Velis

The bill requires nursing home administrators to certify budgets meet resident care needs (with a medical director) or face sanctions, including possible license suspension.

House concurred
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Bill Summary · SD 2135

Summary: Senate Bill SD 2135 — An Act clarifying responsibility for policy and budgetary decision-making in nursing homes

What the bill aims to do

SD 2135 seeks to clarify and assign responsibility for the budgeting, staffing, and policy decisions in Massachusetts nursing homes. It creates mandatory sworn certifications from facility administrators, links those certifications to medical directors, and establishes enforcement mechanisms and potential sanctions for insufficient budgets that fail to meet resident care needs. The core idea is to align financial planning with resident care obligations and hold specific individuals and facility owners accountable for budget sufficiency.

Key provisions

  • Mandatory annual certification (Section 1, new subsection f):

    • Each nursing home administrator must certify under perjury at the start of the facility’s fiscal year that the budget and staffing are sufficient to meet regular operational needs, including care for all residents.
    • The certification must be counter-signed by the facility’s designated medical director, per CMS Operations Manual 100.07, section 483(i).
    • “Care needs” covers the full range of resident care and related costs identified in each resident’s care plan, including housing and management costs apportioned to residents.

  • Enforcement and consequences for lack of budget sufficiency (Section 2, new subsection g):

    • If the administrator fails to assent to the budget’s sufficiency, the administrator’s license may be suspended by the Board of Registration of Nursing Home Administrators.
    • The administrator cannot justify non-signature by claiming corporate approval that disregards the certification.
    • If there is no signed affidavit of budget sufficiency (administrator and medical director), the facility may be prohibited from accepting new residents until the affidavit is provided to the Department of Public Health (DPH).

  • DPH authority to sanction insufficient budgets (Section 3, new Section 72CC):

    • If the DPH determines a facility’s budget is insufficient to meet residents’ care needs, it may sanction the facility after a public hearing, up to license revocation or receivership.
    • DPH is authorized to promulgate regulations to implement this provision.

  • Liability for adverse events (Section 4, new Section 72DD):

    • Adverse events attributable to operating with an insufficient budget may be attributed to the nursing home administrator and/or medical director if a signed affidavit of budget sufficiency exists; or to the facility’s owners if no such affidavit exists.
    • Criminal and civil liability may apply for those responsible.

  • Regulatory timeline (Section 5):

    • DPH must develop implementing regulations by July 1, 2027.

Who is affected

  • Primary individuals: Nursing home administrators and designated medical directors (they share responsibility via the affidavit and must countersign).
  • Facility stakeholders: Facility owners and operators; boards and licensees may face licensure actions or sanctions.
  • State agencies: Department of Public Health (DPH) and the Board of Registration of Nursing Home Administrators (BRNHA).
  • Residents and families: Potentially affected through changes in budgeting, staffing, and eligibility for new admissions.

Procedural and timeline notes

  • The bill was introduced on March 10, 2025, and is noted as House concurred with referrals to the Committee on Elder Affairs.
  • If enacted, regulations implementing the act are due by July 1, 2027.
  • The bill creates binding certification requirements and specified penalties, including license suspension and potential criminal/civil liability for insufficient budgets.

Compiled from official sources — confirm details with the bill’s official record.

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