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SD 3917

Long-Term Care Facility Quality Improvement Fund FY21 Annual Report

194th Legislature (2025-2026)

Creates a dedicated Long-Term Care Facility Quality Improvement Fund to fund safety and quality initiatives, training, staffing, inspections, and related activities.

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Bill Summary · SD 3917

Summary of SD 3917 (Session 194th) — Massachusetts

Purpose and intent

  • Establishes and documents the Long-Term Care Facility Quality Improvement Fund (the Fund) and requires annual reporting on its activity.
  • The Fund is designed to support initiatives aimed at improving safety and quality of care in long-term care facilities, including staff training, technical assistance, dissemination of best practices, state operation of facilities when deficiencies are not corrected, resident relocations, and department inspection resources.

Key provisions and changes

  • Creation and administration:
    • The Department of Public Health (DPH) administers the Fund.
    • The Fund may be used for various quality-improvement measures in long-term care facilities.
  • Authorized uses (non-exhaustive list):
    • Staff training and education.
    • Technical assistance to implement best practices.
    • Dissemination of best practice models on quality of care.
    • State operation of facilities pending correction of deficiencies or closure.
    • Costs of relocating residents between facilities.
    • Funding to support adequate DPH resources to inspect facilities under state and federal law.
  • Sources of Fund revenue:
    • Fines and penalties imposed under M.G.L. ch. 111, § 73 (for unlicensed operations or violations of licensure requirements and related rules).
    • Appropriations or other money designated by the General Court to credit to the Fund.
    • Funds from public or private sources (gifts, grants, donations, rebates, settlements) explicitly designated for the Fund.
  • Financial management:
    • The Department may incur expenses and the state comptroller may certify payments in anticipation of expected receipts.
    • No expenditure may cause the Fund to be deficient at the end of a fiscal year.
    • Amounts credited to the Fund are not subject to further appropriation, and unspent funds do not revert to the General Fund.
  • Annual reporting:
    • The commissioner must report annually (by October 1) to the chairs of relevant committees on Fund activity, including:
    • Revenue received by the Fund.
    • Expenditures from the Fund (recipient, date, and purpose).
  • FY21 Annual Report (example data in the bill text):
    • FY21 covers July 1, 2020 – June 30, 2021.
    • Revenue primarily from fines/penalties under M.G.L. ch. 111, § 73 and settlements with the Office of the Attorney General.
    • Fine structure (FY21):
    • Initial fine of $500 for operating without a license or license violations (with higher fines for subsequent violations, up to $1,000).
    • Initial fine of $50 for violations of rules/regulations, plus $50 per day for continued noncompliance.
    • Beginning Fund balance (FY21): $95,619.80
    • Revenue in FY21: $50.00
    • Expenditures in FY21: $65,816.89
    • Ending Fund balance (FY21): $29,852.91
    • Example expenditure: Disbursed to Mass Senior Care Association to administer a project reimbursing COVID-19 PPE supplies for licensed Rest Homes and non-CMS certified Nursing Homes.
  • Administrative note:
    • The Department indicates ongoing consideration of additional uses for Fund expenditures to further safety and quality improvements in long-term care facilities.

Who or what would be affected

  • Long-term care facilities subject to licensure and regulation under M.G.L. ch. 111 (including Rest Homes and non-CMS certified Nursing Homes in the FY21 example).
  • Department of Public Health, which would administer the Fund and oversee expenditures.
  • Massachusetts residents in long-term care, particularly as related to safety, quality of care, staffing, and resource availability (via training, best practices, and potential facility operations or relocations).
  • State and possibly private entities that receive Fund disbursements for quality-improvement initiatives.

Procedural and timeline aspects

  • The Fund is perpetual in concept, with annual reporting requirements.
  • The annual report to the Senate and House chairs of the Joint Committee on Elder Affairs and Ways & Means is due each year (no later than October 1).
  • The FY21 data provided illustrates how the Fund operated during one fiscal year: July 1, 2020 – June 30, 2021.
  • Expenditures must be aligned with available fund balances, ensuring no year-end deficiency.
  • The bill references ongoing opportunities to allocate Fund resources to further safety and quality improvements beyond the FY21 example.

Overall assessment

  • The bill formalizes a dedicated financing mechanism (the Long-Term Care Facility Quality Improvement Fund) to support quality and safety enhancements in long-term care facilities.
  • It clarifies eligible uses, revenue sources (fines, appropriations, and designated private/public funds), and reporting requirements to provide transparency and accountability.
  • It accommodates interim and future expenditures focused on training, best practices dissemination, staffing, and inspection capacity, with a specific example of supporting COVID-19-related supplies through an administrative arrangement.

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

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