Following the submission of the Assisted Living Residence (ALR) Commission’s final report to the Legislature, which outlines both regulatory and legislative solutions to improve the safety and well-being of residents, Governor Healey is beginning to implement the group’s recommendations.

The ALR Commission was established through the 2024 Act to Improve Quality and Oversight of Long-Term Care and undertook an extensive review of the ALR sector to ensure it continues to meet the needs of an aging population while prioritizing resident health and safety. The Commission was expected to file its final report on August 1, 2025. Following the tragic fire at Gabriel House in Fall River, Governor Healey signed into law an extension passed by the Legislature so that the Commission had additional time to incorporate lessons learned from the fire. The Commission voted unanimously by those in attendance to approve its final report on January 12, 2026.

The Commission’s recommendations aim to ensure ALRs continue to meet the evolving needs of older adults while significantly strengthening transparency and oversight, emergency preparedness, staffing, and consumer protections. The Commission met 16 times, held two public hearings, and incorporated direct feedback from residents, families, industry experts, and first responders. Key recommendations include:

• Stronger Fire Safety & Emergency Preparedness Standards – enhance inspections and coordination with local fire departments to prevent future tragedies.
• Transparent Public Data – create a new statewide online database to provide families with clear access to compliance records, ownership information, and corrective action plans.
• Standardize Disclosures – standardize information on services, costs, staffing, and resident rights for easier comparison across ALRs.
• Staffing & Nursing Leadership Requirements – ensure every ALR has access to licensed nursing support and leadership training that matches resident needs.
• Clear Assessment Practices – ensure consistent evaluations of resident needs with clear notice of any cost or care changes.
• Affordability Task Force – create a task force to evaluate new models that expand access for low- and middle-income older adults.

The Healey-Driscoll Administration announced they are taking action to begin the implementation of a majority of the regulatory and administrative recommendations in this report.

The Commission recommends legislative action to further strengthen resident safety and consumer protections, including establishing a dedicated funding mechanism to expand state oversight and public reporting, amending state law to authorize certified medication aides in assisted living settings, and creating a statewide registry for ALR executive directors. The report also urges the review of ALR building classifications and the modernization of building code requirements. Finally, the Commission recommends forming an ALR Affordability Task Force to look into sustainable models that expand access for low- and middle-income older adults.

More information is available in the full ALR Commission Report here.