Massachusetts approves regulations strengthening nursing home oversight

On October 14, 2026, the Massachusetts Public Health Council unanimously approved long-pending regulations strengthening state oversight of nursing homes and long-term care facilities. Promulgated following a Boston Globe Spotlight investigation into poor care by out-of-state operators, the new rules expand health officials' authority to scrutinize ownership suitability, examine associated corporate affiliates, appoint temporary managers, and levy higher financial penalties for fraud. Simultaneously, state regulators moved to revoke the licenses of RegalCare owner Eli Mirlis over license application misrepresentations.

Approval of new nursing home regulations

• ▪The new Massachusetts nursing home rules set standards for small-house nursing homes designed for home-like care and require nursing homes to undergo more frequent state inspections.
• ▪The Massachusetts Public Health Council unanimously approved new regulations on October 14, 2026, to strengthen state oversight of long-term care facilities and nursing homes.
• ▪The new Massachusetts nursing home regulations finalize rules required by a landmark long-term care law enacted by the Massachusetts Legislature in 2024.

Enhanced ownership vetting and corporate oversight

• ▪Under the new regulations, Massachusetts health regulators possess expanded legal powers to scrutinize and restrict transactions involving affiliated corporate landlords that extract profits by charging inflated rents.
• ▪Massachusetts health officials will now evaluate staffing levels and quality care metrics at an applicant's other facilities during suitability reviews for nursing home license applications and renewals.
• ▪The new Massachusetts rules expand the Department of Public Health's authority to review management companies and real estate holding companies associated with prospective nursing home owners.

Penalties and enforcement powers for violations

• ▪A ten-year operational ban in Massachusetts applies to nursing home owners whose facility licenses are permanently revoked following an administrative legal appeal.
• ▪The approved regulations increase financial penalties against nursing home operators that commit fraud, engage in deceptive business practices, or break state health rules.
• ▪Massachusetts state health officials gained the authority to appoint temporary managers to operate long-term care facilities when state inspectors discover serious violations.

Nurse aide training deadlines

• ▪Original proposed Massachusetts regulations required nurse aides hired after November 1, 2026 to have CPR and naloxone training, with existing staff required to complete training by May 1, 2027.
• ▪Massachusetts pushed back mandatory CPR and naloxone certification deadlines for nurse aides to January 1, 2027 for new hires and October 1, 2027 for existing staff due to industry cost concerns.

Spotlight investigation into state oversight

• ▪Massachusetts Public Health Commissioner Robbie Goldstein stated at the October 14, 2026 meeting that the Spotlight investigation raised serious questions about the department's oversight.
• ▪A September 28, 2026 Boston Globe Spotlight investigation reported that Massachusetts public health officials had approved out-of-state nursing home buyers with track records of poor care.

Enforcement actions against Eli Mirlis

• ▪Massachusetts state health department officials placed RegalCare facilities under enhanced monitoring while RegalCare appeals the license revocation before an administrative law judge.
• ▪Eli Mirlis reached a settlement regarding allegations that he billed MassHealth and Medicare for unnecessary physical therapy performed on frail nursing home residents.
• ▪New Jersey regulators permanently revoked Eli Mirlis's nursing home administrator license in 2018 for falsifying continuing education credits, a revocation Mirlis omitted on Massachusetts license applications.
• ▪The Massachusetts Department of Public Health moved to revoke the licenses of RegalCare owner Eli Mirlis after finding he misrepresented his credentials on license applications.