Massachusetts has implemented stricter regulations for nursing home operators following concerns raised about care quality and oversight failures, particularly involving a New Jersey-based chain, RegalCare. On Wednesday, the state’s Public Health Council approved new rules designed to strengthen regulatory authority over nursing home providers. The move comes shortly after the Department of Public Health initiated efforts to revoke all 12 licenses held by RegalCare in Massachusetts, marking the state’s most significant enforcement action against a nursing home operator in recent years.
RegalCare acquired its Massachusetts homes since the onset of the COVID-19 pandemic. Investigations, including a recent report, revealed rapid declines in the quality of care at many of these facilities. Prior to the new regulations, state law limited the Department of Public Health’s ability to deny licenses based on poor performance records. However, legislation passed in 2024 expanded regulatory powers, with the new rules set to take effect in November. These regulations enable more rigorous evaluation of affiliated companies related to nursing home operators, such as those that provide management services, therapy, and real estate leasing—a practice critics say has allowed owners to divert funds and increase profits in an already highly regulated sector.
The updated rules also mandate more frequent inspections of nursing homes and impose stiffer financial penalties for owners found guilty of fraud or deceptive practices. The Public Health Council’s vote followed an extensive review of over 100 public comments and legal scrutiny of the proposed changes.
During the council meeting, Department of Public Health Commissioner Robbie Goldstein acknowledged past shortcomings in oversight, including the department’s 90 inspections of RegalCare facilities over three years, which he conceded were insufficient. He emphasized the need for urgency and transparency in addressing quality-of-care issues, highlighting that the recent actions against RegalCare stemmed from a comprehensive review triggered by concerns raised in public reports.
The department’s move to revoke RegalCare’s licenses was influenced by a settlement in which the company’s CEO, Eli Mirlis, admitted to billing MassHealth and Medicare for unnecessary intensive physical therapy on vulnerable patients. Additionally, New Jersey regulators had previously revoked Mirlis’s nursing home administrator license in 2018 for falsifying continuing education completion, a fact omitted in Massachusetts licensing applications.
RegalCare has indicated it will appeal the license revocations, a process that could delay changes in ownership and ongoing operations of affected facilities. If the state prevails, RegalCare would be barred from operating in Massachusetts for ten years, with its homes likely transitioning to new operators over time.
Council members expressed concerns about ownership and financial arrangements reminiscent of the collapse of Steward Health Care, a for-profit hospital chain whose owners profited while the company failed. Robert Engell, executive director of homes and housing at the state’s Veterans’ Services Office, questioned how the new rules would address landlord relationships and staffing reductions, both issues highlighted in recent investigations.
Commissioner Goldstein responded that the expanded regulatory authority would allow the department to scrutinize these arrangements more thoroughly and to consider staffing levels at all company-owned facilities when evaluating license applications.
Goldstein reaffirmed the department’s commitment to prioritizing the dignity, safety, and well-being of nursing home residents in Massachusetts. The Health Department has established a dedicated call center to receive reports of concerns from residents, families, and staff, available weekdays between 8 a.m. and 6 p.m. at 617-468-2189 or 833-305-2070.