Legislative Priorities


The Commonwealth’s nursing facilities provide a core state service to frail elders and disabled individuals who can no longer be cared for safely at home. Approximately two-thirds of nursing facility residents (over 22,000) have their care paid for by the state Medicaid program, which reimburses $25 per day below the cost of patient care.  And, since three-quarters of a nursing facility's budget is used to fund employee wages and benefits, a nursing facility's ability to increase wages and benefits is largely dependent upon state funding for nursing facility care.  The Nursing Facility Stabilization bills would make significant investments in the long term care workforce and would seek to close the record-high gap between Medicaid payments and the cost of providing quality care. 



The Nursing Facility Quality Jobs Initiative would provide nursing facility staff with a pathway to a living wage, greater career advancement opportunities and promote a supportive work environment. In particular, The Nursing Facility Quality Jobs Initiative focuses on provides direct care workers with:

  • Pathway to a Living Wage

    Nursing Facility Quality Jobs Initiative would fund an annual wage increase that recognizes the critical need to provide a living wage to support direct care workers and their families
  • Accessible education to reduce staffing vacancies

    Nursing Facility Quality Jobs Initiative would establish a CNA Scholarship Training Program designed to increase the number of nursing facility caregivers.
  • Training opportunities for increased retention

    Nursing Facility Quality Jobs Initiative would implement a supervisory and leadership training program to improve staff retention.

Additional Information:

Quality Jobs for Quality Care, The Path to a Living Wage for Nursing Home Workers Report (2015)



Massachusetts legislators filed over 6,000 bills to be debated during the 2021-2022 legislative session, including important nursing facility legislation, which would provide further support for quality nursing facility care. 

  • Ensure a living wage and quality job for frontline workers and provide career advancement opportunities for Certified Nursing Assistant (CNA) training.
  • Expand the nursing facility workforce by funding the staff needed to meet resident care needs.
  • Stabilize the nursing facility sector by making significant investments in direct care workers and help ensure continued access to quality nursing facility care.
  • Enhance infection control by providing training and compensation for Infection Preventionists in nursing facilities and have designated quarantine space.
  • Expand career opportunities for certified medication aides to dispense non-narcotic medications to residents living in nursing facilities, as allowed in many other states.
  • Create career pathway for Resident Care Assistants working during the COVID-19 pandemic to become Certified Nursing Assistants.
  • Make CNA training accessible by offering the Nurse Aide Certification Exam in other languages.
  • Provide ongoing best practice education and training to nursing facility staff.
  • Promote innovation in eldercare services by providing zero-interest loans and rate updates to convert entire or parts of nursing facilities to single-occupancy rooms or community-based residences.
  • Ensure access to high-quality PPE by establishing a PPE Exchange for elder care providers.
  • Meet the care needs for residents with SUD by establishing criteria for a post-acute substance use disorder unit within skilled nursing facilities.