The purchase of an assisted living facility in Massachusetts may require several approvals by various state agencies. For instance, the Massachusetts regulations for assisted living facilities (the “Regulations”) require that purchasers of an existing assisted living facility submit an Application for Certification within 30 days prior to a change in ownership to the Executive Office of Elder Affairs (“EOEA”), the agency responsible for the oversight of Massachusetts assisted living facilities. A change in ownership occurs when a party acquires 25% or greater interest in an existing assisted living facility. The application must include notarized signatures for both the purchaser and seller. When a completed application is submitted timely to EOEA, the purchaser will be deemed certified from the date of closing until such time that EOEA approves or denies the application. As part of the application process, EOEA may require a partial or full review for compliance with the Regulations.

Additional approvals are required if a purchased facility provides group adult foster care (“GAFC”) services, a program funded by the Massachusetts’ Medicaid program known as MassHealth and administered by EOEA. GAFC offers reimbursement to assisted living operators providing personal care services to eligible seniors. Qualified residents must be eligible for MassHealth and need help with at least one daily personal care task such as bathing or dressing. In order to receive payment for GAFC services, the certified operator of an assisted living facility must be approved as a GAFC provider by both EOEA and MassHealth.

EOEA and MassHealth each require notice whenever there is a change in an assisted living operator approved as a GAFC provider. This requirement is in addition to the Application for Certification made to EOEA as discussed above. The guidelines do not specify the required timeframe for such notification; however EOEA suggests that a purchaser provide at least 30 days notice to both agencies. In addition, MassHealth requires that a new operator obtain provider status by submitting a Medical Assistance Program Provider Application. Once MassHealth approves the operator, EOEA will conduct its own review to determine whether the operator meets GAFC clinical requirements. The operator will receive retroactive payments for rendered services upon final approval as a GAFC provider.