New Consumer Protection Regulations Further Reshape Assisted Living Operations in Massachusetts

Recent Changes in Senior Living Oversight

On June 22, the AG promulgated consumer protection regulations to protect ALR residents from unfair and deceptive acts (ALR-Specific Regulations). Previously, in September 2025, the AG implemented regulations governing price disclosure practices that apply to all Massachusetts businesses, including ALRs (Junk Fee Regulations). 

These regulations arrive amid broader expansion of consumer protections affecting senior living operators. Two 2024 statutory enactments increased senior living licensure and reporting requirements while significantly broadening the AG’s investigatory and enforcement powers over private equity investors, real estate investment trusts, and management services organizations. As of this publication, the Massachusetts Department of Public Health is finalizing regulations that will extend long-term care suitability reviews beyond nursing facility operators to management companies, capital partners, and real property owners.

New ALR-Specific Consumer Protection Regulations

The ALR-Specific Regulations define unfair or deceptive acts and impose new consumer protection obligations on sponsors, owners, operators, managers, and lessors of ALRs. 

Disclosure Requirements 

The ALR-Specific Regulations impose a series of written and oral disclosure obligations on ALR operators. An ALR must:

• Notify each resident, both orally and in writing, that the AG has promulgated consumer protection regulations relating to ALRs.

• Furnish a copy of the regulations at the start of tenancy, annually thereafter, and upon request.

• Disclose at tenancy start that residents with insufficient income and no alternative funding could face eviction.

• Post the Long-Term Care Ombudsman and Elder Abuse Hotline contact information in a conspicuous location.

• Disclose to residents the extent to which non-residents may use ALR amenities and any impact on staffing.

• State clearly and conspicuously in the residency agreement the conditions upon which automatic increases in rent or fees will be determined.

• Disclose the existence and impact of any arbitration provision, both orally and in writing.

Payments and Billing

All bills must be clearly itemized. Operators must provide 60 days’ notice before any price increase and may not impose late penalties unless payment is more than 30 days overdue. Upon a resident’s death, ALRs may not enforce a 30-day vacancy notice requirement.

Tenancy Protections 

ALR residents receive legal protections applicable in ordinary landlord-tenant relationships, including security deposit limits. When ALRs terminate residency agreements, they must initiate formal eviction proceedings, and notices to quit may not demand charges other than rent.

Resident Rights 

As a condition of admission or continued stay, ALRs may not require a resident to:

• Use a facility-chosen physician, pharmacy, or basic health services provider.

• Waive the ALR’s liability.

• Agree to pay attorneys’ fees in legal disputes with the ALR.

• Provide a third-party guarantee of payment. 

Privacy and Other Personal Rights

ALRs must permit visitation from family, friends, and support people unless it endangers resident safety. Additionally, ALRs must protect resident privacy and may not enter a resident’s unit without permission or a legitimate operational purpose.

The “Junk Fee” Regulations

Under the Junk Fee Regulations, ALRs must comply with several requirements when presenting fees and contract terms in marketing materials.

Total Price Disclosure

At every price presentation, ALRs must display Total Price more prominently than any other pricing information. Total Price is the maximum amount a consumer must pay, inclusive of all fees, charges, or expenses. For ALRs, this must capture community or admission fees, level-of-care charges, medication administration charges, technology or cable fees, parking, storage, pet fees, and any other mandatory charges. Optional or waivable fees must be labeled as such with instructions on how the fees can be avoided. Operators may not collect personal medical or payment information until Total Price is disclosed in writing.

Negative-Option and Trial Offer Controls

ALRs may offer discounted trial stays or introductory rates. Under the Junk Fee Regulations, residents must receive written notice of when charges will begin if the term is not canceled. For negative-option terms exceeding 31 days (e.g., month-to-month residency after an incentive period), ALRs must provide reminder notices five to 30 days before charging for upcoming services. Cancellation must be as simple as the enrollment method.

Civil Liability Exposure

The ALR-Specific Regulations and Junk Fee Regulations incorporate by reference Consumer Protection Act civil liability exposure. The AG may bring enforcement actions seeking injunctive relief, civil penalties, restitution, and disgorgement. The AG’s $4 million settlement agreement with a long term care provider in 2024 demonstrates the AG’s intent to pursue enforcement in the senior living industry. The Consumer Protection Act also provides a private right of action for people who suffer losses from unfair or deceptive practices. Prevailing plaintiffs may recover actual or trebled damages and attorneys’ fees. Given these broad obligations, ALR operators face potential exposure on multiple fronts: AG enforcement, class actions, and individual claims.

Key Takeaways

To avoid civil liability under the Consumer Protection Act, ALR operators should take the following steps to comply with the ALR-Specific Regulations and Junk Fee Regulations:

• Audit residency agreements. Ensure that residency agreements include clear disclosures of arbitration provisions, automatic fee increases, eviction standards, and security deposit limits.

• Train staff. Educate sales counselors, admissions teams, and billing personnel on disclosure and transparency requirements, including the obligation to inform residents of their rights and to furnish residents with copies of the ALR-Specific Regulations.

• Implement billing compliance. Clearly itemize all fees, ensure no charges are imposed for unrequested services, and build in the 60-day notice requirement for price increases.

• Map every fee. Compile a master list of all amounts charged to residents or responsible parties and verify that the Total Price is displayed most prominently in all marketing and disclosures.

• Audit marketing materials. Update websites, brochures, and tour packets so the Total Price is front-and-center before collecting any personal information from prospective residents.

• Review of negative-option practices. Ensure agreements covering trial stays include proper written disclosures and that cancellation of trial stays or negative option contracts is simple and accessible.

For more information on how these regulations impact your organization, contact a member of the ArentFox Schiff Health Care practice group.