A push to strengthen protections for elderly residents of assisted living facilities may instead end up limiting their choices, industry leaders warned Tuesday.
The proposed rules, issued by Massachusetts officials, may also curtail future public input in the regulatory process governing the residences, industry leaders said.
The regulations would prohibit assisted living residences from accepting residents so frail they need months of skilled nursing care. Regulators detailed their proposals Tuesday at a meeting of the Assisted Living Advisory Council, an appointed board of industry leaders and consumer representatives.
Facilities could not accept residents, or allow them to remain in the facility, if the residents require more than 90 consecutive days of skilled nursing care, under rules proposed by the Massachusetts Executive Office of Elder Affairs, which is charged with overseeing assisted living residences.
Many elders who once would have moved to nursing homes when their health declined are instead choosing to remain in assisted living, often because the cost is significantly less than what nursing homes charge. As a result, these loosely regulated, apartment-like facilities have undergone a profound transformation, with more and more residents who are increasingly frail.
Today, roughly 14,000 people in Massachusetts dwell in about 225 assisted living residences.
Patients requiring long-term nursing care have been allowed to stay in assisted living residences by hiring their own nursing care.
Elder advocates have criticized the practice, saying it has changed the facilities into de facto nursing homes — but without proper oversight. Elder law lawyers who have handled cases of residents harmed or killed in assisted living residences say that often the facilities lack staff or training to cope with their increasingly frail residents.
Yet requiring frail elders to leave assisted living residences may limit their choices and force some into nursing homes, industry leaders said.
“We see that as a conflict of residents’ rights. Residents have a right not to be evicted,” said Elissa Sherman, president of LeadingAge, which represents about 30 nonprofit assisted living residences.
If a facility evicts residents, the proposals would require administrators to provide residents, and their legal representatives, with a notice justifying the decision, including an explanation of why the facility can no longer meet the needs of such residents.
Industry leaders also expressed concerns about a provision in the proposed regulations that would allow state officials to change rules without the usual public hearing process.
“We cannot have a system in which government can subvert an established public process and dictate regulatory changes without review and debate,” Michael Banville, acting president of the Massachusetts Assisted Living Facilities Association, said in a statement. “We strongly urge [regulators] to remove the . . . language.”
A spokeswoman for the Office of Elder Affairs said in a statement that the new provision is “not intended as a substitute for regulations or to establish new requirements,” but did not address the industry concerns about circumventing public input.
Elder Affairs has announced a public hearing about its proposed regulations on Dec. 15, from 10 a.m. to noon at 1 Ashburton Place, Fifth Floor, in Boston.
The new rules are expected to go into effect in January, but industry leaders said they will urge the agency to delay some provisions that call for additional training because it can take several months to bring staff members up to speed.
The updated guidelines mandate education in two areas of special concern: recognizing and reporting elder abuse, and improving techniques for managing and calming aggressive behavior, something commonly encountered in caring for patients with dementia.
State regulators worked on the updates for close to a year and a half, and finally released a draft last month.
Banville said operators of assisted living facilities appreciate the state’s commitment to ensuring safe housing options for seniors. But he said they are concerned about “the shortened review process for these regulations and our inability to complete a full analysis of their effects.
“It is important that we are able to balance the benefits of the new regulations with the risks to flexibility, costs, and our residential model,” he said.
Kay Lazar can be reached at Kay.Lazar@globe.com Follow her on Twitter @GlobeKayLazar.
Correction: An earlier version of this story incorrectly stated Elissa Sherman’s title.