Rest‑home operators urge task force, warn that MAP mandate could force closures

Multiple witnesses representing rest homes told the committee that the Department of Public Health's proposed changes to 105 CMR — which would eliminate or heavily restrict the authority of the longstanding responsible person (RP) to administer medication and substitute the Medication Administration Program (MAP) model — would materially harm rest homes’ operational model and affordability.

A long‑serving rest‑home administrator said the RP model is embedded in day‑to‑day operations, describing comprehensive medication management practices, pharmacy partnerships and nursing oversight. Kondesi Weeks Best, owner of two rest homes, warned the committee that applying MAP requirements statewide without alternatives would create severe operational, workforce and financial consequences and could force some homes to close. Ronald Pawelski of the Massachusetts Association of Residential Care Homes proposed a collaborative task force with DPH, MARCh and LeadingAge to craft policy that preserves safe access to care without imposing unintended closures. Alyssa Sherman of LeadingAge Massachusetts recommended substitute language to form such a task force and offered a cost estimate: "an average net increase in staffing costs of about $3,200 a week, or more than $160,000 a year." Witnesses agreed to provide comparative medication‑error data if available.