Attorney Michael Hooker Highlights Major Changes Coming to the Elder Care Industry

NORTHAMPTON— Elder Law Attorney Michael Hooker is urging healthcare professionals, elder advocates and families to prepare for significant changes in the industry, particularly with assisted living facilities, as Massachusetts moves toward increased oversight, greater consumer protections and expanded regulatory authority.

Hooker recently delivered a keynote presentation on the changing landscape of elder care, placement and financing at the 2026 Western Massachusetts Eldercare Conference, held June 4 at Holyoke Community College. 

The audience included social workers, geriatric care managers, hospital discharge planners, nursing home admissions professionals, assisted living staff, hospice organizations, visiting nurse agencies and elder advocates.

“They all needed to hear what I had to say,” Hooker said. “It is not a pretty, organized picture of where frail elders will live when no longer able to live independently and who pays for it.  Neither our federal government nor our state government has an overarching game plan to address all of these challenges.”

Hooker examined the dramatic shifts that have occurred within elder care over the past several decades and discussed how new regulations could reshape assisted living facilities in the state.

According to Hooker, the elder care system has undergone a significant transformation as nursing homes and rest homes have declined in number while assisted living facilities have expanded rapidly.

“Assisted living facilities have become a major part of the elder care landscape,” Hooker said. “But we’ve also created a situation where many older adults can spend substantial portions of their savings in assisted living and then find themselves with limited options when those resources are exhausted.”

Hooker noted that assisted living facilities have historically operated as landlord-tenant arrangements rather than healthcare facilities. However, as residents increasingly rely on the facilities for services and support, state regulators have begun examining whether additional oversight is needed.

“The days of the Wild West are over,” Hooker said. “If assisted living facilities want to function more like healthcare providers, then they should expect increased regulation and accountability.”

Among the changes Hooker highlighted are anticipated regulations from the Massachusetts Attorney General’s Office under Chapter 93A, the state’s consumer protection statute, which could provide residents and families with additional avenues to pursue claims involving unfair or deceptive practices.

He also discussed regulations being developed by the Executive Office of Aging & Independence, formerly known as the Executive Office of Elder Affairs, under authority granted by Chapter 197 of the Acts of 2024. Those regulations are expected to expand the state’s ability to oversee assisted living facilities and establish standards for facilities seeking to provide certain healthcare-related services.

“These changes provide more transparency for elders and their families who move into assisted living facilities,” Hooker said. “They also give more authority to the state agency responsible for overseeing these facilities and create additional regulations designed to protect consumers.”

Hooker encouraged older adults and their families to become proactive in planning for future care needs.

He said consumers should educate themselves about available options, seek guidance from qualified professionals and understand the financial realities of long-term care before a crisis occurs.

“People should not assume the government is going to take care of everything at the end of life,” Hooker said. “Families increasingly will be expected to play a larger role in caring for aging relatives, particularly for those who have income or assets and may not qualify for public assistance programs.”

To prepare for the presentation, Hooker interviewed leaders from across the elder care continuum, including executives from nursing homes, rest homes and assisted living facilities, as well as healthcare professionals, discharge planners, hospice leaders and policy experts involved in elder services and legislative advocacy.

He also addressed recent changes involving the Program of All-Inclusive Care for the Elderly (PACE), a MassHealth program designed to help eligible older adults remain in their homes and communities while receiving comprehensive care.

Hooker noted that many older adults fall into a difficult financial gap: They may have too many assets or too much income to qualify for MassHealth programs, yet not enough resources to pay for the increasing costs of in-home care or assisted living.

“Most MassHealth programs disallow applicants who have transferred assets within the previous five years,” Hooker added. “Historically, the PACE program was less focused on those transfers. As of April 2026, that has changed. Transfers are now being reviewed, which can result in applicants being disqualified.”

As Massachusetts continues to revise its elder care regulations and oversight structure, Hooker believes education will be critical for families, healthcare providers and legal professionals alike.

“If assisted living facilities continue to become the primary setting for elder care, then everyone involved needs to understand what happens when a resident’s resources run out,” he said. “Those are the questions policymakers, providers and families need to be asking now.”

For more information, visit elderlawservice.com/.