MAURA T. HEALEY JON SANTIAGO, MD, MPH
GOVERNOR SECRETARY
KIMBERLEY DRISCOLL
LIEUTENANT GOVERNOR
December 2, 2024
Steven T. James
House Clerk
State House, Room 145
Boston, MA 02133
Michael D. Hurley
Senate Clerk
State House, Room 335
Boston, MA 02133
Dear Clerk James and Clerk Hurley,
Pursuant to Section 12 of Chapter 115A of the Massachusetts General Laws, please find
enclosed the annual report from the Office of Veterans Homes and Housing within the Executive
Office of Veterans Services (EOVS).
Sincerely,
Jon Santiago
CC:
Senator John Velis, Senate Chair, Joint Committee on Veterans and Federal Affairs
Representative Gerard Cassidy, House Chair, Joint Committee on Veterans and Federal Affairs
 Maura T. Healey Jon Santiago, MD, MPH
Governor Secretary
Kimberley Driscoll
Lieutenant Governor
State of the
Commonwealth’s
Veterans Homes
November 2024
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Executive Office of Veterans Services
Office of Homes and Housing
Massachusetts Veterans Homes Annual Report - Table of Contents
Introduction
Overview and Current Initiatives
Quality of Care
Financial Status
Uniformity of Programs
Capital Needs
Status of the United States Department of Veterans Affairs Accreditation
Conclusion
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 Introduction
The Commonwealth of Massachusetts operates two Veterans Homes: the Massachusetts Veterans
Home at Chelsea and the Massachusetts Veterans Home at Holyoke, which are collectively
referred to in this report as the “Homes.”
The Homes focus on providing long-term care and domiciliary residential services for
Massachusetts veterans. Both Homes have a five-member Board of Trustees, each appointed to a
seven-year term. The Homes’ mission is to provide services and care to Massachusetts veterans
with dignity, honor, and respect.
Pursuant to Section 12 of Chapter 115A of the Massachusetts General Laws, the Office of Veterans
Homes and Housing within the Executive Office of Veterans Services (EOVS) must submit an
annual report on the state of the Veterans Homes. In accordance, the report shall include the
following: (i) the quality of care provided at the Homes; (ii) the financial status of the Homes; (iii)
the uniformity of programs at the Homes; (iv) the capital needs of the Homes; and (v) the status
of the United States Department of Veterans Affairs’ accreditation.
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 Overview and Current Initiatives
Since October of 2023, the Homes have made significant strides to professionalize, standardize,
and significantly increase the quality of life delivered to residents.
The Executive Office of Veterans Services (EOVS) began on March 1, 2023 with the
implementation of Chapter 144 of the Acts of 2022. As a result, the two Massachusetts Veterans
Homes (MVH) and their executive directors report to and are under the direct control of the EOVS
Secretary. The Act also changed the responsibilities of the local boards, created a statewide
veterans council, established the Executive Office of Homes and Housing, created an
ombudsperson role for each MVH, directed that each MVH be licensed by the MA Department of
Public Health (DPH) and certified by the Centers for Medicare and Medicaid (CMS) as long-term
care facilities and renamed them as Veterans Homes. Both Homes have recently become licensed
by DPH and are now managed by experienced nursing home administrators. This year, the
veterans and staff at the MVH at Chelsea have moved into a new facility and a new facility at
Holyoke is scheduled to be opened in 2026.
Progress has also been made to professionalize the Homes through implementing an Electronic
Medical Record (EMR) system. The EMR supports improved coordination of resident care while
easing administrative burdens. In addition to operational efficiency, the EMR supports continuing
enhancements of the quality of care through improved documentation, more effective clinical
communication, increased oversight, and expanded metric-based data collection. The EMR was
implemented at MVH at Holyoke in September 2024 and at Chelsea in November 2024.
Another significant initiative is the comprehensive review and evaluation of all policies and
procedures at both Homes done in partnership with a professional consultant. The objective of this
initiative is to establish a single comprehensive policy and procedure framework to further support
the operational and clinical practice standardization across both Homes. The new policy
framework will comply with the requirements and structure of CMS, DPH and the VA along with
long-term care best practices. This transformational initiative also includes the training of staff at
both Homes as well as an inventory and analysis of all current policies.
We have also implemented the EOVS Ombudsperson program. The Ombudsperson at each Home
receives reports, investigates, and resolves complaints from residents, their representatives, and
Homes personnel. Ombudspeople operate within the Homes but are independent from the Home,
reporting directly to EOVS. Ombudspeople are well respected by staff and residents at each Home.
This important function supports the quality of life for our residents, supports staff, and identifies
opportunities for ongoing improvement within the Homes.
To further invest in frontline staff, EOVS worked with SEIU 888 to implement a Memorandum of
Agreement (MOA) to establish a career ladder for Certified Nursing Assistants (CNAs) at both
Homes. This joint initiative equitably recognizes qualified bargaining unit staff and provides
CNAs an opportunity for career advancement within their field. The MOA delineates the creation
of position descriptions, staffing needs assessments at each Home, and the promotion process for
eligible employees. It also memorializes the position descriptions that will be used for all levels of
the Nursing Assistant job series, addresses current staffing needs at the Home, and describes the
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reclassification and promotion process moving forward. For over 30 years, CNAs at the
Massachusetts Veterans Homes have primarily been classified at the entry-level CNA 1 position,
with only a few reaching CNA 2 level. With the introduction of the nursing assistant career ladder,
employees will now progress through four levels of the CNA job series based on their skills,
experience, and responsibilities.
The Homes continue to focus on equity, including regional equity, staff diversity, and veteran
access. In reviewing regional equity, the Homes are working to engage and attract veteran residents
throughout the entire state. The Homes are also exploring options to increase staff diversity and
support existing staff through career pathways.
Overview of the Massachusetts Veterans Home at Chelsea
The Massachusetts Veteran Home (MVH) Chelsea opened its doors to Massachusetts veterans in
1882 as the first veterans home in the Commonwealth of Massachusetts. Chelsea offers veterans
high-quality long-term and skilled nursing care, domiciliary housing and support services. The
MVH at Chelsea has a total of 154 long-term care beds and 125 domiciliary beds. All residents
who had resided in Chelsea’s Quigley Medical Hospital were transferred to the new facility
between October 2023 and February 2024. The design of the new facility creates a home-like
environment, enhancing resident comfort and privacy while offering more common space to
interact and socialize. These new features, amenities, and designs are based on the VA Small
Homes model, providing a better quality of life for veterans and their families.
MVH at Chelsea achieved licensure from the Massachusetts Department of Public Health (DPH),
certification from the Centers for Medicare and Medicaid Services (CMS) in September 2023, and
recognition by the US Department of Veterans Affairs (VA) in December 2023. In addition,
Chelsea brought in new leadership this year. The new Executive Director and a Deputy Executive
Director, both of whom are licensed nursing home administrators, bring nearly 40 years of
experience to the Home.
The domiciliary campus at the MVH Chelsea is also undergoing significant investment and
evolution through a public-private partnership redevelopment with Pennrose LLC. The
redevelopment project will result in a complete renovation of the domiciliary campus and the
creation of approximately 240 100% veterans’ preference affordable housing units. The project
will accommodate all current domiciliary residents in the new housing units and will offer new,
state-of-the-art living quarters for veterans.
Overview of the Massachusetts Veterans Home at Holyoke
The MVH at Holyoke opened in 1952, offering veterans high-quality long-term and skilled nursing
care. The current facility has a total of 128 long-term care beds. The MVH at Holyoke is building
a replacement facility with $263.5 million in federal funding from the VA and $141.9 million in
funding from the Commonwealth. With the support of the Department of Capital Asset
Management and Maintenance (DCAMM), the building is in the steel infrastructure phase and is
scheduled for occupancy in 2026. In addition to the major facility replacement capital project, the
Home has also completed several capital repairs to the roof and façade of the current buildings.
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The MVH at Holyoke achieved licensure from DPH in July 2024. In support of this
accomplishment, staff of the MVH at Holyoke enhanced their understanding of and compliance
with strict and rigorous regulatory standards and implemented new policies and procedures. In
addition, Holyoke has completed their initial application for certification as a nursing home with
CMS and is actively working on the final readiness phase with physical plant improvements.
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 Quality of Care
The Homes’ Quality Assurance and Performance Improvement (QAPI) program is a data-driven,
comprehensive system that combines quality assurance (QA) and performance improvement (PI)
to continuously monitor and enhance the quality of care and services. The primary goal of QAPI
to improve the quality of life for our veteran residents. This is done by identifying areas for
improvement, implementing systematic changes, and tracking their effectiveness. Progress is
tracked through ongoing monitoring and reporting. Input for the process includes resident feedback
through the resident council, town halls, family council, resident satisfaction surveys and a
grievance process. The QAPI also considers clinical quality measures based on care, outcomes,
and insights gained from the independent surveys conducted by DPH, CMS, and VA.
Each Home has a QAPI team that meets monthly. The QAPI committee is multi-disciplinary and
promotes active participation from all departments, including management and line staff. The
QAPI team identifies targeted initiatives to address specific issues using data collection, analysis,
intervention, and evaluation. Initiatives are reviewed, crafted, implemented, and monitored to
assess their effectiveness. This is an integral component of a continuous process of quality
improvement to ensure our veteran residents with the highest quality of life and to improve their
satisfaction.
The EOVS Quality Management team provides support and oversight to each Home’s QAPI
program. Through a recently developed dashboard, key metrics, initiatives and accomplishments
are shared with EOVS. The Homes develop annual program plans for their QAPI initiatives,
presenting progress on initiatives to the EOVS Secretary on quarterly basis. QAPI information is
also shared with the Homes Board of Trustees and the Statewide Homes Council.
QAPI is an ongoing journey of improvement and is beginning to show results. Several examples
of this past year’s QAPI focus include aiming for reductions in falls and skin injuries. Through
comprehensive efforts of the entire team, there has been a reduction in total falls and a reduction
in skin injuries by 30% at Holyoke compared to last year.
Additionally, an important quality indicator is resident and family satisfaction. Confidential
surveys are conducted monthly by an independent nationally recognized health care survey
agency, Pinnacle Quality Insights. Chelsea achieved a favorability rating of 94% and Holyoke
reached 100% for the year. This metric measures the percentage of respondents who would
recommend care at the Home. The overall annual satisfaction rating for Chelsea was 4.5 and
Holyoke was 4.9 on a 5.0 scale. These are two of the more significant metrics used to evaluate
overall customer satisfaction and both Homes have achieved results that are higher than national
averages.
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 Financial Status
The Massachusetts Veterans Homes are funded through the Commonwealth’s annual General
Appropriations Act (“GAA”) on an annual basis. All reimbursements received from residents
and/or the U.S. Veterans Administration (VA) (except for a small amount of retained revenues)
revert to the Commonwealth’s general fund to offset the operating costs. Daily care charges may
be waived or reduced based on monthly income or certain qualifying disabilities.
Financial Status of the Massachusetts Veterans Home at Chelsea
The MVH at Chelsea received an appropriation of $52 million in FY2024 which includes
staffing of 400 full-time employees and revenue of $10.5 million.
Appropriation Number Appropriation Name FY 24 GAA
4190-0010 Administration and Operations 51,351,027
4180-1100 Retained Revenue 600,000
Total $51,951,027
Revenue Source Revenue Source Description FY 24 GAA
3504 Reimb - Blue Cross Blue Shield 1,506
3505 Reimb - Other Insurance 3,616
3506 Reimb - Direct Patient Payer 1,326,238
3508 Free Meals 25,000
3545 Reimb - Medicare Part D 108,347
4531 Sale of Special Plates 600,000
5203 Medicare Reimbursement 12,668
5204 VA Per Diem Domiciliary Care 2,256,336
5205 VA Per Diem Long Term Care 6,137,150
6900 Miscellaneous 30,000
Total $10,500,861
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Financial Status of the Massachusetts Veterans Home at Holyoke
The MVH at Holyoke received an appropriation of $30 million in FY2024 which includes staffing
of 356 full-time employees and revenue of $6.7 million.
Appropriation Number Appropriation Name FY 24 GAA
4190-0010 Administration and Operations 28,728,578
4190-0103 Canteen Retained Revenue 50,000
4190-0300 12 Bed Retained Revenue 824,198
4180-1100 Retained Revenue 400,000
Total $30,002,776
Revenue Source Revenue Source Description FY 24 GAA
3505 Reimb - Other Insurance 1,677
3506 Reimb - Direct Patient Payer 685,500
3508 Free Meals 30,000
3545 Reimb - Medicare Part D 76,985
4000 Occupancy/Rent Fees 75,000
4033 Agent Rental Service Fee 1,500
4500 Miscellaneous Sales 400
4531 Sale of Special Plates 400,000
4556 Holyoke Canteen Revenue 50,000
5205 VA Per Diem Long Term Care 5,342,034
6900 Miscellaneous 12,000
Total $6,675,096
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 Uniformity of Programs
The Homes are licensed by DPH as long-term care facilities and recognized by the VA State
Veterans Home Program as nursing homes. Both Homes are making significant efforts to enhance
uniformity, achieving compliance with rigorous standards and regulations set by DPH, CMS and
VA. Progress can be measured through annual unannounced surveys conducted by both the DPH
and VA to ensure compliance.
The Homes operate a new model of care, known as resident-centered care, that aligns with the VA
Small Home design. Each Home provides comprehensive and compassionate care which is tailored
to the unique needs of each veteran resident. The Homes offer a holistic model of care to ensure
that each resident receives the support they need to maximize their physical, mental, and emotional
well-being. They also offer a range of social, recreational, and therapeutic activities tailored to
each veteran’s interests and abilities, including music therapy, arts and crafts, fitness programs,
and opportunities for spiritual support through religious services. All of this combines to provide
the highest quality of life for each or our veteran residents.
As described earlier in this report, EOVS has also initiated a comprehensive review process of all
policies and procedures utilizing an outside consultant. This process will further enhance
uniformity of policies, procedures, and care, as well as facilitate the implementation of these
enhancements. The implementation of an EMR at both home