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Massachusetts nursing home chain settles for $4 million over deliberate improper staffing allegations



Attorney General Andrea Joy Campbell

BOSTON – Attorney General Andrea Joy Campbell today announced a $4 million settlement with Next Step Healthcare, LLC, a Woburn-based long-term care management company that operates sixteen nursing homes in Massachusetts. The settlement, which is the largest nursing home settlement ever reached by the AG’s Office, resolves allegations that Next Step deliberately failed to properly staff the nursing homes it owned and operated, resulting in resident harm and neglect. As part of the settlement, most of Next Steps’ facilities will be required to be overseen, at Next Steps’ own expense, by an independent compliance monitor.   

The settlement follows a years-long investigation by the AG’s Office, which investigated reports of substandard care or regulatory violations at Next Step’s nursing homes based on complaints and referrals received from the Department of Public Health.  

“For years, Next Step prioritized profit over care by failing to adequately staff its nursing homes,” said AG Campbell. “I am proud of my team’s efforts in securing this settlement, the largest of its kind, which will send a message that this conduct will not be tolerated and ensure that Next Step’s facilities comply with staffing requirements moving forward, assuring that vulnerable elderly residents receive the proper care they need.”    

“We have an obligation to create a safe and caring environment for some of our most vulnerable residents in Massachusetts,” said Secretary of Health and Human Services Kate Walsh. “I am grateful to the Attorney General’s Office for their work to ensure protections and appropriate measures are taken when patients can’t speak up for themselves.” 

Next Step, co-founded and co-owned by Damien Dell’Anno and William Stephan, owns, operates, and manages 16 nursing homes throughout Massachusetts, including in Attleboro, Fall River, Fitchburg, Lee, Malden, Melrose, Middleborough, Norwood, Plymouth, Taunton, Walpole, West Newton, Westborough, and Worcester. (Fall River Healthcare, Garden Place Healthcare, Wedgemere Healthcare)

Under the terms of the settlement agreement, Next Step agrees to budget staffing at state-mandated levels and pay an additional $4 million to resolve the allegations. $750,000 of those settlement funds will be paid to the Commonwealth, which will evenly distribute the amount to MassHealth and the Long-Term Care Facility Quality Improvement Fund, a DPH-operated fund that aims to improve the quality of care delivered to residents of long-term care facilities. The remaining $3.25 million will be overseen by the independent compliance monitor and must be used for additional staffing improvements, recruitment, retention, additional benefit costs, bonuses, overtime, wage increases, and/or other staffing-related initiatives over the next three years.  

In addition to the monetary penalties, Next Step has also agreed to hire, at its own expense, an independent compliance monitor, who will oversee the improvement of Next Step’s staffing levels and ensure that Next Step’s facilities comply with state staffing requirements. The compliance monitor will also be responsible for reviewing the quality of care delivered to residents at eight Next Step facilities. As part of the settlement, the compliance monitor will conduct on-site reviews of Next Step’s facilities and will submit compliance reports to the AG’s Office every six months. 

The settlement resolves the AG’s Office’s allegations that Next Step implemented staffing reductions in April 2019, despite its facilities already struggling to ensure adequate staffing levels to meet the needs of residents. Those staffing reductions included reductions of both certified nursing assistant positions and non-CNA positions. The AG’s Office alleges that Next Step implemented such reductions without consideration of patient needs.   

The AG’s Office further alleges that Next Step continued to understaff its facilities even after state regulations went into effect in April 2021 requiring certain staffing requirements. As a result, many of Next Step’s nursing facilities had staffing levels that ranked in the bottom 10% of their counties.   

The AG’s Office alleges that the low staffing levels at Next Step’s facilities led to resident neglect and harm.  

The AG’s Office contends that Next Step’s submission of claims to MassHealth for these substandard services were false claims, in violation of the Massachusetts False Claims Act, and that this conduct also violated the Massachusetts Consumer Protection Act, and a state statute protecting elders from abuse and neglect in nursing homes. 

This matter was handled by Deputy Division Chief Kevin Lownds, Assistant Attorneys General Scott Grannemann and Natalie Rutkowski, and Senior Healthcare Fraud Investigator Erica Schlain, all of the AG’s Medicaid Fraud Division, and Victim Witness Advocates Lia Panetta and Megan Murphy, both of the AG’s Victim and Witness Services Division. The Massachusetts Department of Public Health and the Massachusetts Long-Term Care Ombudsman Program provided substantial assistance with the investigation. 

Members of the public who are aware of similar practices at Next Step’s facilities and/or by other nursing homes or health care providers should call the Attorney General’s Medicaid Fraud Division at (617) 963-2360 or file a complaint through DPH’s website.  



  1. Disgusted

    June 10, 2024 at 10:25 am

    Now do Anthony Fauci

  2. RedPilled

    June 10, 2024 at 10:43 am

    Every single nursing home in Massachusetts is understaffed deliberately or not.

    • Christine E Parks

      June 11, 2024 at 11:44 pm

      Not every Nursing Home, but most. I work agency so I have been everywhere. I used to tell other nurses at Next Step, your next step is out the door! The Sub Acute units which MUST by law have 2 nurses the 11-7 shift NEVER did. Medicare is paying for 2 nurses! But other chains are horrible. Life Care, Care One but the absolute worst is Genesis.

  3. James Hodges

    June 10, 2024 at 11:42 am

    What nursing homes in Fitchburg, leominster, and grrdner?

  4. John Sorabella

    June 10, 2024 at 4:44 pm

    They should have closed Watertown’s only nursing facility for good as well never mind handing it over to two other monied investors who never cared about the quality of care just the profits only and they have lacked imperative clean hands on care ! All disinterested from the top on down or the bottom on up to the highest echelon. Mass does not even have the staffing to evaluate them frequently by complaint after complaint by H& H services They have been short staffed and neglected the disabled residents for years on end, and leave them in bed for years to have them get ill intentionally, and cover up all the problems with hiring inadequate, uneducated, disinterested and uncaring staff members, and have caused unnecessary harm, neglect.and the ultimate death of many ! Simply despicable, cruel, inhumane treatment that lead real good honest human beings into being victimized and actually forced to die against their own wishes. If this committee really cared e red light would zing them every time a disabled resident landed so frequently in the hospital and the hospital staff have a duty and responsibility to the patient to report every single complaint and incident that warned their own VP of care never to return them to this absolutely abhorrent facility. Falling thru the cracks while hospital attorneys and other’s try like heck to cover up their wrongdoing at the expense of patients lives and the heartbreak of their immediate families who the only people who really care but are never heard until it’s too late and it falls on deaf ears. I’m sure this has been going on for years to save the state money as well for its one less disabled person to cover their expenses for, even though the family cried for help and guidance for multiple years in many letters and meetings that went totally ignored. A lot of people need to be fired in positions of power in this one particular case alone for their derelict of duties and non care of a person who suffered for nine years at the hands of strangers who did not do their due diligence. Justice can only be achieved in changing an inept system and making Massachusetts an additional surrogacy state to protect the rights of parents who have disabled children. The state should never overstep their boundaries when malpractice is involved but all too often corruption is involved to protect the parties that caused the injuries from the onset.

  5. Ana silva

    June 11, 2024 at 8:49 pm

    All nursing homes are the same. The only time the nursing homes are fully staffed is when the state comes in for inspections and audits they get the night shift aides to do double shifts because the inspector leave. As soon as they are gone it goes back to the same s*** understaffed. Been there done that.

  6. Christine E Parks

    June 11, 2024 at 11:51 pm

    Windermere on Martha’s Vineyard,Carlton Willard in Bedford, Mary Ann Morse in Natick, The Regal Chain not Royal, Regal. royal is horrible. The k owlwood in Worcester. These are exceptional and well staffed Nursing homes. I know I worked Agency in all of them.

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