Guardianship Backlog Strains Hospital Capacity in Massachusetts

Patients without appointed health care proxies face delays in getting specialized post-acute care due to a shortage of available legal guardians.

Feb. 5, 2026 at 12:15am

Got story updates? Submit your updates here. ›

Massachusetts hospitals are facing capacity issues as patients without appointed health care proxies are stuck waiting for the appointment of a legal guardian, which can take weeks. This is exacerbating the strain on hospitals, especially during flu season when emergency rooms are already full. Hospitals are calling for more funding and volunteers to help address the guardianship backlog.

Why it matters

The lack of available legal guardians is preventing patients from receiving the specialized post-acute care they need, leading to overcrowding in emergency rooms and hospitals across Massachusetts. This issue disproportionately impacts the aging population who may not have friends or family available to serve as a guardian.

The details

In Massachusetts, if a patient has not appointed a health care proxy, only a legal guardian is recognized to make decisions on their behalf. The process to appoint a guardian can take weeks, leaving patients stuck in hospitals and unable to be discharged. The number of petitions for guardianship has been increasing, with hospitals reporting over 50 patients waiting for a guardian to be appointed in September 2026.

  • The guardianship backlog issue has been exacerbating during the flu season when hospital capacity is already strained.
  • In September 2026, the Massachusetts Health and Hospital Association found that 38 hospitals across the state reported 50 patients were stuck in hospitals waiting for the appointment of a legal guardian.

The players

Brandon Saunders

A partner at BSK Law Offices who goes to court to appoint guardians for patients.

Michelle McGrory

The associate chief nursing officer for care transitions and rehab services at Beth Israel Deaconess Medical Center.

Got photos? Submit your photos here. ›

What they’re saying

“The emergency rooms are full, and a lot of that are people waiting to be admitted to another floor of the hospital, but there's no beds.”

— Brandon Saunders, Partner, BSK Law Offices (nbcboston.com)

“It's just exacerbated, as I say, in the winter, when when we are experiencing a flu surge, so capacity constraints are even worse.”

— Michelle McGrory, Associate Chief Nursing Officer, Beth Israel Deaconess Medical Center (nbcboston.com)

What’s next

Hospitals are asking anyone who is eligible to be a guardian to volunteer, and they are also asking legislators to provide funding for a volunteer guardianship program to help address the backlog.

The takeaway

The guardianship backlog in Massachusetts is straining hospital capacity, especially during flu season, by preventing patients without appointed health care proxies from receiving the specialized post-acute care they need. Addressing this issue will require more funding and volunteers to help appoint legal guardians in a timely manner.