A deadly fire at a Massachusetts assisted living home on Sunday highlights the need for federal legislation strengthening oversight of such facilities, according to long-term care resident advocates.

There are federal regulations for skilled nursing facilities, but states set the standards for safety, staffing and quality at assisted living facilities. Advocates say these guidelines are too lax and poorly enforced.

“In the absence of having any type of federal quality safety staffing requirements...these facilities are really operating in a kind of a no man’s land while they’re caring for some of our most vulnerable citizens,” said Richard Mollot, executive director of the Long Term Care Community Coalition.

Sunday’s fire at the Gabriel House in Fall River, Mass., killed nine people and seriously injured 30 more. The cause of the fire, which apparently started on the third floor, remains under investigation. Officials have ruled out foul play and suspect an electrical failure was to blame.

Local news outlets reported the facility was up to date on its fire and safety assessments, including having its exit routes approved. It was reportedly cited in 2023 for failing to immediately report more than two dozen health and safety incidents.

Gabriel House and its owners did not respond to requests for comment on this article.

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