2019 -- S 0571

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTH CARE FACILITIES

     Introduced By: Senator Joshua Miller

     Date Introduced: March 14, 2019

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 23-17-44 of the General Laws in Chapter 23-17 entitled "Licensing

of Health-Care Facilities" is hereby amended to read as follows:

     23-17-44. Moratorium on new initial nursing-facility licensed beds and on increases

to the licensed capacity of existing nursing-facility licenses.

     (a) The licensing agency shall issue no new initial licenses for nursing facilities prior to

July 1, 2019 2022; provided, however, that any person holding a nursing facility license may

undertake activities to construct and operate a replacement nursing facility with the same or lower

bed capacity as is presently licensed, provided that the replacement facility may only be licensed

upon the otherwise unconditional cessation of operation of the previously licensed nursing

facility;

     (b) Prior to July 1, 2019 2022, and with the exception of the culture initiative pursuant to

subsection (d), the licensing agency shall not increase the licensed bed capacity of any existing

licensed nursing facility, including any nursing facility approved for change in ownership

pursuant to §§ 23-17-14.3 and 23-17-14.4, to greater than the level of the facility's licensed bed

capacity as of August 21, 1996, plus the greater of ten (10) beds or ten percent (10%) of the

licensed bed capacity. Any person holding a previously issued and valid certificate of need as of

the date of passage of this section, or who shall subsequently be granted a certificate of need

pursuant to subsection (a), shall be permitted to effect a prior certificate from the licensing agency

consistent with any other statutory and regulatory provisions that may further apply.

Notwithstanding any other provision of the law to the contrary, including any moratorium on

increasing bed capacity in nursing facilities that may otherwise apply, the licensing agency shall

be permitted to increase the licensed bed capacity of an existing nursing facility by no more than

the number of beds previously licensed to one or more other licensed nursing facilities provided

that:

     (1) All nursing facilities involved in any such transaction must be located within the same

municipality;

     (2) The owner of a licensed nursing care facility seeking to increase its licensed bed

capacity must receive approval, following review by the health services council from the

licensing agency for change in owner of the nursing facility or facilities;

     (3) The nursing facility's licensed bed capacity may only be increased upon the otherwise

unconditional cessation of operation of the previously licensed other nursing facility or facilities

and the return of the license of the nursing facility or nursing facilities to the licensing agency;

and

     (4) The licensed nursing care facility seeking to increase its licensed bed complement

must comply with any requirements of the health care certificate of need act, chapter 15 of title

23.

     (c) Notwithstanding any other provision of the law to the contrary, including any

moratorium on increasing bed capacity in nursing facilities that may otherwise apply, a nursing

facility may take out of service any or all beds of its licensed capacity without impediment to its

right to place back into service those beds at a future date under the same terms and conditions as

applied at the time of taking them out of service.

     (d) Culture-change initiative. Notwithstanding any other provision of the law to the

contrary, including any moratorium on increasing bed capacity in nursing facilities that may

otherwise apply, the licensing agency may increase the licensed bed capacity of any existing

licensed nursing facility, including any nursing facility approved for change in ownership

pursuant to §§ 23-17-14.3 and 23-17-14.4, for the purposes of nursing facility culture change, in

accordance with the following criteria and procedures:

     (i) Culture-change definitions and criteria shall be established through regulation to

restrict beds added under this initiative only to beds that are designed to provide enhanced quality

of life to nursing facility residents through the adoption of principles and building designs

established by the "Eden Alternative", "Green House", or "Small House" programs or other like

means;

     (ii) Only beds taken out of service due to facility closure after January 1, 2010, shall be

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available for facility expansion under this culture-change initiative subsection. The total number

of beds that may be licensed to increase capacity under this culture-change initiative shall be

limited to ninety percent (90%) of the first fifty (50) beds that are taken out of service, to seventy

percent (70%) of the next fifty (50) beds that are taken out of service, and to fifty percent (50%)

of any additional beds taken out of service;

     (iii) Only nursing facilities licensed in the state are eligible to expand under the culture-

change initiative;

     (iv) The department shall promulgate regulations to govern an open and competitive

process to determine the licensure of expansion beds under this culture-change initiative, and

shall consider the impact on the regional distribution of, and access to, nursing facility beds in the

state; and

     (v) Any facility seeking to expand its licensed bed capacity under this initiative, that will

result in an expenditure that meets or exceeds the criteria for determination of need review under

chapter 15 of title 23, shall be required to receive approval under chapter 15 of title 23.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTH CARE FACILITIES

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     This act would mandate that no new initial licenses for nursing facilities would be issued

prior to July 1, 2022. Also, prior to July 1, 2022, the licensing agency would not be allowed to

increase the licensed bed capacity of any existing licensed nursing facility including any nursing

facility approved for change in ownership.

     This act would take effect upon passage.

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