2022 -- H 8287

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LC006032

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTHCARE FACILITIES

     Introduced By: Representatives Craven, and Shanley

     Date Introduced: May 26, 2022

     Referred To: House Finance

     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 Healthcare 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, 2022 2025; 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, 2022 2025, 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 this title.

     (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:

     (1) 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;

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

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;

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

change initiative;

     (4) 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

     (5) 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 this title, shall be required to receive approval under chapter 15 of this title.

     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 HEALTHCARE FACILITIES

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     This act would extend the moratorium on the issuance of licenses for new initial nursing

facilities and any increases to nursing facilities capacity to July 1, 2025.

     This act would take effect upon passage.

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