Chapter 060
2010 -- S 2289 SUBSTITUTE A
Enacted 06/12/10
A N A C T
RELATING TO HEALTH AND SAFETY
Introduced By: Senators C Levesque, Blais, Perry, Miller, and Gallo
Date Introduced: February 11, 2010
It is enacted by the General
Assembly as follows:
SECTION 1. Sections 23-17-8 and 23-17-44 of the General Laws
in Chapter 23-17
entitled "Licensing of Health Care Facilities" are
hereby amended to read as follows:
23-17-8.
Denial, suspension, or revocation of license. --
The licensing agency, after
notice and opportunity for hearing to the applicant or
licensee, is authorized to deny, suspend, or
revoke a license, including the licensure of culture
change beds approved pursuant to section 23-
17-44, in any
case in which it finds that there has been a failure to comply with the
requirements
established under this chapter. The notice shall be effected by registered or certified mail or by
personal service, setting forth the particular reasons for the
proposed action, and fixing a date not
less than thirty (30) days from the date of the mailing or
service, at which the applicant or
licensee shall be given an opportunity for a prompt and fair
hearing. On the basis of the hearing,
or upon default of the applicant or licensee, the
licensing agency shall make a determination
specifying its findings of fact and conclusions of law. A copy
of the determination shall be sent
by registered or certified mail or served personally
upon the applicant or licensee. The decision
denying, suspending, or revoking the license or application
shall become final thirty (30) days
after it is so mailed or served, unless the applicant or
licensee, within the thirty (30) day period,
appeals the decision pursuant to section 42-35-15. The
procedure governing hearings authorized
by this section shall be in accordance with sections
42-35-9 -- 42-35-13 as stipulated in section
42-35-14(a). A full and complete record shall be kept of all
proceedings, and all testimony shall
be reported but need not be transcribed unless the
decision is appealed pursuant to section 42-35-
15. A copy or copies of the transcript may be obtained
by any interested party on payment of the
cost of preparing the copy or copies. Witnesses may be
subpoenaed by either party.
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, 2010 2013; provided, however,
that:
(1) Any person holding
a previously issued and valid certificate of need as of August 21,
1996 shall be permitted to effect
a prior certificate from the licensing agency consistent with any
other statutory and regulatory provisions which may further
apply;
(2) 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; .
(3) Any certificate of
need application under active review before the state agency as of
January 10, 1996, which application seeks approval of
a proposal to establish a new nursing
facility or seeks to increase the licensed bed capacity of an
existing nursing facility shall continue
to be reviewed under all the statutory and regulatory
requirements in effect at the time the
application was accepted for review by the state agency; and
(4) On July 1, 1999,
if the statewide occupancy rate of licensed nursing facility beds
exceeds ninety-two percent (92%) for the preceding calendar
year, as determined by the
department of human services, an assisted living residence
licensed pursuant to chapter 17.4 of
this title may propose to seek nursing facility licensure
by conversion of assisted living residence
rooms within its existing physical plant; provided however,
that:
(i)
The number of nursing facility beds to be licensed does not exceed the lesser
of
twenty (20) beds or ten percent (10%) of the licensed bed
capacity of the assisted living
residence;
(ii) The capital
expenditures associated with the implementation of the nursing facility
beds does not exceed five hundred thousand dollars
($500,000);
(iii) The nursing
facility shall be limited in taking residents to those persons who are
transferring from residency at the assisted living residence;
(iv)
The application must be submitted to the health services council on or
before
October 1, 1999;
(v) The facility
must comply with all requirements of the Health Care Certificate of
Need Act, chapter 15 of title 23.
(b) Prior to July 1, 2010
2013 and with the exception of the culture initiative pursuant to
section 23-17-44(3),
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 sections 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
which 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 a change in owner of the other nursing
facility or facilities;
(3) That the nursing
facility 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 all 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) From July 1 of 2009
through June 30 of 2010, notwithstanding any other provision
herein to the contrary, including any moratorium on
increasing bed capacity in nursing facilities
that may otherwise apply, a nursing home member of a
multi-facility group may transfer its
entitlement to add up to ten (10) beds through the "ten (10)
beds or ten percent (10%) of capacity"
exception provided for and in accordance with subsection (b)
hereof to another nursing facility in
the same multi-facility group, provided that:
(1) The beds thereby added
are, in the discretion of the director of the department of
health, designed to provide enhanced quality of life to
nursing facility residents through the
adoption of principles and building designs established by the
"
" programs or other like means;
(2) The nursing
facility applying to receive the transferred beds has fewer than fifty (50)
licensed beds and has at least a ninety-four percent (94%) bed
occupancy rate at the time of
application to obtain said additional bed licenses;
(3) The transferred
beds provided for in this subsection (d) shall be limited to a
maximum total of ten (10) beds per multi-facility group;
(4) The transfer of
beds results in a reduction in the number of nursing facility beds in
the state, including the beds transferred under this
authority; and
(5) For purposes of
this subsection (d), the term "multi-facility group" shall mean two
(2)
or more nursing facilities that are affiliated, which
for purposes of this subsection shall mean two
(2) or more nursing
facilities that are controlled by, in control of, or in common control with,
each
other.
(e) Nursing facility
culture change joint legislative commission. - There is hereby
established a joint legislative commission to make
recommendations on nursing facility culture
change and its relationship to the nursing facility bed
moratorium, the certificate of need program,
and nursing facility principles and methods of
reimbursement.
(1) The commission
shall consist of eleven (11) members, as follows:
(i)
Two (2) members of the senate, one of whom shall be from the minority party,
appointed by the senate president;
(ii)
Two (2) members of the house of representatives, one of whom shall be from the
minority party, appointed by the speaker;
(iii)
Two (2) shall be representatives of the
designated by the president of the association;
(iv)
Two (2) shall be representatives of the
aging, designated by the president of the association;
(v) One shall be the
director of health, or designee;
(vi)
One shall be the director of human services, or designee;
(vii) One shall be the
secretary of health and human services, or designee.
(2) The commission
shall be co-chaired by a senator and representative as appointed by
the senate president and speaker of the house.
(3) The commission
shall report its findings and recommendations to the general
assembly on or before September 15, 2009, including
recommendations for legislative change.
(e) 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 sections 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 “
means;
(ii) 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;
(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;
(v) Any facility seeking
to expand their 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 23-15, shall be required to receive
approval under chapter 23-15.
(vi)
On or before March 15, 2012, the department shall gather
information from the
department of human services and shall report to the president
of the senate and the speaker of the
house of representatives on the costs and benefits to the
state of this culture change initiative,
including recommendations for revision or termination of the
initiative.
SECTION
2. This act shall take effect on
July 1, 2010.
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LC00608/SUB A
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