2009 Rhode Island Code
Title 23 - Health and Safety
CHAPTER 23-17 - Licensing of Health Care Facilities
§ 23-17-44 - Moratorium on new initial nursing facility licensed beds and on increases to the licensed capacity of existing nursing facility licenses.

SECTION 23-17-44

   § 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; 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 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 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 "Eden alternative" or "Green house " 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 Rhode Island health care association, designated by the president of the association;

   (iv) Two (2) shall be representatives of the Rhode Island facilities and services for 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.