§ 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 initialnursing facility licensed beds and on increases to the licensed capacity ofexisting nursing facility licenses. – (a) The licensing agency shall issue no new initial licenses for nursingfacilities prior to July 1, 2010; provided, however, that:
(1) Any person holding a previously issued and validcertificate of need as of August 21, 1996 shall be permitted to effect a priorcertificate from the licensing agency consistent with any other statutory andregulatory provisions which may further apply;
(2) Any person holding a nursing facility license mayundertake activities to construct and operate a replacement nursing facilitywith the same or lower bed capacity as is presently licensed provided that thereplacement facility may only be licensed upon the otherwise unconditionalcessation of operation of the previously licensed nursing facility;
(3) Any certificate of need application under active reviewbefore the state agency as of January 10, 1996, which application seeksapproval of a proposal to establish a new nursing facility or seeks to increasethe licensed bed capacity of an existing nursing facility shall continue to bereviewed under all the statutory and regulatory requirements in effect at thetime the application was accepted for review by the state agency; and
(4) On July 1, 1999, if the statewide occupancy rate oflicensed nursing facility beds exceeds ninety-two percent (92%) for thepreceding calendar year, as determined by the department of human services, anassisted living residence licensed pursuant to chapter 17.4 of this title maypropose to seek nursing facility licensure by conversion of assisted livingresidence rooms within its existing physical plant; provided however, that:
(i) The number of nursing facility beds to be licensed doesnot exceed the lesser of twenty (20) beds or ten percent (10%) of the licensedbed capacity of the assisted living residence;
(ii) The capital expenditures associated with theimplementation of the nursing facility beds does not exceed five hundredthousand dollars ($500,000);
(iii) The nursing facility shall be limited in takingresidents to those persons who are transferring from residency at the assistedliving residence;
(iv) The application must be submitted to the health servicescouncil on or before October 1, 1999;
(v) The facility must comply with all requirements of theHealth Care Certificate of Need Act, chapter 15 of title 23.
(b) Prior to July 1, 2010 the licensing agency shall notincrease 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 thefacility'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 holdinga previously issued and valid certificate of need as of the date of passage ofthis section or who shall subsequently be granted a certificate of needpursuant to subsection (a) shall be permitted to effect a prior certificatefrom the licensing agency consistent with any other statutory and regulatoryprovisions which may further apply. Notwithstanding any other provision of thelaw to the contrary, including any moratorium on increasing bed capacity innursing facilities that may otherwise apply, the licensing agency shall bepermitted to increase the licensed bed capacity of an existing nursing facilityby no more than the number of beds previously licensed to one or more otherlicensed nursing facilities provided that:
(1) All nursing facilities involved in any such transactionmust be located within the same municipality;
(2) The owner of a licensed nursing care facility seeking toincrease its licensed bed capacity must receive approval, following review bythe health services council, from the licensing agency for a change in owner ofthe other nursing facility or facilities;
(3) That the nursing facility licensed bed capacity may onlybe increased upon the otherwise unconditional cessation of operation of thepreviously licensed other nursing facility or facilities and the return of thelicense of the nursing facility or nursing facilities to the licensing agency;and
(4) The licensed nursing care facility seeking to increaseits licensed bed complement must comply with all requirements of the HealthCare Certificate of Need Act, chapter 15 of title 23.
(c) Notwithstanding any other provision of the law to thecontrary, including any moratorium on increasing bed capacity in nursingfacilities that may otherwise apply, a nursing facility may take out of serviceany or all beds of its licensed capacity without impediment to its right toplace back into service those beds at a future date under the same terms andconditions 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 anymoratorium on increasing bed capacity in nursing facilities that may otherwiseapply, a nursing home member of a multi-facility group may transfer itsentitlement to add up to ten (10) beds through the "ten (10) beds or tenpercent (10%) of capacity" exception provided for and in accordance withsubsection (b) hereof to another nursing facility in the same multi-facilitygroup, provided that:
(1) The beds thereby added are, in the discretion of thedirector of the department of health, designed to provide enhanced quality oflife to nursing facility residents through the adoption of principles andbuilding designs established by the "Eden alternative" or "Green house "programs or other like means;
(2) The nursing facility applying to receive the transferredbeds has fewer than fifty (50) licensed beds and has at least a ninety-fourpercent (94%) bed occupancy rate at the time of application to obtain saidadditional 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 numberof nursing facility beds in the state, including the beds transferred underthis authority; and
(5) For purposes of this subsection (d), the term"multi-facility group" shall mean two (2) or more nursing facilities that areaffiliated, which for purposes of this subsection shall mean two (2) or morenursing facilities that are controlled by, in control of, or in common controlwith, each other.
(e) Nursing facility culture change joint legislativecommission. There is hereby established a joint legislative commission tomake recommendations on nursing facility culture change and its relationship tothe nursing facility bed moratorium, the certificate of need program, andnursing facility principles and methods of reimbursement.
(1) The commission shall consist of eleven (11) members, asfollows:
(i) Two (2) members of the senate, one of whom shall be fromthe minority party, appointed by the senate president;
(ii) Two (2) members of the house of representatives, one ofwhom shall be from the minority party, appointed by the speaker;
(iii) Two (2) shall be representatives of the Rhode Islandhealth care association, designated by the president of the association;
(iv) Two (2) shall be representatives of the Rhode Islandfacilities and services for the aging, designated by the president of theassociation;
(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 humanservices, or designee.
(2) The commission shall be co-chaired by a senator andrepresentative as appointed by the senate president and speaker of the house.
(3) The commission shall report its findings andrecommendations to the general assembly on or before September 15, 2009,including recommendations for legislative change.