Chapter 083
2009 -- S 0867 SUBSTITUTE A AS
AMENDED
Enacted 07/08/09
A N A C T
RELATING TO HEALTH AND SAFETY
Introduced By: Senator C Levesque
Date Introduced: April 22, 2009
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, 2009 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, 2009
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 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
"
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
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.
SECTION 2. This act shall take effect upon passage.
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LC02291/SUB A
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