June 1, 2010                 

Rep. Joseph M. McNamara at (401) 222-2296

Sen. Charles J. Levesque at (401) 683-9194

Assembly approves legislation promoting more
home-like care in Rhode Island nursing homes

STATE HOUSE – The General Assembly gave final approval today to legislation aimed at shifting the culture of Rhode Island nursing facilities to more home-like, resident-driven settings.

The legislation (2010-S-2289A, 2010-H 7169A), sponsored by Sen. Charles J. Levesque and House Health, Education, and Welfare Committee Chairman Joseph M. McNamara, would allow beds to be added in home-like settings in nursing facilities as other traditional-care beds in the state are lost when other facilities close. The limits are aimed at preventing damage to Rhode Island’s nursing home industry. The legislation will now be forwarded to the governor.

“Patients and their families are increasingly seeking more comfortable, personal, home-like atmospheres in nursing facilities. This is a plan that will help transform and improve the care of the elderly in Rhode Island without harming the industry. It will help Rhode Island’s nursing homes move toward the cutting edge and provide the kind of setting that the patients and families of today want,” said Senator Levesque (D-Dist. 11, Portsmouth, Bristol).

Said Representative McNamara (D-Dist. 19, Warwick, Cranston), “This legislation ensures that nursing facilities will be able to maintain their strength as the industry develops, making plenty of room for innsovation without weakening traditional-care facilities. Keeping the whole system robust is important to the health of every individual who relies on one of these facilities for care.”

The legislation maintains the statewide cap on nursing facility beds. As beds become available due to closure or reduction at some facilities, those beds could be transferred. However, under the terms of the legislation, the vast majority of transferred beds would be required to go to facilities that conform with the principles and building designs established by the “Eden alternative,” “Green house,” or “small house” programs or similar options.

By way of example, the “Eden alternative” promotes quality of life and inspires well-being for elders and those who collaborate with them as “care partners” by de-institutionalizing the environment of nursing homes and granting residents autonomy over their daily lives in a vibrant atmosphere. It seeks to prevent loneliness, helplessness and boredom for the frail and elderly to and create a sense of warmth and autonomy in a home-like setting.

The legislation is the result of a Joint Legislative Study Commission on Nursing Home Culture Change, of which Representative McNamara and Senator Levesque served as co-chairmen.

The bill stemmed from legislation introduced in 2009 that would have allowed the addition of new nursing home beds in Rhode Island for the purposes of expanding the availability of homes that embrace the move toward home-like environments and individualized care.

However, many nursing home providers in the state were concerned that such an expansion would oversaturate a nursing facility market that is already witnessing unprecedented vacancy rates. Concerns were also raised about the potential budgetary impact on the state Medicaid program, which funds almost 75 percent of all nursing home care in the state, and the state’s policy to serve more individuals in need of long-term care in home and community settings.

The General Assembly created the study commission, which included representatives of the Departments of Human Services and Health, the Rhode Island Health Care Association (RIHCA), the Rhode Island Association of Facilities and Services for the Aging (RIAFSA), and two nursing home operators, to address the issue, and that panel drafted this legislation.

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