PROVIDENCE – State legislators are sponsoring bills that aim to promote more home-like care in Rhode Island’s nursing homes by making it easier for facilities that have embraced “culture change” to add beds as other facilities in the state shut down.

The measures, sponsored by Sen. Charles J. Levesque, D-Portsmouth, and House Health Education and Welfare Chairman Joseph M. McNamara, D-Warwick, only focus on replacing beds from closed nursing homes to avoid oversaturating the market.

Last year, similar legislation was introduced but without that limitation – just to expand the availability of nursing home beds in more home-like environments with individualized care. But many nursing home leaders said that could hurt their industry, which is already seeing unprecedented vacancy rates.

There were also concerns about the potential impact on the state Medicaid program, which funds almost 75 percent of all nursing home care in Rhode Island, and on a possible conflict with state efforts to shift seniors out of nursing homes and into home and community settings.

The General Assembly created a study commission to address those questions, and the newly introduced bills were developed by that panel over the fall. Levesque and McNamara co-chaired the group, which included representatives of the R.I. Departments of Human Services and Health, the Rhode Island Health Care Association, and the Rhode Island Association of Facilities and Services for the Aging, and two nursing home operators.

“I am glad that the parties were able to agree on this legislation,” said McNamara. “In 2009, the nursing homes in the state were divided about how to accomplish the goal of spreading culture change in a responsible manner.”

Culture change is based on the notion that nursing homes shouldn’t just be medical facilities, but rather should work to be as home-like as possible and adapt to their residents’ individual needs and preferences. More sophisticated models built on that philosophy, such as Eden Alternative homes, create smaller residential communities within the institutions and make special efforts to connect seniors to one another and to the outside world.

Several nursing homes in Rhode Island have embraced culture change on various levels, but those that want to expand their facilities and add more beds are hindered by a statewide moratorium on new beds.

However, Virginia Burke, president and CEO of RIHCA, noted in a statement that many facilities are implementing culture change without adding beds, so the organization opposes lifting the moratorium “without tight control on the growth in the state.”

Jim Nyberg, executive director of RIAFSA, said the proposed legislation “is a responsible balance of the differing interests and issues,” because some providers will need more beds to be able to fully embrace culture change.

The full text of the proposed legislation is available online.