H 8406Medical Services

Human Services - Medical Assistance - Long-Term Care Service and Finance Reform - Assisted Living Services

It requires the state to pay assisted living facilities to hold rooms for Medicaid residents absent over 10 days.

Introduced

Population
Affected

Introduced Apr 3, 2026Committee House Finance

Plain-English Summary

This bill changes the rules for assisted living facilities when a Medicaid-eligible resident temporarily leaves for a hospital or nursing home. Facilities are not required to hold a resident's room for more than 10 days unless the state provides a Medicaid bed hold payment. For holds extending past 10 days, the state must pay the facility at least 50% of the resident's normal Medicaid rate. Facilities are never required to hold an unpaid bed for more than 45 days. The rules only apply if the facility is notified in writing that the resident expects to return.

For younger readers

Sometimes, people living in assisted living homes (places where older adults get help with daily tasks) need to go to the hospital for a while. This bill says that if a person who uses Medicaid (a government program that pays for healthcare) leaves for more than 10 days, the government must pay the home to keep their room empty and waiting for them. If the government doesn't pay, the home doesn't have to save the room. The home only has to save the room for up to 45 days without being paid.

Who & Where It Applies

Impacted groups

Medicaid-eligible residents in assisted livingAssisted living facility owners and operatorsFamilies of assisted living residentsExecutive Office of Health and Human ServicesHospital discharge planners

Impacted communities

All

Constitutional & Fiscal Check

None Likely. The bill regulates Medicaid reimbursement rates and the conditions under which state-licensed assisted living facilities participate in the Medicaid program. These are standard regulatory and administrative functions that do not implicate free speech, due process, or protection from unreasonable searches and seizures.

Estimated cost

Amount unknown

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Protects housing stability for vulnerable, low-income seniors on Medicaid by providing state funding to hold their rooms while they recover in a hospital or nursing home.
Strengthens the social safety net by ensuring the state takes financial responsibility for the care and housing continuity of disadvantaged residents during medical emergencies.
Encourages assisted living facilities to accept and retain Medicaid patients by guaranteeing they will receive at least partial payment when a resident is temporarily absent.
Places vulnerable Medicaid residents at risk of losing their housing if they are hospitalized for more than 10 days and the state fails to provide the required bed hold payment.
Creates a hard cap of 45 days for unpaid bed holds, which could displace residents who suffer severe medical emergencies requiring extended hospital or nursing home stays.
Explicitly allows private-pay arrangements for bed holds, which could create a two-tiered system where wealthier residents can guarantee their housing while low-income residents risk displacement.

For Conservatives

Protects the corporate freedom and financial viability of assisted living facilities by ensuring they are not forced to hold empty rooms without compensation for extended periods.
Limits the regulatory burden on private businesses by establishing a strict 45-day maximum limit on unpaid bed holds for Medicaid residents.
Preserves free-market principles by explicitly protecting the right of facilities to enter into voluntary, private payment arrangements with residents or their families to hold residential units.
Increases government spending and taxpayer burden by mandating new Medicaid payments to facilities for empty beds when residents are absent for more than 10 days.
Expands government bureaucracy by requiring the executive office of health and human services to amend regulations and submit new state plan amendments or waivers.
Still restricts property rights and corporate freedom by forcing assisted living facilities to hold an unpaid bed for a Medicaid resident for up to 10 days.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 22 additions

SECTION 1. Chapter 40-8.9 of the General Laws entitled "Medical Assistance — Long- Term Care Service and Finance Reform" is hereby amended by adding thereto the following section: 40-8.9-10. Assisted living services -- Medicaid bed hold requirements.

(a) Notwithstanding any provision of law or regulation to the contrary, a licensed assisted living community shall not be required to hold a residential unit for a Medicaid-eligible resident who is temporarily absent due to hospitalization or admission to a skilled nursing facility for a period exceeding ten (10) days, unless a Medicaid bed hold payment is provided pursuant to subsection (b) of this section.

(b) For any required bed hold period beyond ten (10) days, the executive office of health and human services shall provide a Medicaid bed hold payment to the assisted living community at a rate not less than fifty percent (50%) of the resident's assessed Medicaid assisted living reimbursement rate.

(c) No assisted living community shall be required to maintain an unpaid bed hold for a Medicaid resident for a period exceeding forty-five (45) days in total, regardless of anticipated return status.

(d) Nothing in this section shall be construed to prohibit an assisted living community, at its discretion, from voluntarily holding a unit for a longer period or from entering into a private payment arrangement with the resident or the resident’s representative.

(e) The provisions of this section shall apply only where the assisted living community has received written notice that the resident is reasonably expected to return to the assisted living setting.

(f) The executive office of health and human services shall amend its regulations governing assisted living services to conform with this section and shall submit any necessary Medicaid state plan amendments or waivers required for implementation.

SECTION 2. This act shall take effect upon passage and shall apply to Medicaid-assisted living residents absent on or after July 1, 2026.