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S 2714Public Health

Health and Safety - Abuse in Healthcare Facilities

This bill removes the requirement that abuse or neglect of patients and the elderly must be intentional to be illegal.

Introduced
Population
Affected
25
Introduced Feb 27, 2026Committee Senate Judiciary

Plain-English Summary

This legislation modifies the legal definitions of "abuse," "neglect," "emotional abuse," and "physical abuse" within Rhode Island's laws governing healthcare facilities and the Office of Healthy Aging. Specifically, the bill removes the requirements that actions must be "intentional" or "willful" to constitute abuse or neglect. This means that caregivers, hospitals, and nursing homes can be held liable for harming or neglecting patients and elderly persons based on the outcome of their actions (or failure to act), regardless of whether they specifically intended to cause harm.

For younger readers

There are laws that protect older people and sick people in hospitals from being hurt or ignored by the people taking care of them. Before, the law said a caretaker only got in trouble if they *meant* to be mean or *meant* to ignore the person. This new bill changes the rules. Now, if a caretaker hurts someone or forgets to take care of them, they can get in trouble even if it was an accident or they didn't do it on purpose. It makes sure caretakers are always very careful.

Who & Where It Applies

Impacted groups
Elderly ResidentsHealthcare FacilitiesNurses and CaregiversHospital AdministratorsPatients with Disabilities
Impacted communities
All

Constitutional & Fiscal Check

Moderate risk

There is a moderate risk regarding Due Process. By removing the "intentional" and "willful" requirements (mens rea), the bill potentially converts abuse and neglect into strict liability offenses or negligence-based offenses. Courts generally require a mental state element for serious criminal liability. If these definitions apply to criminal prosecution without requiring intent, it could be challenged as violating due process rights by punishing accidental conduct too severely.

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Strengthens protections for vulnerable populations, including the elderly and those with disabilities, by removing the difficult legal hurdle of proving a perpetrator's "intent" in abuse cases.
  • Increases accountability for healthcare corporations and facilities, preventing them from using "accidental" neglect as a defense for maintaining poor care standards or understaffing.
  • Expands the legal recourse available to victims of neglect, ensuring that the actual harm suffered by the victim is prioritized over the mindset or excuses of the caregiver.
  • May unfairly penalize overworked and underpaid low-wage healthcare workers for mistakes caused by systemic issues like understaffing, rather than actual malice.
  • Could lead to increased criminalization or administrative penalties for individual employees, ignoring the root causes of poor care which are often tied to corporate profit-seeking.
  • Removes the distinction between an honest accident and malicious behavior, potentially ensnaring well-meaning staff in legal or administrative penalties that could end their careers.
For Conservatives
  • Strengthens law and order by closing legal loopholes that allowed negligent caregivers to escape consequences by claiming ignorance or lack of specific intent to harm.
  • Prioritizes the sanctity of life and the protection of elders, ensuring that families can trust institutions to provide a rigorous standard of care for their loved ones.
  • Imposes stricter standards of personal responsibility on caregivers, mandating high levels of competence and duty in the performance of their jobs.
  • Increases legal liability and insurance costs for private healthcare businesses and nursing homes by significantly lowering the threshold for abuse and neglect claims.
  • Removes the mens rea (guilty mind) standard, a fundamental legal principle, potentially punishing individuals and businesses for unintentional errors or accidents.
  • Expands government regulatory power over private healthcare facilities, potentially leading to excessive bureaucratic oversight, litigation, and government interference in business operations.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 3 additions · 9 deletions

SECTION 1. Section 23-17.8-1 of the General Laws in Chapter 23-17.8 entitled "Abuse in Healthcare Facilities" is hereby amended to read as follows: 23-17.8-1. Definitions. (a)(1) “Abuse” means:

(i) Any assault as defined in chapter 5 of title 11, including, but not limited to, hitting, kicking, pinching, slapping, or the pulling of hair; provided, however, unless it is required as an element of the offense charged, it shall not be necessary to prove that the patient or resident was injured by the assault;

(ii) Any assault as defined in chapter 37 of title 11;

(iii) Any offense under chapter 10 of title 11;

(iv) Any conduct that harms or is likely to physically harm the patient or resident except where the conduct is a part of the care and treatment, and in furtherance of the health and safety of the patient or resident; or

(v) Intentionally engaging Engaging in a pattern of harassing conduct that causes or is likely to cause emotional or psychological harm to the patient or resident, including but not limited to: ridiculing or demeaning a patient or resident; making derogatory remarks to a patient or resident or cursing directed towards a patient or resident; or threatening to inflict physical or emotional harm on a patient or resident.

(2) Nothing in this section shall be construed to prohibit the prosecution of any violator of this section under any other chapter.

(b) “Department” means the department of health when the incident occurs in a healthcare facility, and the department of behavioral healthcare, developmental disabilities and hospitals when the incident occurs in a community residence for persons with intellectual or developmental disabilities.

(c) “Facility” means any healthcare facility or community residence for persons with intellectual or developmental disabilities as those terms are defined in this section. “Healthcare facility” means any hospital or facility that provides long-term health care required to be licensed under chapter 17 of this title, and any assisted living residence required to be licensed under chapter 17.4 of this title, and any community residence whether privately or publicly owned. “Community residence” for persons with intellectual or developmental disabilities means any residential program licensed by the department of behavioral healthcare, developmental disabilities and hospitals that meets the definition of a community residence as defined in § 40.1-24-1 and provides services to persons with intellectual or developmental disabilities.

(d) “High managerial agent” means an officer of a facility, the administrator and assistant administrator of the facility, the director and assistant director of nursing services, or any other agent in a position of comparable authority with respect to the formulation of the policies of the facility or the supervision in a managerial capacity of subordinate employees.

(e) “Immediate jeopardy” means a situation in which the nursing facility’s alleged noncompliance with one or more state or federal requirements or conditions has caused, or is likely to cause serious injury, harm, impairment, or death to a resident; or shall be defined in accordance with 42 C.F.R Part 489 or any subsequent applicable federal regulations.

(f) “Mistreatment” means the inappropriate use of medications, isolation, or use of physical or chemical restraints:

(1) As punishment;

(2) For staff convenience;

(3) As a substitute for treatment or care;

(4) In conflict with a physician’s order; or

(5) In quantities that inhibit effective care or treatment, or that harms or are likely to harm the patient or resident.

(g) “Neglect” means the intentional failure to provide treatment, care, goods, and services necessary to maintain the health and safety of the patient or resident; or the intentional failure to carry out a plan of treatment or care prescribed by the physician of the patient or resident; or the intentional failure to report patient or resident health problems or changes in health problems or changes in health conditions to an immediate supervisor or nurse; or the intentional lack of attention to the physical needs of a patient or resident including, but not limited to toileting, bathing, meals, and safety. No person shall be considered to be neglected for the sole reason that the person relies on or is being furnished treatment in accordance with the tenets and teachings of a well-recognized church or denomination by a duly-accredited practitioner of a well-recognized church or denomination.

(h) “Non-immediate jeopardy — high potential for harm” means a situation in which a nursing facility’s alleged noncompliance with one or more state or federal requirements or conditions may have caused harm that negatively impacts the individual’s mental, physical, and/or psychosocial status; or shall be defined in accordance with 42 C.F.R Part 489 or any subsequent applicable federal regulations.

(i) “Non-immediate jeopardy — low potential for harm” means a situation in which a nursing facility’s alleged noncompliance with one or more state or federal requirements or conditions may have caused mental, physical, and/or psychosocial discomfort that does not constitute injury or damage; or shall be defined in accordance with 42 C.F.R Part 489 or any subsequent applicable federal regulations.

(j) “Non-immediate jeopardy — medium potential for harm” means a situation in which a nursing facility’s alleged noncompliance with one or more state or federal requirements or conditions has caused or may have caused harm that is of limited consequence and does not significantly impair the individual’s mental, physical, and/or psychosocial status to function; or shall be defined in accordance with 42 C.F.R Part 489 or any subsequent applicable federal regulations.

(k) “Patient” means any person who is admitted to a facility for treatment or care, while “resident” means any person who maintains their residence or domicile, on either a temporary or permanent basis, in a facility.

(l) “Person” means any natural person, corporation, partnership, unincorporated association, or other business entity.

SECTION 2. Section 42-66-4.1 of the General Laws in Chapter 42-66 entitled "Office of Healthy Aging" is hereby amended to read as follows: 42-66-4.1. Definitions. As used in this chapter:

(1) “Abuse” means physical abuse, sexual abuse, and/or emotional abuse of an elderly person by a caregiver as defined in subsection (2).

(i) “Emotional abuse” means a pattern of willful infliction of mental or emotional harm upon an elderly person by threat, intimidation, isolation, or other abusive conduct.

(ii) “Physical abuse” means the willful infliction of physical pain or injury (e.g., slapping, bruising, or restraining) upon an elderly person.

(iii) “Sexual abuse” means the infliction of non-consensual sexual contact of any kind upon an elderly person. Sexual abuse includes, but is not limited to, sexual assault, rape, sexual misuse or exploitation of an elderly person, as well as threats of sexual abuse where the perpetrator has the intent and the capacity to carry out the threatened abuse.

(2) “Caregiver” means a person who has assumed the responsibility for the care of the elderly person voluntarily, by contract, or by order of a court of competent jurisdiction, or who is otherwise legally responsible for the care of the elderly person.

(3) “Elderly person” or “elder” means any person sixty (60) years of age or older.

(4) “Exploitation” means the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including, but not limited to, a caregiver or fiduciary, who uses the resources of an elderly person for monetary or personal benefit, profit, gain, or that results in depriving an elderly person of rightful access to, or use of, benefits, resources, belongings, or assets by use of undue influence, harassment, duress, deception, false representation, or false pretenses.

(5) “Neglect” means the willful failure by a caregiver or other person with a duty of care to provide goods or services necessary to avoid physical harm, mental harm, or mental illness to an elderly person, including, but not limited to, “abandonment” (withdrawal of necessary assistance) and denial of food or health-related services.

(6) “Protective services” means services and/or action intended to prevent and/or alleviate the abuse, neglect, exploitation, or self-neglect of elderly persons. Protective services may include supervision, counseling, and assistance in securing health and supportive services, safe living accommodations, and legal intervention.

(7) “Self-neglect” means a pattern of behavior in an elderly person that directly, imminently, and significantly threatens his/her own health and/or safety. Self-neglect includes, but is not limited to, an inability or an incapacity to provide self with food, water, shelter, or safety to the point of establishing imminent risk of any of the harm(s) described in the immediately preceding sentence.

(8) “Willful” means intentional, conscious, and directed toward achieving a purpose.

SECTION 3. This act shall take effect upon passage.