In the smallest state in the union, a major legislative barrier has just been erected. As of January 2026, Rhode Island lawmakers have introduced Senate Bill 2128 (SB 2128), a sweeping act that imposes a strict moratorium on the issuance of new licenses for home care providers, home nursing care providers, and hospice organizations.
This isn’t just a temporary pause; the “lock” is set to remain in place until July 1, 2031. For entrepreneurs looking to enter the market and for existing Home Healthcare Providers Rhode Island, this mandate fundamentally changes the competitive landscape, shifting the focus from market expansion to operational consolidation and survival of the fittest.
Understanding the SB 2128 Licensure Freeze
The primary driver behind SB 2128 is a “Determination of Need.” The General Assembly has signaled that before more players can enter the field, the state must conduct a comprehensive utilization and capacity study. The goal is to prevent a “saturation crisis” where an overabundance of small, under-resourced agencies competes for a limited workforce, potentially diluting the quality of care.
Under this new law, the Rhode Island Department of Health (RIDOH) and the Health Services Council are prohibited from reviewing or approving new license applications for the next five years. While this may sound like a total shutdown, there are critical exceptions designed to protect patient access in specific scenarios.
The Exceptions: When the Door Stays Ajar
- Changes in Ownership: The moratorium does not stop the sale of existing agencies. If you are looking to enter the Rhode Island market, your primary path now lies in acquiring a currently licensed provider.
- Emergency Circumstances: RIDOH maintains the authority to issue licenses if an emergency such as a sudden facility closure or a public health crisis threatens the safety of a specific subpopulation.
- Geographic Gaps: If a specific town or “underserved” neighborhood lacks adequate pain control or symptom management services, a “compelling circumstance” waiver may be granted.
Survival of the Licensed: Maximizing Current Capacity
For agencies already holding a license, the 2031 deadline creates a “protected” market, but it also invites higher state scrutiny. With no new competition coming, the state expects existing providers to handle the increasing volume of Rhode Island’s aging population with higher efficiency.
In this environment, “administrative bloat” is your greatest enemy. Agencies are turning to specialized myezhome care software to do more with less. When you cannot simply “grow your way out” of a problem by opening new branches, you must optimize your current staff’s output through automated scheduling and real-time communication tools.
Focusing on the 2026 Medicare Final Rule
The state moratorium coincides with a difficult federal landscape. The CY 2026 Home Health Prospective Payment System Final Rule has introduced a permanent prospective adjustment of -1.023%, alongside temporary cuts. For Rhode Island agencies, this means your reimbursement for a 30-day episode of care is shrinking exactly when your labor costs are rising.
To survive these dual pressures, your EHR must be more than a digital filing cabinet. It needs to be a financial watchdog that validates every OASIS entry to ensure you are capturing the correct functional impairment levels for maximum legitimate reimbursement.
Compliance and Quality as the New Currency
Since the state has effectively capped the number of licenses, the “value” of your existing license has skyrocketed. Protecting that license from revocation or suspension is paramount.
- Integrated Verification: Rhode Island requires strict adherence to EVV (Electronic Visit Verification). In an era of licensure control, an audit showing “paper-thin” verification could be grounds for the state to pull your license, which under SB 2128 would reduce the total number of allowed licenses in the state permanently.
- Data Integrity: As providers share more data with the state to prove they are meeting “utilization needs,” the risk of exposure increases. Utilizing a platform that is fully hipaa compliant is the only way to ensure that your agency remains an “approved” provider in the eyes of the Health Services Council.
Preparing for the 2031 Reopening
The next five years in Rhode Island will be a “test of endurance.” The agencies that thrive will be those that embrace technology to offset federal cuts and prove their clinical necessity to the state.
By leveraging a unified system like myEZcare, you can ensure your agency isn’t just surviving the moratorium, but setting the standard for the utilization study that will eventually decide the future of the industry in 2031.
Frequently Asked Questions: Rhode Island SB 2128
Can I still open a home care agency if I already started the application?
If your “Certificate of Need” application was officially pending before the enactment of SB 2128, it is generally exempt from the moratorium and will continue to be reviewed.
Does the moratorium apply to hospice care?
Yes. SB 2128 specifically includes home care providers, home nursing care providers, and hospice providers in the licensure freeze.
Will this moratorium increase the cost of care for families?
While the bill is designed to stabilize the market, critics argue that limiting competition could lead to higher prices. However, state-regulated Medicaid rates remain the primary price floor.
Can I move my agency’s office to a new location?
Yes, the moratorium covers new licenses. Changes in location or effective control of an existing license are permitted, provided you notify the licensing agency 60 days in advance.
How can I find out if there are “gaps” in my area to apply for a waiver?
The RIDOH is mandated to conduct a statewide utilization study. Once published, this report will be the “roadmap” used to identify specific geographic areas that might qualify for an emergency license.
