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HB 2249

Requiring the secretary for aging and disability services to grant physical environment waivers for certain rural emergency hospitals to provide skilled nursing facility care and establishing the south central regional mental health hospital.

2025-2026 Regular Session

Allows a rural emergency hospital to convert up to 10 swing beds to skilled nursing facility beds without new SNF standards, preserving local long-term care capacity.

Engrossed on Monday, March 31, 2025
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Bill Summary · HB 2249

Summary — HB 2249 (2025)

Status: Enrolled and approved by the Governor on April 8, 2025. Becomes effective upon publication in the statute book.

Main purpose

HB 2249 makes two primary changes to Kansas law:
1. Authorizes the Secretary for Aging and Disability Services (KDADS) to grant a physical-environment waiver allowing certain rural emergency hospitals (REHs) to convert up to 10 existing swing beds into skilled nursing facility (SNF) beds without having to meet new SNF physical‑plant standards; and
2. Establishes the South Central Regional Mental Health Hospital (a regional state psychiatric hospital) in Wichita, including creating a dedicated fee fund and authorizing an extension to the state security hospital for custody/treatment of criminally committed or transferred individuals with mental illness.

Key provisions — REH physical environment waivers

  • KDADS must, upon application, grant a waiver permitting a REH to transition up to 10 swing beds to SNF beds if the REH:
    • Is currently licensed as a rural emergency hospital under the Rural Emergency Hospital Act;
    • Was licensed as a hospital immediately prior to REH licensure; and
    • While licensed as a hospital, provided SNF services or critical access hospital swing‑bed services for at least 12 months without any finding of “immediate jeopardy.”
  • The waiver is explicitly supplemental to the Rural Emergency Hospital Act.
  • Definitions for “critical access hospital” and “hospital” are adopted from existing K.S.A. statutes (K.S.A. 65‑468 and 65‑425).

Intended effect: permit older hospital buildings that previously ran long‑term care/swing‑bed units to continue providing long‑term skilled nursing care without incurring the cost of meeting new construction/physical‑environment standards required of newly licensed SNFs.

Key provisions — South Central Regional Mental Health Hospital

  • Creates a new state hospital in Wichita (serving Sedgwick County and surrounding south‑central Kansas).
  • Establishes the South Central Regional Mental Health Hospital Fee Fund in the state treasury, administered by KDADS; receipts from patient charges and operations are deposited into the fund and spent pursuant to appropriation.
  • Authorizes KDADS to establish and operate an extension to the State Security Hospital at this facility to hold, examine, treat, and care for persons committed by criminal courts or transferred from corrections; the Larned State Hospital superintendent will act as superintendent for that extension.

Who is affected

  • Primary beneficiaries: qualifying rural emergency hospitals and their long‑term care residents and communities that rely on local SNF capacity.
  • KDADS: gains authority to grant the waiver and administer the new regional hospital fund and facility operations.
  • Potential impact on Medicare and Medicaid reimbursements if the Centers for Medicare & Medicaid Services (CMS) permits REHs to be certified for Title XVIII/XIX (federal certification would affect billing for the converted SNF beds).
  • At present KDADS indicated only one REH in Kansas appears eligible.

Fiscal impact

  • KDADS estimates a negligible direct fiscal effect.
  • The bill could increase Medicare/Medicaid payments if CMS permits certification of REH SNF beds, potentially increasing federal reimbursements to providers (limited to up to 10 beds per eligible REH).
  • Creation of the regional mental health hospital establishes a fund to receive and spend institutional receipts; overall state appropriations/long‑term costs depend on later budgeting and implementation.

Legislative history & timeline

  • Introduced Jan 30, 2025 (House) at the request of Rep. W. Carpenter on behalf of the Kansas Hospital Association. Companion SB 82 progressed in the Senate.
  • Passed both chambers after committee consideration and amendments; enrolled and presented to the Governor Apr 4, 2025; approved Apr 8, 2025.
  • Effective upon publication in the statute book.

Stakeholder input / rationale

  • Proponents (Kansas Hospital Association, Mercy Hospital, LeadingAge Kansas) argued the waiver prevents closure of long‑term beds and avoids costly physical upgrades for older hospital buildings, preserving local access to long‑term care.
  • KDADS provided neutral testimony noting limited applicability (only one REH currently eligible) and that fiscal effects depend on CMS federal certification policy.

This summary highlights the substantive changes made by HB 2249 and the practical effects expected for rural hospitals, long‑term care capacity, KDADS, and regional mental‑health services in south‑central Kansas.

Compiled from official sources — confirm details with the bill’s official record.

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