Kansas Advocacy Updates: August 20, 2025

Last week, McKnights ran an article on the nationwide increase in survey trends with stricter scrutiny being applied to simpler tasks that can still have devastating impacts for a nursing home, such as accuracy with assessments, PBJ reporting, adequate staffing, and infection control. CMS also seems to be “doubling down” on chemical restraints and antipsychotics by tying that into tags related to staffing. LeadingAge Kansas is reviewing some of the trends outlined in this article to help with future education and advocacy efforts for members.

In addition to the trends outlined in the McKnights article, there seems to be a trend on ANE reporting and contacting law enforcement for “reasonable suspicion of a crime.” By federal law, nursing homes have to also contact law enforcement within specific time frames depending on the report that was made. LeadingAge Kansas is working on putting a matrix together to share on this Friday’s Weekly Webinar for the Regulation of the Week to help providers know how to handle this. 

Now is a great time to ensure you are reviewing applicable statutes, regulations, and reporting requirements for your facility type. Email Kylee Childs if you need help with locating those. 

On a call with KDADS last week, the agency provided some updates on expectations around the HCBS Final Settings Rule for aging services providers. These HCBS, state licensed only, long-term care providers that accept Medicaid HCBS will now have to comply with the Kansas Landlord Tenant Act in addition to state discharge rules. Historically this law has not applied in healthcare settings, but CMS is requiring it. 

What this means: 

• Medicaid resident agreements must include landlord–tenant rights, not just discharge allowances. 

• Evictions require court action — not just discharge notices. 

• Notices for evictions range from 3–30 days, plus extra cure periods and appeal rights. 

• Tenants can delay discharge further by appealing and posting a bond. 

• Providers must still follow state involuntary discharge rules on top of this. 

This creates longer discharge timelines, more administrative work, and higher liability exposure. Since these protections only apply to HCBS Medicaid residents, not others on campus, providers should carefully consider these impacts with their boards and in context with their community makeup. 

Here’s the follow-up answer to last week’s Regulation of the Week on the weekly webinar. 

Q. Does the involuntary discharge notice have to have the next placement identified or could general language such as “TBD” or “we assist in identifying the next placement option and continue to provide care until it is identified” sufficient? 

A. Technically yes, you need to list the specific location. Per 42 CFR § 483.15 the nursing facility must include the following:  

• The reason for transfer or discharge;  

• (ii) The effective date of transfer or discharge;  

• (iii) The location to which the resident is transferred or discharged;  

• (iv) A statement of the resident’s appeal rights, including the name, address (mailing and email), and telephone number of the entity which receives such requests; and information on how to obtain an appeal form and assistance in completing the form and submitting the appeal hearing request;  

• (v) The name, address (mailing and email) and telephone number of the Office of the State Long-Term Care Ombudsman;  

• (vi) For nursing facility residents with intellectual and developmental disabilities or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with developmental disabilities established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (Pub. L. 106-402, codified at 42 U.S.C. 15001 et seq.); and  

• (vii) For nursing facility residents with a mental disorder or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with a mental disorder established under the Protection and Advocacy for Mentally Ill Individuals Act.  

Another important part of this is if that location or anything else about the details of the discharge were to change (i.e. resident condition), then a new notice with updated details would need to be issued.  

• If the changes are deemed “significant,” then the 30-day discharge clock starts over. That isn’t found in 42 CFR § 483.15, but is found in the CMS Surveyor Guidance:  

• For significant changes, such as a change in the transfer or discharge destination, a new notice must be given that clearly describes the change(s) and resets the transfer or discharge date in order to provide 30 day advance notification and permit adequate time for discharge planning. 

This is also a great time for a reminder, the Ombudsman does not have any regulatory or survey authority. They are supposed to obtain resident consent (or duly authorized agent’s consent) before making any reports to KDADS, with only a few exceptions for system issues impacting multiple residents’ wellbeing. Additionally, they are not trained in how to interpret regulations and enforcement so their interpretation may not be correct. We always recommend following up with LeadingAge Kansas or with KDADS SCCC if an Ombudsman shares something related to regulations. 

We’ve been hearing from members that they have been getting calls from KDADS after making self-reports on ANE asking if a report was made to local law enforcement due to “reasonable suspicion of a crime.” We did some digging on requirements and here’s what we found: 

• In the Social Security Act, Sec. 1150B. [42 U.S.C. 1320b–25], there is language that states not only should reports of ANE be made to the Secretary, but also the local law enforcement authority. 

• Depending on whether there is bodily injury or no bodily injury determines when to contact local law enforcement. 

• These reporting requirements extend to all CMS Medicare and/or Medicaid certified long-term care providers, especially nursing homes and long-term care units of hospitals as outlined in 42 C.F.R. § 483.12, and state-licensed only facilities receiving more than or equal to $10,000 in federal funds. 

Now you may be asking, what constitutes “reasonable suspicion of a crime”? The best answer: anything seen or heard that is considered a crime by Kansas law. So, if a resident reports being hit by another resident or by a staff member, regardless of their mental status or history, you must report to both KDADS and law enforcement – because hitting is battery in Kansas state law. 

Essentially, it is not up to providers to determine what is “reasonable” in these scenarios, despite all the history and knowledge you may have regarding the resident or staff. If the act that is being described is a crime by law in Kansas, then report it to law enforcement. 

Read more on “reasonable suspicion of a crime” and how to craft your policies in the State Operations Manual Surveyor Guidance.