SESSION OF 2023
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2264
As Amended by Senate Committee on Public
Health and Welfare

Brief*
HB 2264, as amended, would establish the No Patient
Left Alone Act (Act). The Act would establish who may visit a
patient in a patient care facility and would require patient care
facilities to provide for in-person visitation. The bill would
require patient care facilities to establish visitation policies
and procedures by September 1, 2023. The bill would also
establish a Patient’s Bill of Rights to protect and promote the
rights of each patient in a patient care facility.

Definitions
The bill would define terms, including:
● “Essential caregiver” would mean an individual
designated by the patient who meets an essential
need of the patient by assisting with the tasks of
daily living or providing important emotional, social,
or psychological support;
● “Immediate family member” would mean father,
mother, stepparent, child, grandchild, stepchild,
sibling, spouse, or grandparent of the patient;
● “Patient” would mean an individual who is receiving
care at or is a resident of a patient care facility; and

____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org
 ● “Patient care facility” would mean any adult care
home including any nursing facility, nursing facility
for mental health, intermediate care facility for
people with intellectual disability, assisted living
facility, residential health care facility, home plus,
boarding care home, adult day care facility, and
hospice facility certified to participate in the
Medicare program that provide service only to
hospice patients.
Patient Visitation Requirements
The bill would specify that a patient care facility would
not be able to take action to prevent a patient from receiving
in-person visitation from any person designated by the
patient, if the patient has the capacity to make such
designation. If the patient does not have the capacity for such
designation, the patient’s agent for health care decisions
established by a durable power of attorney would be allowed
to designate visitors. Visitors could include, but would not be
limited to:
● An immediate family member, domestic partner, or
significant other;
● The agent for health care decisions established by
a durable power of attorney for health care
decisions;
● An essential caregiver; or
● A minister, priest, rabbi, or clergyperson of any
religious denomination or sect to which the patient
is an adherent.
The bill would prohibit patient care facilities from
preventing a patient who is terminally ill or receiving end-of-
life care from receiving in-person visitation from two
individuals at a time.

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 The bill would also establish that a patient may refuse
in-person visitation or revoke previously granted in-person
visitation from any person at any time.

Patient Care Facilities
The bill would provide that patient care facilities must
establish visitation policies by September 1, 2023. Further,
the bill would provide that visitation policies and procedures
must allow in-person visitations, unless the patient objects.
The bill would require visitation policies and procedures,
if established, to be provided to the patient care facility’s
licensing agency at the time of initial licensure, renewal, or at
any time upon request and be easily accessible from the
home page of the medical care facility’s website.
The bill would specify that visitation policies and
procedures cannot contain more stringent infection control
protocols for visitors than for employees of the patient care
facility who are providing direct care to patients.
The bill would establish that a patient care facility may:
● Adopt visitation policies and procedures that are
more stringent for intensive or critical care units;
● Require a visitor to agree in writing to follow the
facility’s policies and procedures;
● Temporarily suspend a visitor’s in-person visitation
if such visitor violates the facility’s policies and
procedures;
● Revoke a visitor’s in-person visitation if such visitor
repeatedly violates the facility’s policies and
procedures or displays any violent or aggressive
behavior; or

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 ● Require a visitor to adhere to infection control
procedures, including wearing personal protective
equipment.
The bill would specify that the Department of Health and
Environment must publish on its website an explanation of
visitation requirements and a link to report complaints alleging
violations by a patient care facility.
The bill would provide civil liability immunity for damages
to the patient care facility except in cases of gross negligence
or willful, wanton, or reckless conduct.

Patient’s Bill of Rights
The bill would require patient care facilities to protect
and promote the rights of each patient, as follows:
● Patients have the right to choose a personal
attending physician, be fully informed in advance
about care and treatment, be fully informed in
advance of changes to their care and treatment
that may affect well-being, and to participate in
planning or changing the plan of care and
treatment except for a patient adjudged
incompetent;
● Patients have the right to be free from mental or
physical abuse, corporal punishment, involuntary
seclusion, and physical or chemical restraints used
for discipline or convenience;
● Patients have the right to privacy in their
accommodations, medical treatment,
communications, visits or meetings;
● Patients have the right to confidentiality in personal
and clinical records; right to access within 24
hours, excluding weekend and holiday, current

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 clinical records upon request of patient or patient’s
legal representative;
● Patients have the right to receive services with
reasonable accommodation of individual needs
and preferences except where the health and
safety of the patient or another patient would be
endangered;
● Patients have the right to voice grievances
regarding treatment or care that is or fails to be
provided without reprisal and to timely efforts by a
patient care facility to resolution of grievances;
● Patients have the right to participate in social,
religious, and community activities that do not
interfere with the rights of other patients in the
facility; and
● Patients have the right to examine, upon
reasonable request, surveys by the patient care
facility’s licensing body and any plan of correction
in effect.
The bill would also make technical amendments.

Background
The bill was introduced by the House Committee on
Health and Human Services at the request of Representative
Eplee on behalf of Representative Resman.


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House Committee on Health and Human Services
In the House Committee hearing on February 7, 2023,
proponent testimony was provided by two private citizens
who practice in the medical community stating that the bill
addresses the main issue of ensuring that patients in a facility
are permitted to have in-person visits during their stay in the
facility.
Written-only proponent testimony was received from
representatives of HCA Healthcare and the Kansas Medical
Society.
Opponent testimony was provided by a representative
of LeadingAge Kansas, who suggested amendments to the
bill, particularly regarding the need for patient care facilities to
adhere to federal laws, rules, and other guidance in order to
remain eligible for federal funding and programs.
Neutral testimony was provided by a representative of
Kansas Health Care Association and Kansas Center for
Assisted Living. Neutral written-only testimony was received
from representatives of the Kansas Hospital Association and
Kansas Adult Care Executives.
The House Committee amended the bill to:
● Specify that a patient care facility could not prevent
a patient from receiving in-person visitation from
any person designated by the patient or, if the
patient does not have the capacity to make such a
designation, by the patient’s agent for health care
decisions established by a durable power of
attorney;
● Add domestic partners and significant others to the
list of individuals that would be allowed in-person
visitation of a patient;

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 ● Specify that patient care facilities may, rather than
shall, establish visitation policies and procedures
and that such policies and procedures would not
be limited to those listed in the bill;
● Provide that patient care facilities would be able to
require a visitor to adhere to infection control
procedures, including wearing personal protective
equipment, though such protocols could not be
more stringent for visitors than those providing
direct care to patients;
● Provide for civil liability from damages to patient
care facilities acting in compliance with the Act
unless such actions would constitute gross
negligence or willful, wanton, or reckless conduct;
and
● Specify the Act would not supersede any federal
law, rules, regulations, or guidance regarding
patient care facilities and would not prohibit a
patient care facility from taking actions necessary
to ensure eligibility for federal financial
participation, federal funds, participation in federal
programs, and reimbursement for services
provided.
Senate Committee on Public Health and Welfare
In the Senate Committee hearing on March 16, 2023,
proponent testimony was provided by Representative Eplee
and a representative of LeadingAge Kansas who stated
generally the intent of the bill was to address issues of patient
care to ensure respectful care of patients and their families
while balancing the need of patients with the needs of other
stakeholders.


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 Written-only proponent testimony was provided by
representatives of Kansas Hospital Association and HCA
Healthcare.
Opponent testimony was provided by a representative
of Kansans for Health Freedom, a precinct committee
woman, and a private citizen who stated generally this bill
transfers the decision making authority to the hospital and the
bill does not address people.
Written-only neutral testimony was received from a
representative of the Kansas Medical Society.
The Senate Committee amended the bill to:
● Modify the option for patient care facilities to have
visitor policies and made it a requirement;
● Remove the minimum requirements of what a
patient care facility includes in the visitation policy
and procedure, which were infection control
protocols and education for visitors, a set schedule
of dates and times when visitation is allowed,
allowable visit length, and limits on number of
visitors;
● Remove the circumstances of when a patient was
to be permitted in-person visitors which were:
○ Terminally ill or receiving end-of-life care;
○ Making one or more major medical decisions;
○ Experiencing emotional distress or grieving
the recent loss of a friend or family member;
○ Experiencing functional, cognitive, or
nutritional decline;
○ Struggling with the change in environment at
the patient care facility after having previously
lived with such patient’s immediate family
member;
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 ○ Admitted to a medical care facility for
childbirth, including care related to a
miscarriage or stillbirth; or
○ Under 18 years of age.
● Remove the provision that a patient care facility
could modify visitation based upon a patient’s
condition or need for rest;
● Remove the provision allowing a patient care
facility to take the steps necessary to ensure
eligibility with federal programs or financial
participation and would not supersede any federal
law, rules, regulations, or guidance regarding
patient care facilities; and
● Add provisions that would establish a patient’s bill
of rights.
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on the bill, as introduced, both the Department of
Health and Environment and the Kansas Department for
Aging and Disability Services (KDADS) indicate that
enactment of the bill would have no fiscal effect. KDADS’
regulatory role for adult care homes, subject to federal
regulation, would continue under the provisions of the bill. If
the federal Centers for Medicare and Medicaid Services
(CMS) impose a requirement for infection control procedures
or limits on visitation for all Medicaid and Medicare providers,
those federal mandates would supersede the requirements of
the bill as a condition of participation for payment. KDADS
would survey and enforce the federal requirements under its
agreement with CMS.
Patient’s Bill of Rights; No Patient Left Alone Act; patient care facilities; in-person
visits; patient


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Statutes affected:
Enrolled - Law effective July 1, 2023: 40-2, 65-4a01, 65-6701, 65-6708, 65-6723, 65-6742
Enrolled: 40-2, 65-4a01, 65-6701, 65-6708, 65-6715, 65-6723, 65-6742