WashingtonHB 17552025-2026 Regular SessionHouseWALLET

Exempting elective percutaneous coronary intervention performed in certain hospitals owned or operated by a state entity from certificate of need requirements.

Sponsored By: Chipalo Street (Democratic)

Became Law

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Bill Overview

Analyzed Economic Effects

10 provisions identified: 8 benefits, 0 costs, 2 mixed.

CCRCs can add nursing home beds

Beginning July 27, 2025, qualifying continuing care retirement communities (CCRCs) can add nursing home beds without a certificate of need. They must serve only contractual members, guarantee a full care continuum, and assume costs above each member’s obligation so the state is not liable. They are limited to no more than one nursing bed per four living units and must show a recent independent review of pricing and long‑term solvency. They must apply at least 30 days before construction or licensure.

Hospital-at-home programs skip CON review

Beginning July 27, 2025, hospital-at-home services defined in state law are not subject to CON review. Hospitals can provide approved hospital‑level care at home without the CON process.

More psychiatric beds without CON through 2028

From May 5, 2017 through June 30, 2028, hospitals can switch licensed beds to psychiatric use without CON review. Each exemption lasts two years. The law also allows creating behavioral health hospitals with up to 16 beds for adults on 90‑ or 180‑day involuntary commitment orders, without CON.

Nursing homes can restore reduced beds

Beginning July 27, 2025, a nursing home that voluntarily reduced beds can restore up to its former bed count without CON review if it stayed open and was not bought or leased. The home must keep life and safety standards (or approved waivers). It must notify the state within 30 days after the reduction to preserve the option, then give at least one year’s notice if construction is needed or 90 days if not. The conversion must finish within four years, with one possible four‑year extension for good cause. Those reduced beds still count in planning while the option is kept.

Older surgery centers keep CON exemption

Beginning July 27, 2025, ambulatory surgery centers that operated or were approved before January 19, 2018 and were already exempt remain exempt from CON review. The exemption survives ownership changes if use stays limited to the group’s own physicians. It does not cover changes in services, specialties, or operating room counts.

Rural clinics in shortage areas exempt

Beginning July 27, 2025, a rural health clinic serving a home health shortage area named by the state under 42 C.F.R. 405.2416 is not subject to CON review. The exemption applies only while the area is officially declared a shortage area.

Small, culture-based hospices are exempt

Beginning July 27, 2025, a hospice designed for a specific religious or cultural group can avoid CON review if it meets strict rules. The operator must provide a full range of long‑term care (including a licensed, Medicare‑certified nursing home) and have at least 10 continuous years of operation. The hospice must coordinate with existing programs, keep a census of no more than 40 patients, get and keep Medicare certification, and serve patients in the same county as the operator’s main services. It cannot be sold or transferred. The state counts its patients in future planning.

State hospitals can offer elective PCI

Beginning July 27, 2025, elective percutaneous coronary intervention (PCI) in hospitals owned or operated by a state entity is exempt from CON review. State hospitals can offer elective PCI without the certificate of need process.

HMO facilities can add tertiary care

Beginning July 27, 2025, HMOs with at least 50,000 local members can offer inpatient tertiary care without a certificate of need. The site must be reasonably close to those members, and at least 75% of patients must be HMO enrollees. Leased sites need 15 years left on the lease. The HMO must apply at least 30 days before starting, and the state decides within 30 days. Exempt sites generally cannot be sold, leased, or transferred without approval or unless the new owner independently meets the same HMO rules.

Rural hospitals can restore beds and licenses

Beginning July 27, 2025, a rural hospital that cut beds can restore up to its prior licensed number within three years without CON review. A former hospital that became a rural health care facility can reapply for a hospital license within three years without CON, if it keeps the same bed count, does not shift beds between acute and long-term care, stays in continuous operation, and was not bought or leased. A rural hospital that lost critical access status under the state pilot can also renew its hospital license without CON if it does not add beds. Sales or leases during these periods can still trigger CON review.

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Sponsors & Cosponsors

Sponsor

Chipalo Street
Democratic • House

Cosponsors

Joe Schmick
Republican • House
Julia Reed
Democratic • House
Lisa Parshley
Democratic • House
Monica Jurado Stonier
Democratic • House
My-Linh Thai
Democratic • House
Nicole Macri
Democratic • House
Osman Salahuddin
Democratic • House
Timm Ormsby
Democratic • House

Roll Call Votes

All Roll Calls

Yes: 145 • No: 0

Senate vote • 4/14/2025

3rd Reading & Final Passage

Yes: 49 • No: 0

House vote • 3/8/2025