Freeman Health System and Kansas Renewal Institute (KRI) issued a joint statement Monday announcing the signing of a non-binding Letter of Intent to explore the future ownership and operation of Freeman Fort Scott Hospital.
“The Letter of Intent provides Freeman Health System and Kansas Renewal Institute (KRI) the opportunity to evaluate whether a transition of ownership and operations could further support the long-term access to healthcare,” according to the press release.
“The Letter of Intent is non-binding, and no final agreement has been reached. Any potential transaction remains subject to due diligence, negotiation of definitive agreements, regulatory review and other necessary approvals,” according to the press release. “Throughout this process, patient care, hospital operations and services will continue as normal.”
“Freeman Health is trying to sell its hospital to KRI,” said Gregg Motley, who is the Bourbon County Commission Chairman. “They (Freeman Health System) don’t have a building to sell; they have its operations to sell.”
“KRI would have to acquire expertise to run the hospital, and all the Freeman staff would have to be willing to reassign their contract with KRI,” he said. “KRI has to be willing to buy the operations of Freeman Fort Scott. The fly in the ointment is that the State of Kansas will have to give licensing to KRI.”
“I tried to trigger the ‘Claw Back Provision’ with the Bourbon County Commission (who previously owned the building), to give the building to Freeman, and the commission would not support that,” Motley said.
“Now KRI has to be willing to buy the operations of Freeman Fort Scott Hospital,” he said.
Some background
The hospital building at 401 Woodland Hills Blvd. has changed hands more than once. Mercy Hospital Fort Scott announced its closure in 2018, and the Ascension Via Christi emergency room that followed closed in December 2023. Bourbon County donated the building and $2 million to Legacy Healthcare Foundation in November 2022, writing in a “clawback” that returns the property to the county if the terms of the donation are not met. KRI bought the building in December 2024 and runs a mental health treatment center there. Freeman opened its hospital and emergency department in the building on Sept. 4, 2025.
Part of what keeps the emergency department running is a tax county voters approved themselves. On May 14, 2024, Bourbon County voters approved a quarter-cent countywide retail sales tax, 1,611 to 496. It took effect Oct. 1, 2024 and runs five years. The ballot language limits the money to the “establishment and operation of an emergency department in Bourbon County,” and says that when the tax ends, whatever is left goes to emergency medical services or to reducing property taxes.
A citizens committee appointed by the commission checks that the money is spent that way. Charles Gentry and Dr. Randy Nichols reported to commissioners on Aug. 31 that the tax collected $336,741.49 in the first half of 2026 and that $280,602.05 of it was disbursed to Freeman to operate the emergency department.
The county is not a party to the Letter of Intent. Commissioners declined in July to put $300,000 in the 2027 budget to pursue the clawback against KRI and Legacy, a push Motley had led and said he would stop; he laid out his reasoning in a June interview with FortScott.biz. Separately, a federal rural hospital bill introduced in July could change what a hospital like Fort Scott’s can bill for.
The press release, as sent
Joint Statement
Freeman Health System and KRI Sign Letter of Intent Regarding the Future of Fort Scott Healthcare Services
Freeman Health System and KRI today announced the signing of a non-binding Letter of Intent (LOI) to explore the future ownership and operation of Freeman Fort Scott Hospital.
Since opening Freeman Fort Scott Hospital on September 4, 2025, Freeman has remained committed to providing the residents of Fort Scott and Bourbon County with access to high-quality local healthcare. During that time, healthcare organizations across the country, particularly those serving rural communities, have continued to face significant workforce, reimbursement, operational and financial pressures.
As part of its ongoing commitment to the community, Freeman has worked closely with local leaders, providers and stakeholders to evaluate opportunities that could support the long-term sustainability of healthcare services in Fort Scott. Those efforts have included operational improvements and evaluation of potential care delivery models, including opportunities associated with the Rural Emergency Hospital model.
The Letter of Intent provides Freeman Health System and KRI the opportunity to evaluate whether a transition of ownership and operations could further support the long-term access to healthcare.
The LOI is non-binding, and no final agreement has been reached. Any potential transaction remains subject to due diligence, negotiation of definitive agreements, regulatory review and other necessary approvals.
Throughout this process, patient care, hospital operations and services will continue as normal.
Both organizations remain committed to supporting employees, providers, patients and community stakeholders while exploring opportunities to preserve and strengthen local healthcare access.
Additional information will be shared as appropriate as discussions progress.
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About Freeman Health System
Locally owned and nationally recognized, Freeman Health System is a not-for-profit health system serving communities across Missouri, Arkansas, Oklahoma and Kansas through a network of hospitals, physician clinics, outpatient locations, and specialty services. The system includes Freeman Hospital West, Freeman Hospital East, Freeman Neosho Hospital, Freeman Fort Scott Hospital, Inc. and the Freeman Health System facilities in Bentonville, Springdale, Johnson and Siloam Springs. Freeman Health System also operates Ozark Center—the region’s largest provider of behavioral health services, and offers comprehensive cancer, cardiology, neurology and neurosurgery, orthopedics, and women’s and children’s services. The system is supported by more than 7,000 employees and is the only Children’s Miracle Network Hospital in a 70-mile radius. For more information, visit Freeman Health System.