Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 86 - Residential Care Facilities and Assisted Living Facilities › Section 19 CSR 30-86.012 - Construction Standards for Assisted Living Facilities and Residential Care Facilities

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes construction standards
				  for Residential Care Facilities and Assisted Living Facilities.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
AGENCY NOTE: All rules relating to long-term care
				  facilities licensed by the department are followed by a Roman Numeral which
				  refers to the class (either class I, II or III) of standard as designated in
				  section 198.085.1, RSMo 2000.
(1) These standards apply to assisted living
				facilities and residential care facilities as indicated in the rule.
(2) A facility shall submit a copy of plans
				of proposed new construction, additions to or major remodeling of an existing
				facility to the Section for Long Term Care of the Department of Health and
				Senior Services (here-inafter-the department). If the facility is to be
				licensed for more than nine (9) residents, a registered architect or registered
				professional engineer shall prepare the plans and specifications for new
				construction or additions to an existing facility in conformance with Chapter
				327, RSMo. III
(3) Construction of
				facilities shall begin only after the plans and specifications have received
				the written approval of the department. Facilities shall then be built in
				conformance with the approved plans and specifications. The facility shall
				notify the department when construction begins. If construction of the project
				is not started within one (1) year after the date of approval of the plans and
				specifications and completed within a period of three (3) years, the facility
				shall resubmit plans to the department for its approval and shall amend them,
				if necessary, to comply with the then current rules before construction work is
				started or continued. III
(4) If
				the facility employs more than fifteen (15) people, it shall conform with
				section 504 of the Rehabilitation Act of 1973. Any facility that houses
				handicapped residents shall have the first floor rooms and living areas
				designed to be accessible to these residents. III
(5) Facilities shall not house residents on a
				level where the outside grade line is more than three feet (3') above the floor
				level on the window side of the room. II
(6) Facilities whose plans were approved
				after December 31, 1987, shall provide a minimum of seventy (70) square feet
				per resident in private and multiple occupancy bedrooms. This square footage
				calculation shall include the floor space used for closets and built-in
				furniture and equipment if these are for resident use and the closet space does
				not exceed five (5) square feet per resident. Private bedrooms in existing
				facilities that are required to comply with the requirements of
				19
				CSR 30-86.043 or
				19
				CSR 30-86.047, and multiple occupancy bedrooms in
				facilities licensed between November 13, 1980 and December 31, 1987, shall have
				a minimum of sixty (60) square feet of floor space per resident. II
(7) Ceilings in bedrooms shall be a minimum
				of seven feet (7') in height or if a room with sloping ceiling is used, only
				the area where the ceiling height is at least seven feet (7') can be used to
				meet the required minimum square footage per resident. II
(8) Facilities shall provide bedrooms with at
				least one (1) functional outside window with screen. Window size shall be not
				less than one-twentieth (1/20) or five percent (5%) of the required floor area.
				II
(9) Facilities shall provide
				resident rooms with a full nonlouvered door that swings into the room.
				Facilities formerly licensed as residential care facilities II and existing
				prior to November 13, 1980, are exempt from this requirement. II
(10) Facilities shall permit no more than
				four (4) beds per bedroom, regardless of the room size. Facilities formerly
				licensed as residential care facilities II and existing prior to November 13,
				1980, are exempt from this requirement. II
(11) One (1) tub or shower bath shall be
				provided for each twenty (20) residents or major fraction of twenty (20).
				Facilities exceeding twenty (20) residents shall have separate bathing
				facilities for each sex. II
(12)
				One (1) toilet and lavatory shall be provided for each six (6) residents or
				major fraction of six (6). Facilities formerly licensed as residential care
				facilities II and in operation or whose plans were approved prior to November
				13, 1980 are required to provide one (1) toilet for each ten (10) beds or major
				fraction of ten (10) and one (1) lavatory for every fifteen (15) residents or
				major fraction of fifteen (15). II
(13) Separate toilet rooms shall be provided
				for each sex if common rooms with multi-stalls and stools are provided.
				II
(14) Bath and toilet facilities
				shall be conveniently located so that residents can reach them without passing
				through the kitchen, another bedroom, or auxiliary service areas. Facilities
				formerly licensed as residential care facilities II and in operation or whose
				plans were approved prior to November 13, 1980 are exempt from this
				requirement. III
(15) Bath and
				toilet facilities shall be ventilated. III
(16) Facilities whose plans were approved or
				were initially licensed after December 31, 1987, shall have a community living
				and dining area separate from resident bedrooms with at least twenty-five (25)
				square feet per resident. The community living and dining area may be combined
				with footage required for another long-term care facility when the facility is
				on the same premises as another licensed facility. Facilities that are required
				to comply with the requirements of
				19
				CSR 30-86.043 licensed prior to November 13, 1980,
				must have a living room area but they are exempt from minimum size
				requirements. Facilities licensed between November 13, 1980 and December 31,
				1987, shall have a community living area with twenty (20) square feet per
				resident for the first twenty (20) residents and an additional fifteen (15)
				square feet per resident over a census of twenty (20). II
(17) Facilities shall provide the following
				in the dietary area: a kitchen, dishwashing, refrigeration, and garbage
				disposal facilities. The facility shall arrange the kitchen and equipment to
				efficiently and sanitarily enable the storage, preparation, cooking and serving
				of food and drink to residents. II
(18) Residential care facilities and assisted
				living facilities shall provide a designated attendant's working area which
				includes: a storage space for records; locked storage space for medications; a
				handwashing sink with hot and cold running water, a soap dispenser and paper
				towels; and a telephone conveniently located to the area. Facilities licensed
				for twelve (12) or fewer residents are exempt from a separate working area.
				III
(19) Facilities shall have a
				laundry area in a separate room for storing, sorting, washing, drying and
				distributing linen and personal clothing. Laundry facilities of a licensed
				long-term care facility located on the same premises may be used. Facilities
				licensed for twelve (12) or fewer residents will be exempt from having a
				separate room for laundry but the laundry room shall be separate from the
				kitchen and shall not be located in a room used by residents. III
(20) All newly licensed facilities shall be
				of sturdy construction with permanent foundations. III
(21) In buildings built prior to September
				28, 1979, corridors shall have a minimum width of thirty-six inches (36").
				First-floor resident room doors shall be a minimum of thirty-two inches (32")
				wide. Resident room doors of these buildings on the second floor and above
				shall be a minimum of thirty inches (30") wide. II/III
(22) In newly licensed buildings constructed
				on or after September 28, 1979, all resident room doors shall be a minimum of
				thirty-two inches (32") wide on all floors. Corridors shall be a minimum of
				forty-eight inches (48") wide and interior stairs shall be at least thirty-six
				inches (36") wide. II/III
(23) Exit
				doors in newly licensed facilities shall be at least thirty-six inches (36")
				wide, at least seventy-two inches (72") high and shall swing outward.
				II/III
(24) Residential care
				facilities that accept deaf residents, shall have appropriate assistive devices
				to enable each deaf person to negotiate a path to safety, including, but not
				limited to, visual or tactile alarm systems. II/III
(25) Residential care facilities and
				facilities formerly licensed as residential care facilities II whose plans were
				initially approved between December 31, 1987 and December 31, 1998, shall have
				at least one (1) hydraulic or electric motor-driven elevator if there are more
				than twenty (20) residents with bedrooms above the first floor. The elevator
				installation(s) shall comply with all local and state codes, American Society
				for Mechanical Engineers (ASME) A17.1,
Safety Code for Elevators,
				Dumbwaiters, and Escalators
, and the National Fire Protection
				Association's applicable codes. All facilities with plans approved on or after
				January 1, 1999, shall comply with all local and state codes, ASME A17.1, 1993
Safety Code for Elevators and Escalators,
and the 1996
National Electrical Code.
These references are incorporated by
				reference in this rule and available at: American Society for Mechanical
				Engineers, Three Park Avenue, New York, NY 10016-5990; and The American
				National Standards Institute, 11 West 42nd Street, 13th Floor, New York, NY
				10036. This rule does not incorporate any additional amendments or additions.
				II
(26) Facilities whose plans were
				approved or which were initially licensed after December 31, 1987, shall
				provide an air-conditioning system, or individual room air-conditioning units,
				capable of maintaining resident-use areas at eighty-five degrees Fahrenheit (85
				
				oF) (29.4 
				oC) at the summer design temperature.
				II
(27) Home-Like Requirements with
				Respect to Construction Standards.
(A) Any
				assisted living facility formerly licensed as a residential care facility shall
				be more home-like than institutional with respect to construction and physical
				plant standards. II
(B) Any
				assisted living facility licensed as a residential care facility II prior to
				August 28, 2006, shall qualify as being more homelike than institutional with
				respect to construction and physical plant standards. II
(C) Any assisted living facility that is
				built or has plans approved on or after August 28, 2006, shall be more
				home-like than institutional with respect to construction and physical plant
				standards. II