Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 85 - Intermediate Care and Skilled Nursing Facility › Section 19 CSR 30-85.042 - Administration and Resident Care Requirements for New and Existing Intermediate Care and Skilled Nursing Facilities

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment clarifies and updates the
				  requirements regarding the nursing assistant training program as a result of
				  revisions made to regulation set in
				  19 CSR
				  30-84.010 Nursing Assistant Training
				  Program.
(1) The operator
				shall designate a person as administrator who holds a current license as a
				nursing home administrator in Missouri. II
(2) The facility shall post the
				administrator's license. III
(3)
				The operator shall be responsible to assure compliance with all applicable laws
				and rules. The administrator shall be fully authorized and empowered to make
				decisions regarding the operation of the facility and shall be held responsible
				for the actions of all employees. The administrator's responsibilities shall
				include the oversight of residents to assure that they receive appropriate
				nursing and medical care. II/III
(4) The administrator shall be employed in
				the facility and serve in that capacity on a full-time basis. An administrator
				cannot be listed or function as an administrator in more than one (1) licensed
				facility at the same time, except that one (1) administrator may serve as the
				administrator of more than one (1) licensed facility if all facilities are on
				the same premises. II/III
(5) The
				licensed administrator shall not leave the premises without delegating the
				necessary authority in writing to a responsible individual. If the
				administrator is absent from the facility for more than thirty (30) consecutive
				days, the person designated to be in administrative charge shall be a currently
				licensed nursing home administrator. Such thirty (30) consecutive-day absences
				may only occur once within any consecutive twelve (12)-month period.
				I/II
(6) The facility shall not
				knowingly admit or continue to care for residents whose needs cannot be met by
				the facility directly or in cooperation with outside resources. Facilities
				which retain residents needing skilled nursing care shall provide licensed
				nurses for these procedures. I/II
(7) When outside resources are used to
				provide services to the resident, the facility shall enter into a written
				agreement with each resource. III
(8) Persons under seventeen (17) years of age
				shall not be admitted as residents to the facility unless the facility cares
				primarily for residents under seventeen (17) years of age. III
(9) The facility shall not care for more
				residents than the number for which the facility is licensed. II
(10) The facility's current license shall be
				readily visible in a public area within the facility. Notices provided to the
				facility by the Division of Aging granting exceptions to regulatory
				requirements shall be posted with the facility's license. III
(11) Regular daily visiting hours shall be
				established and posted. Relatives or guardians and clergy, if requested by the
				resident or family, shall be allowed to see critically ill residents at any
				time unless the physician orders otherwise in writing. II/III
(12) A supervising physician shall be
				available to assist the facility in coordinating the overall program of medical
				care offered in the facility. II
(13) The facility shall develop policies and
				procedures applicable to its operation to insure the residents' health and
				safety and to meet the residents' needs. At a minimum, there shall be policies
				covering personnel practices, admission, discharge, payment, medical emergency
				treatment procedures, nursing practices, pharmaceutical services, social
				services, activities, dietary, housekeeping, infection control, disaster and
				accident prevention, residents' rights and handling residents' property.
				II/III
(14) A pharmacist currently
				licensed in Missouri shall assist in the development of written policies and
				procedures regarding pharmaceutical services in the facility. II/III
(15) All personnel shall be fully informed of
				the policies of the facility and of their duties. II/III
(16) All persons who have any contact with
				the residents in the facility shall not knowingly act or omit any duty in a
				manner which would materially and adversely affect the health, safety, welfare
				or property of a resident. I
(17)
				Effective August 28, 1997, each facility shall, not later than two (2) working
				days of the date an applicant for a position to have contact with residents is
				hired, request a criminal background check, as provided in sections
				43.530,
				43.540
				and
				610.120,
				RSMo. Each facility must maintain in its record documents verifying that the
				background checks were requested and the nature of the response received for
				each such request. The facility must ensure that any applicant who discloses
				prior to the check of his/her criminal records that he/she has been convicted
				of, plead guilty or
nolo contendere
to, or has been found
				guilty of any A or B felony violation of Chapter 565, 566 or 569, RSMo, or any
				violation of subsection 3 of section
				198.070,
				RSMo, or of section
				568.020, RSMo,
				will not be allowed to work in contact with patients or residents until and
				unless a check of the applicant's criminal record shows that no such conviction
				occurred. II/III
(18) The facility
				must develop and implement written policies and procedures which require that
				persons hired for any position which is to have contact with any patient or
				resident have been informed of their responsibility to disclose their prior
				criminal history to the facility as required by section 660.317.5, RSMo. The
				facility-
(A) Shall also develop and implement
				policies and procedures which ensure that the facility does not knowingly hire,
				after August 28, 1997, any person who has or may have contact with a patient or
				resident, who has been convicted of, plead guilty or
nolo
				contendere
to, in this state or any other state, or has been found
				guilty of any A or B felony violation of Chapter 565, 566 or 569, RSMo, or any
				violation of subsection 3 of section
				198.070,
				RSMo, or of section
				568.020, RSMo,
				unless the person has been granted a good cause waiver by the
				division;
(B) May consider for
				employment, in positions which have contact with resident or patients, any
				person who has been granted a good cause waiver by the division in accordance
				with the provisions of section
				660.317,
				RSMo Supp. 1999 and 13 CSR 15-10.060; and;
(C) Shall contact the division to confirm the
				validity of an applicant's good cause waiver prior to hiring the applicant.
				II/III