Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 81 - Certification › Section 19 CSR 30-81.010 - General Certification Requirements

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule sets forth application procedures
				  and general certification requirements for nursing facilities certified under
				  the Title XIX (Medicaid) program and skilled nursing facilities under Title
				  XVIII (Medicare), and procedures to be followed by nursing facilities when
				  requesting a nurse staffing waiver.
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.
(1) Definitions.
(A) Certification shall mean the
				determination by the Missouri Department of Health and Senior Services, or the
				Centers for Medicare and Medicaid Services, that a licensed skilled nursing or
				intermediate care facility (SNF/ICF) licensed under Chapter 198, RSMo, or an
				ICF for person with mental retardation (ICF/MR), is in substantial compliance
				with all federal requirements and is approved to participate in the Medicaid or
				Medicare programs.
(B) CMS shall
				mean the Centers for Medicare and Medicaid Services of the U.S. Department of
				Health and Human Services.
(C) Cost
				reporting year shall mean the facility's twelve (12)-month fiscal reporting
				period covering the same twelve (12)-month period that the facility uses for
				its federal income tax reporting.
(D) Distinct part shall mean a portion of an
				institution or institutional complex that is certified to provide SNF or NF
				services. A distinct part must be physically distinguishable from the larger
				institution and must consist of all beds within the designated area. The
				distinct part may be a separate building, floor, wing, ward, hallway or several
				rooms at one end of a hall or one side of a corridor.
(E) Department shall mean the Missouri
				Department of Health and Senior Services.
(F) ICF/MR shall mean intermediate care
				facility for persons with mental retardation.
(G) Medicaid shall mean Title XIX of the
				federal Social Security Act.
(H)
				Medicare shall mean Title XVIII of the federal Social Security Act.
(I) Nursing facility (NF) shall mean an SNF
				or ICF licensed under Chapter 198, RSMo which has signed an agreement with the
				Department of Social Services to participate in the Medicaid program and which
				is certified by the department. As used within the contents of this rule,
				licensed SNFs, SNF/ICF and ICFs participating in the Medicaid program are
				subject to state and federal laws and regulations for participation as an N
				F.
(J) Section for Long Term Care
				(SLTC) shall mean that section of the department responsible for licensing and
				regulating long-term care facilities licensed under Chapter 198,
				RSMo.
(K) Skilled nursing facility
				(SNF) shall mean an SNF licensed under Chapter 198, RSMo which has a signed
				agreement with the CMS to participate in the Medicare program and which has
				been recommended for certification by the department.
(L) Title XVIII shall mean the Medicare
				program as provided for in the federal Social Security Act.
(M) Title XIX shall mean the Medicaid program
				as provided for in the federal Social Security Act.