State of Missouri Nursing Home Regulations

Anyone considering a nursing home for themselves, or for a family member, knows that it is a daunting task to choose the best facility. Although Medicaid and Medicare provide guideline standards that apply to all states, ultimately each state is responsible for governing and regulating its own nursing homes and adult care facilities. Missouri provides an extensive list of regulations regarding the well-being of its senior citizens including construction, fire safety, medication management, and dietary guidelines.

Construction Standards

• Missouri requires several building standards necessary to provide safe and adequate care for seniors including sufficient heating and air-conditioning systems, and sanitary food preparation areas. Resident rooms must be at least 70 square-feet per person, with 7-feet or higher ceilings, and non-louvered doors that swing into the room. For every 20 residents a tub or shower stall must be provided. Separate bathing facilities are necessary for more than 20 residents. One toilet facility is required for every six residents, with separate bathrooms provided for each gender.

Fire Safety

• Due to fire safety, multi-leveled facilities must accommodate disabled persons on first floor rooms. Hearing-impaired residents must be provided with an alternative visual fire alarm system. Fire extinguishers are to be placed throughout the building, with no more than 75 feet between locations, and must be pressure checked monthly. Fire drills and evacuation plans must be written and practiced regularly according to local Fire Marshall standards. Resident bedrooms and required exits cannot be locked. Smoke detectors must be installed throughout the building no more than 30 feet apart. Lighted exit signs, sprinkler systems, and intercoms are all required equipment.

Extra-Curricular

• Senior residential care facilities must provide activities that promote gross motor activities like exercise, gardening, dancing, cooking or other routine-like activities. Therapeutic activities must also be offered for relaxation, socialization, and leisure all promoting overall mental and physical well being. Self care, grooming and personal hygiene must be encouraged and adhered to. Staff assigned to residents with Alzheimer's or dementia are required to participate in in-depth training, and individualized care plans, for those patients.

Medications

• Strict rules are set forth regarding the handling of medications. Detailed logs must be kept for each resident indicating current medications, dosages levels, and time of day they are administered. All injections are to be given only by a licensed nurse or physician. All prescriptions are to be followed explicitly according to the doctor's specifications and cannot be modified without physician approval.

Dietary

• Food preparation areas must be sanitary and have adequate refrigeration and garbage facilities. Dining areas are to be clean and attractive. Three meals must be provided daily, two of which must be hot meals, with no more than 14 hours between breakfast and dinner. A minimum three-day food supply must be on hand at all times. Water must always be available, and snacks offered throughout the day. Menu plans should be posted in advance, and are required to be reviewed quarterly by a dietician or nutritionist. Any resident with special dietary must have their meals prepared according to their individual physician's orders.