PURPOSE: This rule establishes standards for the physical plant of new or existing residential care facilities I and II.

Editor's Note: The secretary of state has determined that the publication of this rule in its entirety would be unduly cumbersome or expensive. The entire text of the material referenced has been filed with the secretary of state. This material may be found at the Office of the Secretary of State or at the headquarters of the agency and is available to any interested person at a cost established by state law.

Editor’s Note: All rules relating to long-term care facilities licensed by the Division of Aging are followed by a Roman Numeral notation which refers to the class (either class I, II or III) of standard as designated in section 198.085.1, RSMo 1986.

1. (1) The building shall be substantially constructed and shall be maintained in good repair and in accordance with the construction and fire safety rules in effect at the time of initial licensing. II/III
2. (2) Only activities necessary to the administration of the facility shall be contained in any building used as a long-term care facility except that related activities may be conducted in buildings subject to prior written approval of these activities by the Division of Aging. Examples of these activities are Home Health Agencies, physician’s office, pharmacy, ambulance service, day care and food service for the elderly in the community. II/III
3. (3) All stairways shall be equipped with permanently secured handrails on at least one (1) side. III
4. (4) There shall be a telephone in the facility and additional telephones or extensions as necessary so that help may be summoned promptly in case of fire, accident, acute illness or other emergency. II/III
5. (5) Bath and toilet facilities shall be provided for the convenience, privacy, comfort and safety of residents. Fixed partitions or curtains shall be provided in toilet and bathrooms to assure privacy. II/III
6. (6) Newly licensed facilities shall have handrails and grab bars affixed in all toilet and bathing areas. Existing licensed facilities shall have handrails and grab bars available in at least one (1) bath and toilet area. II
7. (7) There shall be adequate storage areas for food, supplies, linen, equipment and resident’s personal possessions. III
8. (8) Each room or ward in which residents are housed or to which residents have reasonable access shall be capable of being heated to not less than eighty degrees Fahrenheit (80°F) under all weather conditions. Temperature shall not be lower than sixty-eight degrees Fahrenheit (68°F) and the reasonable comfort needs of individual residents shall be met.I/II
9. (9) In newly licensed facilities or if a new heating system is installed in an existing licensed facility, the heating of the building shall be restricted to steam, hot water, permanently installed electric heating devices or a warm air system employing central heating, plants with installation such as to safeguard the inherent fire hazard, or approved installation of outside wall heaters which bear the approved label of the American Gas Association or National Board of Fire Underwriters. All oil or gas heating appliances shall be properly vented to the outside. The use of portable heaters of any kind is prohibited. If approved wall heaters are used, adequate guards shall be provided to safeguard residents. I/II
10. (10) Wood-burning stoves shall not be installed in newly licensed facilities or in existing licensed facilities that did not previously have a wood-burning stove. If woodburning stoves are used in an existing licensed facility, or wood-burning furnaces or fireplaces are used, flues or chimneys shall be maintained in good condition and kept free of accumulation of combustible materials. II
11. (11) Fireplaces may be used only if there is a protective screen in place; if there is direct staff supervision of residents while in use; and the fire shall not be left burning overnight. II
12. (12) In newly constructed facilities, electrical wiring shall be installed and maintained in accordance with the requirements of the National Electrical Code and local codes. In existing licensed facilities and newly licensed existing buildings built prior to September 28, 1979 electrical wiring shall be maintained in good repair and shall not present a safety hazard. II
13. (13) Wiring shall be inspected every two (2) years by a qualified electrician. III
14. (14) Lighting is restricted to electricity. II
15. (15) Lighting in hallways, bathrooms, recreational and dining areas and all resident-use areas shall be provided with a minimum intensity of ten (10) footcandles. All lights in resident-use areas shall be provided with a shade to prevent direct glare to the residents’ eyes. II/III
16. (16) Night lights shall be provided for corridors, stairways and toilet areas. II
17. (17) A reading light shall be provided for each resident desiring to read. III
18. (18) If extension cords are used, they must be Underwriters’ Laboratory (UL)-approved and sized to carry the current required for the appliance used. Only one (1) appliance shall be connected to one (1) extension cord and only two (2) appliances may be served by one
19. (1) duplex receptacle. If extension cords are used, they shall not be placed under rugs, through doorways or located where they are subject to physical damage. II/III
20. (19) If elevators are used, installation and maintenance shall comply with local and state codes and the National Electric Code. II/III
21. (20) Air conditioning, fans or a ventilating system shall be available and used when the room temperature exceeds eighty-five degrees Fahrenheit (85°F) and the reasonable comfort needs of individual residents shall be met. I/II
22. (21) Gas-fired water heaters shall be properly installed and vented and all water heaters shall be equipped with a temperature and pressure relief valve. II
23. (22) Furniture and equipment shall be maintained in good condition and shall be replaced if broken, torn, heavily soiled or damaged. Rooms shall be so designed and furnished that the comfort and safety of the residents are provided for at all times. II/III
24. (23) Rooms shall be neat, orderly and cleaned daily. II/III
25. (24) An individual bed, in good repair and of a rigid type, shall be provided to each resident. Beds shall be at least thirty-six inches (36") wide. Double beds of satisfactory construction may be provided for married couples. Rollaway, metal cots or folding beds shall not be used. II/III
26. (25) A minimum of three feet (3') shall be available between beds when parallel. III
27. (26) Mattresses shall be clean, in good repair and a minimum of four inches (4") in thickness to provide comfort. II/III
28. (27) Each bed shall be provided with at least one (1) clean, comfortable pillow. Extra pillows shall be available to meet the needs of the residents. III
29. (28) Screens or curtains, either portable or permanently affixed, shall be available and used in multi-resident bedrooms to provide privacy as needed or if requested. III
30. (29) Each resident shall be provided with an individual locker or other suitable space for storage of clothing and personal belongings. III
31. (30) Each resident shall be provided with an individual rack for a towel(s) and washcloth(s) unless provided with a clean washcloth(s) or towel(s) for use each time needed. III
32. (31) A comfortable chair shall be available for each resident’s use. III
33. (32) Each window shall be provided with a shade, drape or curtain to restrict the amount of sunlight when necessary. III
34. (33) All new and existing residential care facilities II and all residential care facilities I whose plans are approved or which are initially licensed for more than twelve (12) residents after December 31, 1987 shall be equipped with a call system consisting of an electrical intercommunication system, buzzer system or hand bells. An acceptable mechanism for calling attendants shall be located in each toilet room and resident bedroom. Call 13 CSR 15-15

systems for facilities whose plans are approved or which are initially licensed after December 31, 1987 shall be audible in the attendant’s work area. II/III

1. (34) Plumbing fixtures which are accessible to residents and which supply hot water shall be thermostatically controlled so that the water temperature at the fixture does not exceed of one hundred twenty degrees Fahrenheit (120°F) (49°C) and the water shall be at a temperature range between one hundred five degrees Fahrenheit (105°F) (41°C) and one hundred twenty degrees Fahrenheit (120°F) (49°C). I/II

AUTHORITY: section 198.076, RSMo 1986. Original rule filed July 13, 1983, effective Oct. 13, 1983. Emergency amendment filed Nov. 9, 1983, effective Nov. 19, 1983, expired March 18, 1984. Amended: Filed Nov. 9, 1983, effective Feb. 11, 1984. Emergency amendment filed Aug. 1, 1984, effective Aug. 13, 1984, expired Dec. 10, 1984. Amended: Filed Sept. 12, 1984, effective Dec. 13, 1984. Amended: Filed May 13, 1987, effective Aug. 13, 1987. Amended: Filed Aug. 1, 1988, effective Nov. 10, 1988.