PURPOSE: This rule defines institutions for the purpose of establishing eligibility for Income Maintenance programs.

1. (1) For the purpose of the administration of public assistance and Blind Pension, a public institution is defined as an institution which provides shelter or care to persons and is managed or controlled, in whole or in part, by or through any public instrumentality, official or employee acting in an official capacity. This does not include controls a designated public official exerts over all institutions, including private or a similar character. Publicly-owned property under formal lease to a private individual or corporation which vests full control of the property in the lessee will not be considered a public institution nor will the fact that the public authority contracts for and makes payments from public funds to, or in support of, individuals in these institutions be considered as governmental participation in financial support of the institution or control of the institution. (Original rule filed May 13, 1948, effective May 23, 1948. Amended: Nov. 4, 1954, effective Nov. 14, 1954.)

2. (2) A person living in or planning to enter an institution under private management is eligible for public assistance or Blind Pension, provided s/he meets all eligibility requirements in the same manner as a person not living in an institution. However, s/he will not be eligible if one (1) or more of the following conditions are present:

   1. (A) If s/he is entitled to care in the institution because of membership in the group operating the institution (fraternal organization, lodge, union, religious group, and the like);
   2. (B) If s/he has made a lump sum payment or has transferred property or other resources in exchange for lifetime care;
   3. (C) If the institution is meeting and will continue to meet the essential needs of the applicant or recipient; and
   4. (D) If the recipient becomes a patient in a private institution for tuberculosis or mental diseases or in a private medical institution as a result of a diagnosis of tuberculosis or psychosis. (Original rule filed May 13, 1948, effective May 23, 1948. Amended: Nov. 4, 1954, effective Nov. 14, 1954.)

3. (3) A patient is an individual who is one or a combination of the following:

   1. (A) Admitted to a medical institution because of illness and for whom there is planned, continuing medical treatment, including nursing care, directed toward improvement in health or for whom palliative medical measures are required though improvement in health or recovery cannot be expected;
   2. (B) Receiving professional medical treatment; or
   3. (C) Free to leave at the conclusion of treatment or any other time upon his/her own decision. (Original rule filed Sept. 26, 1951, effective Oct. 6, 1951.)

4. (4) A public medical institution is one which meets the following criteria:

   1. (A) It is organized to provide medical care, including nursing and convalescent care; has the necessary professional personnel, equipment and facilities to manage the medical and health needs of patients on a continuing basis and is authorized under state law to provide medical services; and
   2. (B) It is staffed by professional medical or professional nursing personnel who have clear and definite responsibility to the institution in the provision of medical services to patients. The term staffed by means that the establishment or facility provides for the patients adequate continual medical care and supervision by a physician; has sufficient registered nurse or licensed practical nurse supervision and services and nurse’s aid services to meet nursing care needs and has appropriate guidance by a physician(s) on the technical aspects of operating the establishment or facility. (Original rule filed Sept. 26, 1951, effective Oct. 6, 1951. Amended: July 24, 1953, effective Aug. 4, 1953. Amended: Nov. 20, 1967, effective Nov. 30, 1967.)

AUTHORITY: section 207.020, RSMo 1986.* Filing dates for original rules are shown in the text of the rule. This version filed March 24, 1976. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986.