PURPOSE: This rule specifies the manner through which hospitals may request a vari- 19 CSR 30-20

ance from 19 CSR 30-20.001 through 19 CSR 30-20.140.

1. (1) Requests for variance from the requirements of 19 CSR 30-20.015 through 19 CSR 30-20.140 shall be in writing to the Department of Health and Senior Services. Department determinations in response to variance requests shall be in writing and both requests and determinations shall be made a part of the Department of Health and Senior Services permanent records for the facility.

   1. (A) Requests shall contain at a minimum—

      1. 1. The section number and text of the

rule in question;

1. 2. Specific reasons why compliance

with the rule would impose an undue hardship on the operator, including an estimate of any additional cost which might be involved;

1. 3. An explanation of the extenuating fac-

tors which may be relevant;

1. 4. A complete description of the individ-

ual characteristics of the facility or patients or any other factors which would fulfill the intent of the rule in question to safeguard the health, safety, and the welfare of the patient, staff, or public if the variance from the requirement is granted; and

1. 5. A length of time the variance is being

requested.

1. (2) The department’s written determination shall identify a variance expiration date, if approved. The facility may re-apply for a variance up to ninety (90) days prior to the expiration of a department-approved variance.
2. (3) Any facility granted a variance by the department shall inform the department in writing if the conditions warranting the variance change. This written notification to the department shall be made within thirty (30) days of the change affecting the variance. The department may revoke the granted variance if the changes in conditions detrimentally impact the health, safety, and the welfare of the patient, staff, or public, as determined by the department.
3. (4) All previously approved variances shall be submitted at the time of annual licensure renewal.

AUTHORITY: section 192.006, RSMo 2000, and sections 197.080 and 197.154, RSMo Supp. 2013.* This rule previously filed as 19 CSR 30-20.021(1) and (1)(A). Original rule filed on June 27, 2007, effective Feb. 29, 2008. Amended: Filed June 6, 2013, effective Jan. 30, 2014.

*Original authority: 192.006, RSMo 1993, amended 1995; 197.080, RSMo 1953, amended 1993, 1995, 2013; and 197.154, RSMo 2004.