PURPOSE: This rule specifies the requirements to operate a massage therapy business.

1. (1) A massage therapy business shall—

   1. (A) Employ or permit to practice on the premises a licensed or provisionally licensed massage therapist (hereinafter referred to as licensee or licensees) to perform massage therapy as defined in section 324.240(7), RSMo;
   2. (B) Ensure that no licensee practices beyond their scope and expertise; direct or require a licensee to practice beyond their scope and expertise; or allow any unlicensed employees, staff, or independent contractors to provide massage pursuant to section 324.240(7), RSMo, for which a license is required;
   3. (C) Maintain a copy of the professional liability insurance of the licensee as required in 20 CSR 2197-3.020(4)(A);
   4. (D) Display, in a conspicuous place, the massage therapy business license;
   5. (E) Display, in a conspicuous place, an original massage therapist license, to include a photograph of the massage therapist taken within the last two (2) years;

   6. (F) Maintain accurate client records. Records must be stored for at least three (3) years from the last date of service and in a manner that secures client confidentiality.

      1. 1. The licensed massage therapist pro-

viding massage therapy must sign each client record.

1. 2. Unless waived in writing and signed

by the client, and prior to providing massage therapy, the client record shall include:

1. A. Purpose for visit to include pres-

ence of pain;

1. B. Allergies, preexisting conditions,

recent surgeries, and current medication;

1. C. If the client is currently under the

care of any health or mental healthcare professional;

1. D. Date, type, and length of massage

therapy service(s);

1. E. Outcome assessment;
2. F. Consent for treatment that is signed

and dated by client;

1. (G) Maintain current general liability insurance and provide proof that the massage therapy business has general liability insurance upon request or during the course of an inspection;
2. (H) Provide safe and unobstructed passage in the public areas of the business;
3. (I) Provide rest room facilities, including at least one (1) water-flushed toilet. A massage therapy business located in a building housing multiple businesses under one (1) roof such as arcades, shopping malls, terminals, and hotels may substitute centralized restroom facilities; and
4. (J) Maintain a sink for hand cleansing within a reasonable distance from where massage therapy is provided. The sink must be clean and in good working condition.

1. (2) The area used for massage therapy must be used exclusively for massage and other clinical or healthcare related purposes adequately lighted, ventilated, and kept clean. Floors, walls, ceilings, and windows must be in good repair and free of dust and other unclean substances.

2. (3) All equipment used to perform massage therapy must be maintained in a safe and sanitary manner that includes, but is not limited to:

   1. (A) Covering the massage table or equipment that does not have an impervious barrier with a single service material;
   2. (B) Repairing all cuts or nicks in upholstery;
   3. (C) Cleaning all equipment such as the massage table, massage chair, face cradle, and items coming into contact with a client with an antibacterial agent between each client usage to eliminate any liquid, oil, and/or body fluid. Massage tables, chairs, face cradles, and arm rests must be cleaned with an antibacterial agent between each client whether or not a single service material was used;

   4. (D) Keeping all multiple use containers such as pump bottles and tubes free of debris.

      1. 1. Storing and dispensing massage ther-

apy products from suitable containers that are sanitized with an antibacterial agent after each client.

1. 2. Products, to include soap, oil, lotion,

alcohol, powder, shampoo, and salt used during the massage, shall be stored separately from cleaning supplies;

1. (E) Storing all single service materials and linens such as towels, sheets, and pillowcases in closed covered shelves, containers, cabinets, or closets;
2. (F) Using a clean, single service material such as sheets, towels, and gowns between each client;
3. (G) Launder or wash in a clothes washing machine, all soiled, single service materials 20 CSR 2197-5

and drapes on a hot water setting with detergent and at least one (1) cup of bleach or an antibacterial laundry detergent used in accordance with product instructions and dried on a high heat setting in a clothes dryer;

1. (H) Store all dirty or soiled single service materials, garbage, or refuse in a closed container, closed shelves, cabinets, or closets and separate from clean, single service materials; and
2. (I) Remove all garbage or refuse in a sanitary manner.

1. (4) A massage therapy business must be free of insects. Only service animals whose purpose is to provide assistance to a client shall be allowed in a massage therapy business.

AUTHORITY: sections 324.240, 324.245, 324.247, 324.250, 324.252, 324.255, 324.257, and 324.260, RSMo 2016.* This rule originally filed as 4 CSR 197-5.010. Original rule filed Feb. 25, 2000, effective Sept. 30, 2000. Amended: Filed Nov. 26, 2003, effective June 30, 2004. Moved to 20 CSR 2197-5.010, effective Aug. 28, 2006. Amended: Filed Aug. 21, 2007, effective March 30, 2008. Rescinded and readopted: Filed Aug. 21, 2019, effective Feb. 29, 2020.

*Original authority: 324.240, RSMo 1998, amended 1999, 2008; 324.245, RSMo 1998, amended 1999, 2003, 2006; 324.247, RSMo 1998, amended 1999, 2006, 2009; 324.250, RSMo 1998, amended 1999; 324.252, RSMo 1998; 324.255, RSMo 1998; 324.257, RSMo 1998, amended 1999, 2006; and 324.260, RSMo 1998, amended 1999.