PURPOSE: This rule defines the minimum standards for veterinary hospitals and clinics, central hospitals, satellite out-patient or mobile small animal clinics, and large animal mobile clinics.

1. (1) All permitted facilities where veterinary medicine is being practiced, and all instruments, apparatus, and apparel used in connection with the practice of veterinary medicine, shall be kept clean and sanitary at all times and conform to the minimum standards specified for different types of facilities. The ownership of the veterinary practice shall conform in all ways to the requirements of section 340.226, RSMo. Additionally, all permitted facilities shall have:

   1. (A) An adequate library of textbooks or current journals;
   2. (B) Proper storage and environmental control for all medicines and biologics based on the manufacturer’s recommendations;
   3. (C) Appropriate current licenses and permits conspicuously displayed; and
   4. (D) Properly maintained records.

2. (2) Veterinary Hospitals or Clinics.

   1. (A) Exterior.

      1. 1. Legible sign.
      2. 2. Facility clean and in good repair.
      3. 3. Grounds clean and well maintained.

   2. (B) Interior.

      1. 1. Indoor lighting for halls, wards, reception areas, exam-

ining, and surgical rooms shall be adequate for the intended purpose, and all surgical rooms be provided with emergency lighting.

1. 2. Hot and cold running water.
2. 3. A reception area and office, or a combination of the two

(2).

1. 4. An examination room separate from other areas of the

facility and of sufficient size to accommodate the doctor, assistant, patient, and client.

1. 5. A designated surgery room(s) not accessible to the gen-

eral public.

1. 6. Facility permit conspicuously displayed.
2. 7. Veterinary license and veterinary technician registration

conspicuously displayed.

1. (C) Housing. In those veterinary hospitals and clinics where animals are retained for treatment or hospitalization, the following shall be provided:

   1. 1. Separate compartments of adequate size, one for each

animal, maintained in a sanitary manner;

1. 2. Facilities allowing for the effective separation of conta-

gious and noncontagious cases;

1. 3. Exercise areas which provide and allow effective sep-

aration of animals and their waste products. Where animals are kept in clinics for twenty-four (24) hours or more, walking the animal meets this requirement. The exercise areas are to be kept clean; and

1. 4. An animal identification system.

2. (D) Practice Management.

   1. 1. Veterinary facilities shall maintain a sanitary environ-

ment to avoid sources and transmission of infection. This is to include the proper routine disposal of waste materials and proper sterilization or sanitation of all equipment used in diagnosis or treatment.

1. 2. Fire precautions shall meet the requirements of local

and state fire prevention codes.

1. 3. The temperature and ventilation of the facility shall be

maintained so as to assure the reasonable comfort of all patients.

1. 4. The veterinary facility must have the capacity to render

adequate diagnostic radiological services, either in the hospital or clinic or through other commercial facilities. If radiological services are provided through other commercial facilities, a written agreement to provide these services must exist. Radiological procedures shall be in accordance with federal and state public health standards.

1. 5. Laboratory and pharmaceutical facilities must be avail-

able either in the hospital or clinic or through commercial facilities.

1. 6. Sanitary methods for the disposal of deceased animals

shall be provided and maintained. Where neither the owner nor the owner’s agent of a deceased animal has given the veterinarian authorization to dispose of his/her animal, the veterinarian shall comply with section 340.288, RSMo.

1. (E) Equipment Requirements.

   1. 1. Sterilization of all appropriate equipment is required.
   2. 2. A library of textbooks or current journals shall be avail-

able on the premises for ready reference.

1. 3. Anesthetic equipment appropriate for the level of sur-

gery performed will be available at all times.

1. 4. Oxygen equipment will be available at all times.
2. 5. Surgeons and assistants shall wear clean attire and ster-

ile gloves for any clean and sterile procedures.

1. 6. Surgical packs shall be used and properly sterilized for

all accepted sterile surgical procedures. Surgical packs include drapes, gloves, sponges and proper instrumentation.

1. 7. Examination and treatment rooms shall be equipped

with waste receptacles, disposable towels, and examination tables with impervious surfaces.

1. 8. Proper storage and environmental control will be avail-

able for all medicines and biologics based on the manufacturer’s recommendations.

1. 9. All waste receptacles, other than those in areas where

animals will not be housed, treated or examined, will be lined with plastic or made of an impervious material (rubber/plastic) that is easily sanitized.

1. (3) Central hospital shall meet the same minimum standards as a veterinary hospital or clinic and also provide on premises twenty-four- (24-) hour nursing care, specialty consultation on a permanent or on-call basis, and be capable of rendering the following major medical and surgical services:

   1. (A) Intensive care unit;
   2. (B) Laboratory facilities;
   3. (C) Radiological services;
   4. (D) Cardiac monitoring; and
   5. (E) Positive ventilation gas anesthesia.

2. (4) Satellite or Out-Patient Clinic.

   1. (A) These clinics shall be owned by or associated with a permitted full-service veterinary hospital or clinic or a central hospital.

   2. (B) At a minimum, these clinics shall have—

      1. 1. Hot and cold running water;
      2. 2. A one hundred ten (110) volt power source for diagnostic

equipment;

1. 3. A collection tank for disposal of waste material;
2. 4. Adequate lighting;
3. 5. Table tops and counter tops, such as formica or stainless

steel, which can be cleaned and disinfected;

1. 6. Floor coverings which can be cleaned and disinfected;
2. 7. Adequate heating, cooling, and ventilation;
3. 8. All necessary equipment compatible with the services

rendered; and

1. 9. Separate compartments when it is necessary to hold an-

imals.

1. (C) These clinics also shall comply with the sanitary and sterilization provisions of 20 CSR 2270-4.011(2).

1. (5) Mobile Small Animal Clinic.

   1. (A) These clinics shall be owned by or associated with a permitted full-service veterinary hospital or clinic or a central hospital.
   2. (B) These clinics shall be maintained in a clean fashion.

   3. (C) At a minimum, these clinics shall have—

      1. 1. A method for disposal of waste materials;
      2. 2. A procedure for disposal of deceased animals;
      3. 3. The capability to sterilize or sanitize equipment;
      4. 4. Surgical packs; and
      5. 5. Separate compartments to transport animals.

2. (6) Large Animal Mobile Clinic.

   1. (A) These clinics shall be maintained in a clean fashion.

   2. (B) The vehicle shall contain those items of equipment that are necessary for the veterinarian to perform physical examinations, surgical procedures and medical treatments consistent with the standards of the profession and the type of veterinary services being rendered. Standard items equipping the unit should include, but not be limited to, the following:

      1. 1. If sterile surgery is to be performed, sterile surgical in-

struments, suturing materials, syringes, and needles should be carried;

1. 2. Protective clothing, rubber or disposable boots and a

means to clean them between each visit to each premises as the disease warrants;

1. 3. Current and properly stored pharmaceuticals and bio-

logicals;

1. 4. A means of cold sterilization; and
2. 5. Obstetrical sleeves for rectal palpation which shall be

cleaned and sanitized between each premises. If disposable sleeves are used, a new sleeve shall be used at each premises.

1. (7) Specialty Facilities.

   1. (A) An application for a facility permit to practice veterinary medicine appropriately limited to procedures such as training, rehabilitation, and other modalities not requiring facilities otherwise permitted by the board, shall be submitted in writing and include:

      1. 1. A description of the procedures to be utilized;
      2. 2. The classes of practitioners who will practice in the

facility;

1. 3. The design of the facility; and
2. 4. The location of the facility.

3. (B) Specialty facilities shall comply with the following:

   1. 1. All applicable building codes and zoning regulations;
   2. 2. The name of the facility shall be prominently displayed

on a legible sign;

1. 3. The name of the veterinarian responsible for the facility

legibly posted on the sign;

1. 4. The facility maintained in a clean and sanitary manner;

and

1. 5. The practice of the facility strictly limited to that ap-

proved by the board, except in an emergency. Such emergencies shall be reported to the board in writing within seventy-two (72) hours of the occurrence. AUTHORITY: sections 340.210, 340.224, 340.264, and 340.288, RSMo 2016.* This rule originally filed as 4 CSR 270-4.011. Original rule filed Nov. 4, 1992, effective July 8, 1993. Amended: Filed April 14, 1994, effective Sept. 30, 1994. Amended: Filed Dec. 1, 2005, effective June 30, 2006. Moved to 20 CSR 2270-4.011, effective Aug. 28, 2006. Amended: Filed May 14, 2007, effective Nov. 30, 2007. Amended: Filed July 25, 2018, effective Jan. 30, 2019. *Original authority: 340.210, RSMo 1992, amended 1993, 1995, 1999; 340.224, RSMo 1992; 340.264, RSMo 1992, 1999; and 340.288, RSMo 1992, amended 1999.