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

1. 2. Hot and cold running water.
2. 3. A reception area and office, or a com-

bination of the two (2). 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 general public.

1. 6. Facility permit conspicuously dis-

played.

1. 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 contagious and noncontagious cases;

1. 3. Exercise areas which provide and

allow effective separation 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 environment 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 facil-

ities must be available 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 the owner of a deceased animal has not given the veterinarian authorization to dispose of his/her animal, the veterinarian shall be required to comply with section 340.288, RSMo.

1. (E) Equipment Requirements.

   1. 1. Sterilization of all appropriate equip-

ment is required.

1. 2. A library of textbooks or current jour-

nals shall be available on the premises for ready reference.

1. 3. Anesthetic equipment appropriate for

the level of surgery performed will be available at all times.

1. 4. Oxygen equipment will be available

at all times. 20 CSR 2270-4

1. 5. Surgeons and assistants shall wear

clean attire and sterile 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 available 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 shall 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;

1. 4. Adequate lighting;
2. 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;

1. 7. Adequate heating, cooling and venti-

lation;

1. 8. All necessary equipment compatible

with the services rendered; and

1. 9. Separate compartments when it is

necessary to hold animals.

1. (C) These clinics also shall comply with the sanitary and sterilization provisions of 4 CSR 270-4.011(2). FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION

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 mate-

rials;

1. 2. A procedure for disposal of deceased

animals;

1. 3. The capability to sterilize or sanitize

equipment;

1. 4. Surgical packs; and
2. 5. Separate compartments to transport

animals.

1. (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 instruments, suturing materials, syringes and needles should be carried;

1. 2. Protective clothing, rubber or dispos-

able boots and a means to clean them between each visit to each premises as the disease warrants;

1. 3. Current and properly stored pharma-

ceuticals and biologicals;

1. 4. A means of cold sterilization; and
2. 5. Obstetrical sleeves for rectal palpa-

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

AUTHORITY: sections 340.210, 340.224 and 340.264, RSMo 2000.* 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.

*Original authority: 340.210, RSMo 1992, amended 1993, 1995, 1999; 340.224, RSMo 1992; and 340.264, RSMo 1992, 1999.