PURPOSE: This rule prescribes requirements for personnel of a community residential facility serving fewer than four residents as required by section 630.710, RSMo.

1. (1) Each facility shall have a chief administrative officer referred to as the head of the facility in these rules.

2. (2) The head of the facility shall—

   1. (A) Report any change in ownership or management of the facility to the department within five (5) days;
   2. (B) Appoint a capable person to act for him/her in his/her absence; and
   3. (C) Provide business, financial and personal references and shall cooperate with the department in a study of his/her qualifications to manage a community residential facility.

3. (3) The head of the facility and any additional staff, including physical therapists, occupational therapists and volunteers, having frequent (regularly scheduled at least once per week) and direct contact with residents shall meet the following conditions:

   1. (A) Annually provide a signed statement from a licensed physician stating they are in good health, free from tuberculosis in its communicable stage and have been screened for communicable diseases. The physician’s statement shall indicate the specific communicable diseases for which the person has been tested;
   2. (B) Attend, before a license is granted on initial application, an initial training session designed by the department;
   3. (C) Be knowledgeable about the facility’s policies and procedures; and
   4. (D) Staff shall be trained in the use of cardiopulmonary resuscitation (CPR) and firstaid so that at least one (1) person with these skills is on duty at all times. Depending on the configuration of the building and the number of residents, more than one (1) trained staff person may be required. The training, and periodic reviews, shall be consistent with the guidelines of the American Red Cross, the American Heart Association, the National Safety Council or other nationally recognized training organization.

4. (4) All staff administering medications shall have successfully completed a course on medication administration. This training shall be updated every two (2) years. The initial training and biennial update shall—

   1. (A) Be approved by the regional center or placement office;
   2. (B) Be offered by an instructor who is a licensed practical nurse (LPN) certified by the Division of Aging as an instructor, a registered nurse (RN), a pharmacist or a physician; 9 CSR 40-6
   3. (C) Not apply to LPNs, RNs or certified medication technicians with lifetime certificates; and
   4. (D) Be documented in the recipient’s personnel file.

5. (5) The course to update training in medication administration shall address at least the following:

   1. (A) Review of Basics.

      1. 1. Medication ordering and storage.

      2. 2. Medication administration.

         1. A. Use of generic drugs.
         2. B. How to pour, chart, administer and

document.

1. C. Information and techniques specif-

ic to the following: inhalers, eye drops, topical medications, insulin injections and suppositories; and

1. D. Infection control.
2. 3. Individual rights and refusal of med-

ications and treatment;

1. (B) Issues specific to the facility\ as indicated by the needs of the residents, and the medications and treatments currently being administered.

   1. 1. Emergency response.
   2. 2. Medication allergies.
   3. 3. Corrective actions based on problems

identified by the staff, the trainees or issues identified by regulatory and accrediting bodies, professional consultants or by any other authoritative source; and

1. (C) Updates on new medications or new procedures.

1. (6) A resident may be at home without the presence of staff, for a specific period of time, if it is documented in the individual habilitation plan (IHP) or individual treatment plan (ITP) that the resident has a necessary knowledge and skills to function safely.

AUTHORITY: sections 630.050 and 630.215, RSMo (1994).* Original rule filed Oct. 13, 1983, effective Jan. 15, 1984. Amended: Filed July 15, 1985, effective Feb. 1, 1986. Amended: Filed Jan. 2, 1990, effective June 11, 1990. Amended: Filed April 1, 1993, effective Dec. 9, 1993. Amended: Filed July 17, 1995, effective March 30, 1996.

*Original authority: 630.050, RSMo (1980), amended 1993, 1995 and 630.215, RSMo (1980), amended 1983.