Frequently Asked Questions

Nursing Home Certification

How can a facility be certified for participation in the Medicare and/ or Medicaid program? How do I obtain an application?
What are the requirements for changes in certified bed status such as an increase or decrease?
Where can I obtain a directory of certified facilities?
What is the difference between licensure and certification?

How can a facility be certified for participation in the Medicare and/ or Medicaid program? How do I obtain an application?
A facility must be licensed as a Skilled Nursing Facility to be certified in the Medicare program. A facility licensed as a Skilled Nursing Facility or an Intermediate Care Facility can be certified in the Medicaid program.

Application forms for Medicare can be obtained thru the CMS (Centers for Medicare and Medicaid Services) website. The following forms and number of forms to be downloaded are as follows: 3 copies-CMS 1561, 3 copies-HHS 690, 1 copy-CMS 671, 1 copy- CMS 855. The CMS 855 can be downloaded at the website above or a hard copy can be obtained by contacting your fiscal intermediary. In addition, an intermediary preference form and state form DA 113 must be completed. You may obtain these forms by calling the Certification Unit in the Section for Long Term Care at 573-526-8507. The CMS 855 form must be completed and sent directly to your designated Fiscal Intermediary. The remaining forms are to be returned to the Certification Unit of the Section for Long Term Care. Hard copies of the first three forms can be obtained by calling the Certification Unit in the Section for Long Term Care at 573-526-8507.

For Medicaid, only the CMS 671 and DA 113 form are required. You may obtain these forms by calling the Certification Unit in the Section for Long Term Care at 573-526-8507.

Regulations covering initial Medicare and Medicaid certification can be found at state regulation 19 CSR 30-81.010 (2).

What are the requirements for changes in certified bed status such as an increase or decrease?
Information regarding federal requirements for changes in certified bed status can be found section 3202 at the CMS website.

In addition, state requirements changes in certified bed status can be found in the certification section of the state regulations at 19 30-81.010 (9).

Where can I obtain a directory of certified facilities?
A directory of all licensed facilities is located on the DHSS website. The directory includes certification status of all long-term facilities. This information can also be obtained by county, city, or zip code by using the Locate a Long Term Care Facility feature on the Show Me Long Term Care website.

What is the difference between licensure and certification?
Licensure is a state term referring to licensing of nursing homes under state law and regulations.

Certification refers to the process followed in certifying nursing homes for participation in the Medicare and/or Medicaid programs under federal laws and regulations. Regulations, procedures, and other information can be obtained at the Centers for Medicare and Medicaid Services (CMS).