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Frequently Asked Questions

Nursing Home Licensing

What are the requirements for opening up a RCF I, RCF II, ICF, or SNF facility?
What is the difference between a residential care facility and an assisted living facility?
What is Certificate of Need?
What is the occupancy rate for facilities licensed by the Section for Long Term Care?
Where can I obtain a directory of nursing homes?
Where can I find the necessary forms used to obtain a state-license for a long term care facility?
How many facilities are licensed by the DHSS?
How can I obtain a regulation book?
Who needs to be notified and what is required if there is a change of administrator in a facility? What about a change in the Director of Nursing?
How do I obtain a listing of facilities with Alzheimer's Special Care Unit?
How do I obtain the names and addresses for facilities by county?

What are the requirements for opening up a RCF I, RCF II, ICF, or SNF facility?
A very good starting point in the process of opening a RCF I, RCF II, ICF, or SNF facility is to get acquainted with the requirements for licensure. The regulations for each level of care, as well as general licensure requirements, including application procedures, can be found at the Show-Me Long-Term Care website. This link allows you to view and print the State Regulations and Statutes. To obtain a hard copy, contact us (there is a cost for this publication). Questions regarding construction, physical plant, and fire safety requirements should be directed to (573) 526-8515.

A facility cannot be licensed without first receiving Certificate of Need approval, therefore, it is a crucial step in the process. For further information, please contact the Certificate of Need program office at (573) 751-6403.

An application for licensure can be obtained by contacting us. An application will be sent to you either electronically or by mail. After receipt by the DHSS, the application is reviewed. Once the application is approved, staff from one of the DHSS regional offices will conduct an inspection to determine if requirements for licensure are met. If requirements are met, a two year license will be issued.

What is the difference between a residential care facility and an assisted living facility?
Residential Care Facility I and II is category of licensed long-term care facility defined by state law. Residential Care Facility I and II are licensed and regulated by the Section for Long Term Care. Definitions for Residential Care Facility I and II can be found in state statutes at Chapter 198, RSMo. In Missouri, there currently is no legal definition for assisted living though many licensed Residential Care Facility I and II are referred to as assisted living facilities.

What is Certificate of Need?
Certificate of Need is a program administered by the Missouri Health Facilities Review Committee and designed to restrain unnecessary health care expenditures while addressing issues of community need, accessibility, financing, and high health costs. Certificate of Need approval is required for licensure of new RCF I, RCF II, ICF, and SNF facilities as well as for addition of beds to existing licensed facilities. For further information, please contact the Certificate of Need office at (573) 751-6403 or visit their website.

What is the occupancy rate for facilities licensed by the Section for Long Term Care?
The DHSS collects occupancy data through use of a survey instrument on a quarterly basis from every licensed RCF I, RCF II, ICF, and SNF facility. The data collected is supplied to the Certificate of Need Program where it is compiled into statistical reports and used for Certificate of Need purposes. Current statistical reports are posted in the Certificate of Need website.

Where can I obtain a directory of nursing homes?
A directory of all licensed facilities may be found on the DHSS website.

Where can I find the necessary forms used to obtain a state-license for a long term care facility
The forms can be found at www.dhss.mo.gov/NursingHomes/AppsForms.html.

How many facilities are licensed by the DHSS?
There currently are 1,168 facilities licensed by the DHSS.

How can I obtain a regulation book?
Missouri Long Term Care State Regulations and Statutes may be obtained at: Show-Me Long-Term Care. This link allows you to view and print the State Regulations and Statutes. To obtain a hard copy, contact us. (There is a cost for this publication.)

Who needs to be notified and what is required if there is a change of administrator in a facility? What about a change in the Director of Nursing?
For a change of administrator, the DHSS must be notified in writing. The letter must be notarized and include the name of the new administrator and license number, the effective date the new administrator took the position, the name of facility, and a copy of administrator's license. Facilities certified to participate in the Medicare and/or Medicaid programs are required to notify the DHSS of changes in Director of Nursing. The DHSS must be notified in writing. The letter must include the name of the new Director of Nursing, the effective date the new Director of Nurses took the position, and the name of the facility. The letter does not need to be notarized.

How do I obtain a listing of facilities with Alzheimer's Special Care Unit?
A listing of Alzheimer's Special Care Units may be obtained on the DHSS website.

How do I obtain the names and addresses for facilities by county?
To obtain the names and addresses of licensed facilities, go to the Show-Me Long-Term Care website. Information regarding licensed facilities is provided by county and city. Using the drop down keys, locate the city or county and click on ShowMe Results! This will provide a listing of facilities and the facility level of care. Further information on each facility can be obtained by clicking on the facility name. In addition, a directory of all licensed facilities is located on the DHSS website.