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					                                                         Rules of
                               Department of Health
                                and Senior Services
                                 Division 73—Missouri Board of
                                 Nursing Home Administrators
                                   Chapter 2—General Rules

     Title                                                                                                               Page
19 CSR 73-2.010            Definitions .......................................................................................3
19 CSR 73-2.015 Fees ...............................................................................................3
19 CSR 73-2.020 Procedures and Requirements for Licensure of Nursing Home Administrators......3
19 CSR 73-2.025 Licensure by Reciprocity ......................................................................4
19 CSR 73-2.031 Prescribed Course of Instruction and Training ............................................5
19 CSR 73-2.050 Renewal of Licenses............................................................................6
19 CSR 73-2.051 Retired Licensure Status.......................................................................7
19 CSR 73-2.053 Inactive Licensure Status ......................................................................8
19 CSR 73-2.055 Renewal of Expired License ..................................................................9
19 CSR 73-2.060 Registration of Training Agencies and Single Offering Providers ......................9
19 CSR 73-2.070            Examination ....................................................................................10
19 CSR 73-2.080 Temporary Emergency Licenses ............................................................11
19 CSR 73-2.085 Public Complaints.............................................................................11
19 CSR 73-2.090 Disciplinary Action ...........................................................................12
19 CSR 73-2.095 Standards of Professional Conduct .........................................................13
19 CSR 73-2.100 Restoration and Rehabilitation of Suspended/Revoked Licenses ......................14
19 CSR 73-2.105 Disciplinary Proceedings.....................................................................14
19 CSR 73-2.110 Display of License ............................................................................14


      ROBIN CARNAHAN        (7/31/08)                   CODE OF STATE REGULATIONS                                                 1
      Secretary of State
19 CSR 73-2.120 Duplicate License .............................................................................14
19 CSR 73-2.130 Notice of Change of Address................................................................14




2                                               CODE OF STATE REGULATIONS               (7/31/08)   ROBIN CARNAHAN
                                                                                                    Secretary of State
Chapter 2—General Rules                                                                                                       19 CSR 73-2


  Title 19—DEPARTMENT OF                           AUTHORITY: section 344.070, RSMo Supp.                  AUTHORITY: section 344.070, RSMo Supp.
HEALTH AND SENIOR SERVICES                         1997.* This rule was previously filed as 13             2007.* This rule was previously filed as 13
      Division 73—Missouri Board of                CSR 73-2.010. Original rule filed March 5,              CSR 73-2.015. Original rule filed Jan. 3,
      Nursing Home Administrators                  1974, effective March 15, 1974. Rescinded               1992, effective May 14, 1992. Amended:
                                                   and readopted: Filed May 13, 1980, effective            Filed March 4, 1993, effective Aug. 9, 1993.
        Chapter 2—General Rules
                                                   Aug. 11, 1980. Amended: Filed April 14,                 Emergency amendment filed Nov. 17, 1999,
19 CSR 73-2.010 Definitions                        1983, effective July 11, 1983. Amended:                 effective Dec. 11, 1999, expired June 7,
                                                   Filed Oct. 16, 1985, effective March 14,                2000. Amended: Filed Nov. 1, 1999, effective
PURPOSE: This rule clearly defines terms as        1986. Amended: Filed Oct. 1, 1987, effective            April 30, 2000. Emergency amendment filed
used in Chapter 344, RSMo and in these             Jan. 14, 1988. Amended: Filed April 30,                 Nov. 30, 2001, effective Jan. 1, 2002, expired
                                                   1998, effective Oct. 30, 1998. Moved to 19              June 29, 2002. Amended: Filed Nov. 30,
rules.
                                                   CSR 73-2.010, effective March 3, 2003.                  2001, effective June 30, 2002. Moved and
                                                                                                           amended: Filed Jan. 31, 2003, effective Aug.
(1) Clock hour shall mean sixty (60) minutes
                                                   *Original authority: 344.070 RSMo 1969, amended 1979,   30, 2003. Amended: Filed Dec. 15, 2005,
of formal instruction by an approved presen-
                                                   1993, 1995.                                             effective July 30, 2006. Amended: Filed Dec.
ter.                                                                                                       28, 2007, effective Aug. 30, 2008.
(2) Continuing education means post-licen-                                                                 *Original authority: 344.070, RSMo 1969, amended
                                                   19 CSR 73-2.015 Fees
sure education in health-care administration                                                               1979, 1993, 1995, 2007.
undertaken to maintain professional compe-         PURPOSE: This rule establishes and fixes
tency to practice nursing home administra-         the various fees and charges authorized by
tion, improve administrative skills and effect                                                             19 CSR 73-2.020 Procedures and Require-
                                                   Chapter 344, RSMo.                                      ments for Licensure of Nursing Home
standards of excellence in the interest of safe-
ty, health and welfare of the people served.                                                               Administrators
                                                   (1) The following fees are required by the
                                                   Board of Nursing Home Administrators:                   PURPOSE: This rule specifies the minimum
(3) Education in health-care administration           (A) Application Review Fee                           requirements for licensure as a nursing home
shall mean the completion of a course of                   (including reciprocity)         $150            administrator in Missouri.
instruction designed to teach the elements of         (B) State Exam Fee                   $100
health-care facility administration and man-          (C) License Renewal Fee                              PUBLISHER’S NOTE: The secretary of state
agement, including training regarding the                1. One-year license               $ 50            has determined that the publication of the
protection of the rights of residents or                 2. Two-year license               $100            entire text of the material which is incorpo-
patients in health-care facilities.                      3. Inactive License               $ 50            rated by reference as a portion of this rule
                                                      (D) License Renewal Late Penalty                     would be unduly cumbersome or expensive.
(4) Examination shall mean a written exami-                Fee (This fee is in addition to                 This material as incorporated by reference in
nation, an oral examination, or both.                      the renewal fee listed in                       this rule shall be maintained by the agency at
                                                           subsection (1)(C))              $ 25            its headquarters and shall be made available
(5) “Experience in health-care administra-            (E) Inactive License Fee             $ 50            to the public for inspection and copying at no
tion” shall mean having management respon-            (F) Reactivate Inactive License Fee $100             more than the actual cost of reproduction.
sibility, which shall include the on-site             (G) Retired License Fee              $ 50            This note applies only to the reference mate-
supervision of at least three (3) staff persons       (H) Duplicate License Fee            $ 10            rial. The entire text of the rule is printed
in a licensed long-term care or acute care            (I) Single Offering Fee                              here.
facility or a licensed inpatient mental health             (per requested clock hour)      $ 15
facility, or a department of one of these facil-                                                           (1) Every applicant shall obtain an applica-
                                                      (J) Single Offering Late Filing Fee $ 50
ities.                                                                                                     tion form from the board. The application
                                                      (K) Insufficient Funds Charge        $ 25
                                                                                                           form, MO 580-2578 (4-04), Application for
(6) Health-care facility shall mean a licensed                                                             Licensure, is incorporated by reference in
                                                   (2) Fees must be made payable to the Depart-
long-term care or acute-care facility or a                                                                 this rule and is available on the web at
                                                   ment of Health and Senior Services in the               www.dhss.mo.gov/BNHA or by contacting
facility licensed as an inpatient mental health    form of a cashier’s check, company check or             the board at PO Box 570, Jefferson City, MO
facility.                                          money order.                                            65102, (573) 751-3511. This rule does not
                                                                                                           incorporate any subsequent amendments or
(7) Resident shall mean a person residing in       (3) All fees are nonrefundable.                         additions. The application shall be completed
a long-term health-care facility.                                                                          and returned to the board with a nonrefund-
                                                   (4) The provisions of this rule are declared            able application fee of one hundred fifty dol-
(8) Training agency shall mean—                    severable. If any fee fixed by this rule is held        lars ($150) made payable to the Department
   (A) An accredited educational institution;      invalid by a court of competent jurisdiction or         of Health and Senior Services. Information
or                                                 by the Administrative Hearing Commission,               provided in the application shall be attested
   (B) A statewide or national membership          the remaining provisions of this rule shall             by signature to be true and correct to the best
agency, association, professional society or       remain in full force and effect, unless other-          of the applicant’s knowledge and belief.
organization in the fields of health care or       wise determined by a court of competent
management approved by the board to pro-           jurisdiction or by the Administrative Hearing           (2) The completed application form shall pro-
vide courses of instruction and training.          Commission.                                             vide satisfactory proof that the applicant has

        ROBIN CARNAHAN        (7/31/08)                        CODE OF STATE REGULATIONS                                                                 3
        Secretary of State
              19 CSR 73-2—DEPARTMENT OF HEALTH AND
                          SENIOR SERVICES                                            Division 73—Missouri Board of Nursing Home Administrators



met the following minimum requirements for        riculum, including a description of each           mitting two (2) letters of reference that con-
Missouri licensure:                               planned course, must be submitted to the           tain the names, addresses and telephone num-
   (A) Twenty-one (21) years of age or over;      board in writing for PRIOR review and              bers of the writers and must show the writers’
   (B) A high school diploma or equivalent;       approval. Failure to do so within six (6)          original signatures and must have been writ-
   (C) Of good moral character;                   months following notification of the board’s       ten within six (6) months of the date of appli-
   (D) Has not been convicted of any crime,       decision will cause reapplication to become        cation.);
an essential element of which is fraud, dis-      necessary for any future consideration.               (D) No conviction of any crime, an essen-
honesty or moral turpitude, or which involves        (B) May submit additional information for       tial element of which is fraud, dishonesty or
the operation of a long-term care facility or     reevaluation if done so no later than two (2)      moral turpitude, or which involves the opera-
other health-care facility, whether or not sen-   weeks prior to the next board meeting. The         tion of a long-term care facility or other
tence is imposed. A copy of the record of         applicant will be given notice of the next         health-care facility, whether or not sentence
conviction or plea of guilty or nolo con-         board meeting date.                                is imposed. A copy of the record of convic-
tendere shall be conclusive evidence of the                                                          tion or plea of guilty or nolo contendere shall
conviction; and                                   AUTHORITY: section 344.070, RSMo Supp.             be conclusive evidence of the conviction; and
   (E) Experience and/or education from an        2007.* This rule was previously filed as 13           (E) Performance as a licensed nursing
accredited educational institution in one (1)     CSR 73-2.020. Original rule filed March 5,         home administrator in a state, territory or the
of the following areas:                           1974, effective March 15, 1974. Rescinded          District of Columbia for at least one (1) year.
      1. Experience: A minimum of three (3)       and readopted: Filed May 13, 1980, effective
years of experience in health-care administra-    Aug. 11, 1980. Amended: Filed April 14,            (3) Information provided in the application
tion, full-time equivalency; or                   1983, effective July 11, 1983. Amended:            shall be attested by signature to be true and
      2. Education:                               Filed Oct. 16, 1985, effective March 14,           correct to the best of the applicant’s knowl-
         A. Associate degree in health-care       1986. Amended: Filed Oct. 1, 1987, effective       edge and belief.
administration, including a minimum of            Jan. 14, 1988. Amended: Filed Dec. 4, 1989,
twenty-one (21) semester hours of course          effective March 1, 1990. Emergency amend-          (4) A reciprocity questionnaire shall be for-
work directly in health-care administration;      ment filed Nov. 17, 1999, effective Dec. 11,       warded by the board to the appropriate state
or                                                1999, expired June 7, 2000. Amended: Filed         nursing home administrator licensure
         B. Baccalaureate degree (Bachelor of     Nov. 1, 1999, effective April 30, 2000.            board(s) where the applicant was/is licensed.
Science or Bachelor of Arts) in one (1) of the    Amended: Filed April 30, 2001, effective Jan.      Upon return of the completed questionnaire
following areas:                                  1, 2002. Moved and amended: Filed Jan. 31,         to the board office, the information supplied
           (I) Health-care administration;        2003, effective Aug. 30, 2003. Amended:            by the licensure board shall be reviewed to
           (II) Gerontology (including a long-    Filed Dec. 28, 2007, effective Aug. 30, 2008.      determine if—
term care practicum, internship, or both);                                                              (A) The license is current and in good
                                                  *Original authority: 344.070, RSMo 1969, amended
           (III) Nursing (BSN or diploma          1979, 1993, 1995, 2007.
                                                                                                     standing; and
nurse); or                                                                                              (B) The licensee has/has not been disci-
         C. Master’s degree or beyond in one                                                         plined in that state.
(1) of the following areas:                       19 CSR 73-2.025 Licensure by Reciprocity
           (I) Health-care administration;                                                           (5) Each case of discipline shall be reviewed
           (II) Gerontology (including a long-    PURPOSE: This rule describes the proce-            by the board to determine if the case for dis-
term care practicum, internship or both);         dures and requirements for reciprocity licen-      cipline falls within the provisions of section
           (III) Nursing; or                      sure.                                              344.050, RSMo.
      3. Experience and education in one (1)
of the following areas:                           (1) An applicant who holds a current license       (6) Upon meeting the requirements of section
         A. Associate degree AND two (2)          as a nursing home administrator in any state,      (2) of this rule and upon board approval, the
years experience in a health-care facility; or    territory or the District of Columbia may          applicant must pay a one hundred dollar
         B. Baccalaureate degree (BS or BA)       apply for a license by reciprocity.                ($100)-examination fee and successfully
AND one (1) year experience in a health-care                                                         complete the state examination administered
facility; or                                      (2) The applicant must file an application for     by the board. The minimum passing score on
         C. Master’s degree or beyond AND         licensure, along with a nonrefundable appli-       that examination is seventy-five percent
one (1) year experience in a health-care facil-   cation fee of one hundred fifty dollars ($150)     (75%).
ity.                                              made payable to the Department of Health
                                                  and Senior Services, and supply the board          (7) If the applicant is unable to meet the
(3) The applicant shall be eligible to take the   with satisfactory evidence that the following      requirements of subsection (2)(E) of this rule,
examinations upon board approval and pay-         requirements have been met:                        but meets all other requirements of section
ment of the required examination fees.               (A) Twenty-one (21) years of age or older;      (2), the candidate shall be considered an
                                                     (B) High school graduate or equivalent (if      applicant for initial licensure pursuant to 19
(4) If the board determines the applicant has     the applicant has completed additional educa-      CSR 73-2.020(2)(E). If the results of that
failed to meet one (1) of the criteria outlined   tion beyond high school, an official college       evaluation show that the applicant meets the
in 19 CSR 73-2.020(2)(E)1.–3., the appli-         transcript must be submitted and may serve         criteria, the board shall accept the applicant’s
cant—                                             as satisfactory evidence of high school grad-      passing of the national examination in anoth-
   (A) Must complete the course of instruc-       uation);                                           er state if it was taken within three (3) years
tion and training approved by the board pur-         (C) Good moral character (Evidence of           of the applicant’s submission for licensure in
suant to 19 CSR 73-2.031. The planned cur-        good moral character can be satisfied by sub-      Missouri. The applicant then must meet the

4                                                            CODE OF STATE REGULATIONS                           (7/31/08)      ROBIN CARNAHAN
                                                                                                                                Secretary of State
Chapter 2—General Rules                                                                                                 19 CSR 73-2


requirements of section (6) of this rule by           (C) An associate degree, must complete               2. Grievance procedures;
paying the examination fee and successfully        six hundred forty (640) clock hours of intern-          3. Effective communication;
complete the state examination administered        ship;                                                   4. Evaluation procedures;
by the board. If the applicant does not meet          (D) A three (3) year diploma program or a            5. Recruitment of staff;
the criteria, the applicant will be required to    baccalaureate of science (BS)/baccalaureate             6. Interviewing candidates;
complete a prescribed course of instruction        of arts (BA), must complete five hundred                7. Selecting future employees;
and training as outlined in 19 CSR 73-2.031.       (500) clock hours of internship; or                     8. Staff development and training;
                                                      (E) A masters or beyond, must complete               9. Personnel policies and procedures;
(8) Applicants for licensure by reciprocity        five hundred (500) clock hours of internship.           10. Health and safety;
shall not act or serve in the capacity of a                                                                11 Departmental organization and man-
nursing home administrator in this state with-     (2) The course of instruction and training        agement;
out first procuring a license from this board      shall follow the core of knowledge areas and            12. Professional ethics and conduct;
as provided in sections 344.010–344.108,           other subject matter as deemed necessary by             13. Total quality management; and
RSMo.                                              the board to properly prepare an applicant for          14. Health care reform;
                                                   health care administration. The core of              (H) Financial Management:
AUTHORITY: section 344.070, RSMo Supp.             knowledge shall include, but shall not be lim-          1. Budgeting;
2007.* This rule was previously filed as 13        ited to, the following subject areas:                   2. Marketing principles;
CSR 73-2.025. Original rule filed June 28,            (A) Nursing and Physician Services:                  3. Asset management; and
1990, effective Dec. 31, 1990. Emergency                 1. Restorative nursing;                           4. Accounting;
amendment filed Feb. 4, 1992, effective Feb.             2. Rehabilitation;                             (I) Marketing and Public Relations:
14, 1992, expired June 12, 1992. Amended:                3. Definition, concept and procedures of          1. Public relation principles;
Filed Feb. 14, 1992, effective June 25, 1992.      nursing;                                                2. Marketing principles;
Amended: Filed March 4, 1993, effective                  4. Skin and wound care;                           3. Newsletters;
Aug. 9, 1993. Moved and amended: Filed                   5. Infection control procedures;                  4. Community and social organizations;
Jan. 31, 2003, effective Aug. 30, 2003.                  6. Drug administration and drug effects;    and
Amended: Filed Dec. 28, 2007, effective Aug.             7. Disease recognition and process;               5. Working with the media;
30, 2008.                                                8. Quality assurance;                          (J) Physical Resource Management:
                                                         9. Physician’s role in the facility; and          1. Building and grounds management;
*Original authority: 344.070, RSMo 1969, amended         10. Physician/resident relationships;             2. Environmental services;
1979, 1993, 1995, 2007.                               (B) Social Services:                                 3. Safety procedures and programs; and
                                                         1. Resident rights;                               4. Fire and disaster plans; and
                                                         2. Living wills and advance directives;        (K) Laws, Regulatory Codes and Govern-
19 CSR 73-2.031 Prescribed Course of                     3. Social, emotional, religious, and        ing Boards:
Instruction and Training                           financial needs of the resident;                        1. Medicare and Medicaid;
                                                         4. Family counsel and consultation;               2. Omnibus Budget Reconciliation Act
PURPOSE: This rule describes the course of               5. Grieving process;                        (OBRA);
instruction and training that may be pre-                6. Death and dying;                               3. Occupational Safety and Health
scribed by the board under the authority as              7. Communication with the resident;         Administration (OSHA);
set forth in section 344.030.1., RSMo.             and                                                     4. Americans With Disabilities Act
                                                         8. Ombudsman program;                       (ADA);
(1) Applicants who do not otherwise qualify           (C) Food Services:                                   5. Life safety;
for examination shall complete one of the fol-           1. Proper nutrition;                              6. Legislative process;
lowing courses of instruction and training.              2. Therapeutic diets; and                         7. Board responsibilities; and
The formal instruction shall be coursework               3. Resident satisfaction;                         8. By-laws.
qualifying for academic credit, completed             (D) Social and Therapeutic Recreational
with a grade of not less than “C.” A portion       Activities:                                       (3) The course of instruction and training
of the formal instruction may be from an                 1. Needs of the resident;                   shall include instruction in the services which
intensive and comprehensive seminar of at                2. Community resources;                     must be provided in nursing homes, the pro-
least forty (40) clock hours specific to nurs-           3. Rehabilitation services;                 tection of the rights and interests of the resi-
ing home administration which has been                   4. Volunteers and auxiliaries; and          dents and the elements of good nursing home
approved by the board. An applicant who has              5. Chemical dependency of the resident;     administration as well as other subject matter
completed—                                            (E) Medical Record Keeping:                    as deemed necessary by the board to proper-
   (A) A high school education or the equiv-             1. Medical records systems;                 ly prepare that applicant for nursing home
alent, must complete three hundred fifteen               2. Appropriate charting and documenta-      administration.
(315) clock hours of formal instruction and a      tion; and
minimum of two thousand (2,000) clock                    3. Evaluation and revision of care plans;   (4) Instruction and training prescribed by the
hours of internship;                                  (F) Pharmaceutical Services:                   board shall be recognized as meeting the
   (B) A licensed practical nurse program,               1. Proper drug handling and control;        requirements of this rule only if it is offered
must complete two hundred twenty-five (225)              2. Proper drug dispensing; and              by an accredited educational institution or
clock hours of formal instruction and a mini-            3. Drug interactions;                       affiliate which has been duly registered with
mum of eight hundred (800) clock hours of             (G) Personnel Management:                      the Missouri Board of Nursing Home Admin-
internship;                                              1. Maintaining a positive atmosphere;       istrators.

        ROBIN CARNAHAN        (7/31/08)                      CODE OF STATE REGULATIONS                                                             5
        Secretary of State
               19 CSR 73-2—DEPARTMENT OF HEALTH AND
                           SENIOR SERVICES                                            Division 73—Missouri Board of Nursing Home Administrators



(5) Internships as required by section (1) shall   (7) The board, for good cause, may refuse to       (1) By April 1 of each year, the board shall
be under the direct supervision of a licensed      approve or renew a preceptor designation or        mail an application for renewal of license, to
nursing home administrator approved and            may refuse to approve an assignment of an          the last recorded address on file, to every per-
designated as a preceptor by the Missouri          intern to a preceptor.                             son whose license is due to be renewed dur-
Board of Nursing Home Administrators. An                                                              ing the current year.
administrator may be approved and designat-        (8) A preceptor may supervise no more than
ed as a preceptor for a period of two (2)          one (1) intern concurrently.                       (2) Licenses that expire on June 30, 2007 will
years, if s/he—                                                                                       be renewed if the licensee:
   (A) Has been licensed and employed as a         (9) Internships shall be completed within             (A) Files an application for renewal on a
Missouri nursing home administrator for at         eighteen (18) months of completion of class-       form furnished by the board on or before
least thirty-six (36) months immediately prior     room or other formal instruction unless            June 15. Information provided in the appli-
to application to become a preceptor;              approved by the board.                             cation shall be attested to by signature to be
   (B) Is currently serving as the administra-                                                        true and correct to the best of the applicant’s
tor of a duly licensed intermediate care facil-    (10) A portion of an internship may be com-        knowledge and belief and include an attesta-
ity (ICF), skilled nursing facility (SNF),         pleted in a duly licensed ALF or RCF (as           tion verifying that the licensee has completed
assisted living facility (ALF) or any Residen-     described above) with sixty (60) or more beds      at least twenty (20) clock hours of board-
tial Care Facility (RCF) that was licensed as      if the intern desires such experience. The         approved continuing education, as outlined in
a residential care II on or before August 27,      maximum hours of internship that may be            19 CSR 73-2.050(4)(A)–(B), obtained during
2006 that continues to meet the licensure          served in such an ALF or RCF (as described         the current licensure year or carried from the
standards for a residential care facility II in    above) are designated as follows. Applicants       preceding year. A minimum of five (5) clock
effect on August 27, 2006, with sixty (60) or      may complete up to—                                hours must be in patient-care related offer-
more beds;                                            (A) 667 clock hours if 2,000 clock hours        ings, as defined in 19 CSR 73-
   (C) Is an administrator of an ICF, SNF,         are required by the board;                         2.031(2)(A)–(F).
ALF or RCF (as described above) with sixty            (B) 267 clock hours if 800 clock hours are           1. Licensees must maintain proof of hav-
(60) or more beds which is in substantial          required by the board;                             ing completed the number of continuing edu-
compliance with the rules governing nursing           (C) 214 clock hours if 640 clock hours are      cation hours claimed at the time of renewal.
homes; and                                         required by the board; or                               2. Upon request of the board, make that
   (D) Has not been the subject of any action         (D) 167 clock hours if 500 clock hours are      proof available for audit to verify completion
by any board of nursing home administrators        required by the board.                             of the number and validity of hours claimed;
or licensing authority which resulted in disci-                                                          (B) Submit a renewal fee of one hundred
pline, including but not limited to, formal        (11) Each day of an internship experience          dollars ($100) made payable to the Depart-
reprimand, probation, suspension or revoca-        shall include at least one (1) four (4)-hour       ment of Health and Senior Services;
tion of license or privileges as a nursing         block of time within the primary working              (C) A two (2)-year license expiring on June
home administrator; and                            hours of the administrator.                        30, 2009 will be issued.
   (E) Has successfully completed a board
approved preceptor training program.               AUTHORITY: section 344.070, RSMo Supp.             (3) Licensees seeking renewal on June 30,
                                                   2007.* This rule was previously filed as 13        2008 or later shall, on or before June 15, of
(6) Designated preceptors shall request in         CSR 73-2.031. Original rule filed May 13,          the year of renewal, file an application for
writing board approval to conduct an intern-       1980, effective Aug. 11, 1980. Amended:            renewal on a form furnished by the board,
ship for an applicant who has been found not       Filed April 14, 1983, effective July 11, 1983.     and shall submit a renewal fee of one hundred
qualified for licensure by the board, based        Amended: Filed Oct. 16, 1985, effective            dollars ($100) made payable to the Depart-
upon 19 CSR 73-2.020. Approval may be              March 14, 1986. Amended: Filed Oct. 1,             ment of Health and Senior Services. Informa-
granted by the board if the preceptor—             1987, effective Jan. 14, 1988. Amended:            tion provided in the application shall be
   (A) Is not related to the intern within the     Filed Jan. 3, 1992, effective May 14, 1992.        attested to by signature to be true and correct
fourth degree of consanguinity;                    Amended: Filed July 14, 1993, effective Jan.       to the best of the applicant’s knowledge and
   (B) Agrees to give the intern an opportuni-     13, 1994. Amended: Filed June 30, 1994,            belief and include an attestation verifying that
ty to observe and take part in the managerial      effective Feb. 1, 1995. Amended: Filed May         the licensee has completed at least forty (40)
tasks of the preceptor;                            15, 1995, effective Nov. 30, 1995. Amended:        clock hours of board-approved continuing
   (C) Will acquaint the intern with the orga-     Filed April 30, 1998, effective Oct. 30, 1998.     education obtained during the current licen-
nization and operation of all the various          Moved and amended: Filed Jan. 31, 2003,            sure period. A minimum of ten (10) clock
departments of the facility by permitting          effective Aug. 30, 2003. Amended: Filed Dec.       hours must be in patient-care related offer-
his/her observation and/or participation in        28, 2007, effective Aug. 30, 2008.                 ings, as defined in 19 CSR 73-
department activities;                             *Original authority: 344.070, RSMo 1969, amended
                                                                                                      2.031(2)(A)–(F).
   (D) Will hold an exit interview with the        1979, 1993, 1995, 2007.
intern upon completion of an internship to                                                            (4) Licensees must maintain proof of having
point out noted strengths and weaknesses;                                                             completed the number of continuing educa-
and                                                19 CSR 73-2.050 Renewal of Licenses                tion hours claimed at the time of renewal and
   (E) Upon satisfactory completion of the                                                            shall, upon request of the board, make that
internship will prepare and return to the          PURPOSE: This rule describes the condi-            proof available for audit to verify completion
board office the mandatory form certifying         tions and procedures for renewal of a nursing      of the number and validity of hours claimed.
the completion of the required hours of            home administrator license according to the        Documentation to prove completion of con-
internship.                                        provisions of section 344.040, RSMo.               tinuing education hours must be maintained

6                                                             CODE OF STATE REGULATIONS                           (7/31/08)      ROBIN CARNAHAN
                                                                                                                                 Secretary of State
Chapter 2—General Rules                                                                                                    19 CSR 73-2


by each licensee for four (4) years from the                 C. Three (3) clock hours if article      continuing education hours as reported on the
last day of the licensure year in which the        appears in a state health-care referred publi-     renewal application or submission of falsified
hours were earned.                                 cation;                                            records can be cause for discipline pursuant
   (A) A minimum of thirty (30) clock hours                  D. Two (2) clock hours if article        to section 344.050.2, RSMo.
toward the forty (40) required shall be            appears in a national health-care publication;
obtained through attendance at board-              and                                                (6) When the required information, docu-
approved continuing education programs or                    E. One (1) clock hour if article is      mentation and fee are received and approved
academic courses, as defined in 19 CSR 73-         published;                                         by the board within the specified time period,
2.031(2)(A)–(K). A maximum of twenty (20)                 3. An administrator lecturing at a board-   the board shall issue the license.
clock hours of the forty (40) clock hours may      approved seminar may receive credit equal to
be from on-line continuing education pro-          each hour or quarter hour of presentation          AUTHORITY: sections 344.040 and 344.070,
grams if a Missouri board-approved training        time with a maximum of six (6) hours credit        RSMo Supp. 2007.* This rule was previously
agency offers the program. The continuing          earned per licensure period. This credit may       filed as 13 CSR 73-2.050. Original rule filed
education programs and the academic cours-         be in addition to actual hours of attendance at    May 13, 1980, effective Aug. 11, 1980.
es must meet the following criteria:               the seminar but credit shall be granted for        Amended: Filed Oct. 16, 1985, effective
      1. Be approved by the board. In the case     only one (1) presentation of the same semi-        March 14, 1986. Amended: Filed Oct. 1,
of academic courses, the licensee must sub-        nar.                                               1987, effective Jan. 14, 1988. Amended:
mit a course description from the college for         (C) Serving as a registered preceptor for an    Filed June 28, 1990, effective Dec. 31, 1990.
board review. A maximum of five (5) clock          applicant who has been required by the board       Emergency amendment filed March 19, 1991,
hours per semester hour may be approved by         to complete an internship as described in 19       effective April 1, 1991, expired July 20,
the board. Upon successful completion of the       CSR 73-2.031. One (1) clock hour per full          1991. Amended: Filed April 1, 1991, effective
course (grade of “C” or above), an official        month as a preceptor shall be granted with a       Aug. 30, 1991. Amended: Filed Jan. 3, 1992,
transcript or grade report must be submitted       maximum of ten (10) clock hours per intern-        effective July 1, 1992. Amended: Filed June
to the board office, upon request, as verifica-    ship. During the two (2)-year licensure peri-      30, 1994, effective Feb. 1, 1995. Amended:
tion of course completion;                         od, a maximum of twenty (20) clock hours           Filed Jan. 31, 1996, effective July 30, 1996.
      2. Be offered by a registered training       will be granted.                                   Moved and amended: Filed Jan. 31, 2003,
agency approved by the board or a single              (D) Each licensee whose initial licensure       effective Aug. 30, 2003. Amended: Filed Dec.
offering provider (as outlined in 19 CSR 73-       period is less than twenty-four (24) months        15, 2005, effective July 30, 2006. Amended:
2.060);                                            shall be required to obtain at least one and       Filed Dec. 28, 2007, effective Aug. 30, 2008.
      3. Be approved by another state licen-       one-half (1 1/2) hours of continuing educa-
sure board for nursing home administrators         tion for each month in the initial licensure       *Original authority: 344.040, RSMo 1969, amended
                                                                                                      1979, 1987, 1989, 2000, 2005, 2007; and 344.070, RSMo
or by the National Continuing Education            period which shall include programs covering       1969, amended 1979, 1993, 1995, 2007.
Review Service (NCERS) under the National          patient-care related topics as defined in 19
Association of Boards (NAB), if the program        CSR 73-2.031(2)(A)–(F). The minimum
is held out-of-state.                              number of clock hours required in patient-         19 CSR 73-2.051 Retired Licensure Status
   (B) A maximum of ten (10) clock hours           care (PC) related programs is as follows. Ini-
toward the forty (40) required may be              tial licensure period of:                          PURPOSE: This rule establishes the proce-
obtained as follows:                                      1. 23 months to 18 months—8 PC clock        dures by which a currently licensed adminis-
      1. For the purposes of this subsection,      hours                                              trator may retire his/her license and the pro-
the following definitions shall apply:                    2. 17 months to 12 months—6 PC clock        cedures for reactivating the license, pursuant
         A. Referred publication—a publica-        hours                                              to section 344.105, RSMo.
tion that undergoes an anonymous review                   3. 11 months to 6 months—4 PC clock
process that determines whether or not the         hours                                              PUBLISHER’S NOTE: The secretary of state
article will be published; and                            4. 5 months or less—2 PC clock hours.       has determined that the publication of the
         B. National health-care publication—a                                                        entire text of the material which is incorpo-
publication that is—                               (5) The board shall annually select on a ran-      rated by reference as a portion of this rule
            (I) Published by a health-care asso-   dom basis at least five percent (5%) of the        would be unduly cumbersome or expensive.
ciation whose mission statement/bylaws indi-       licensees applying for renewal to have their       Therefore, the material which is so incorpo-
cate its scope is national;                        claims of continuing education hours audited       rated is on file with the agency who filed this
            (II) Mailed nationwide; and            for compliance with board requirements. A          rule, and with the Office of the Secretary of
            (III) Addressing content contained     licensee will be notified by mail when a           State. Any interested person may view this
within the long-term care core of knowledge        renewal application has been selected for          material at either agency’s headquarters or
outlined in 19 CSR 73-2.031(2)(A)–(K);             audit and will have up to thirty (30) days to      the same will be made available at the Office
      2. Publishing health-care related articles   provide copies of all certificates of attendance   of the Secretary of State at a cost not to
of at least fifteen hundred (1,500) words shall    and other documentation supporting the con-        exceed actual cost of copy reproduction. The
be granted—                                        tinuing education clock hours claimed on the       entire text of the rule is printed here. This
         A. Five (5) clock hours if article        renewal application. Nothing in this section       note refers only to the incorporated by refer-
appears in a national health-care referred         shall prevent the board from requiring any         ence material.
publication;                                       individual licensee to provide evidence satis-
         B. Four (4) clock hours if article        factory to the board of having completed the       (1) Any currently licensed nursing home
appears in a regional health-care referred         continuing education hours required for            administrator may request to retire the license
publication;                                       license renewal. Failure to provide proof of       if s/he has maintained an active Missouri

        ROBIN CARNAHAN        (7/31/08)                       CODE OF STATE REGULATIONS                                                                  7
        Secretary of State
               19 CSR 73-2—DEPARTMENT OF HEALTH AND
                           SENIOR SERVICES                                             Division 73—Missouri Board of Nursing Home Administrators



license at least ten (10) years and has retired     hours (including a minimum of five (5)             payable to the Department of Health and
from the practice of nursing home adminis-          patient care hours);                               Senior Services;
tration.                                                 2. Seven (7) months or more, but less            (B) His/her original wall license and all
                                                    than ten (10) months—fifteen (15) clock            other indicia of licensure, or evidence satis-
(2) Licensees interested in making applica-         hours (including a minimum of five (5)             factory to the board that the license has been
tion must submit the following information to       patient care hours);                               lost, stolen or destroyed;
the board:                                               3. Four (4) months or more, but less             (C) A signed written request that has been
   (A) A fee of fifty dollars ($50) made            than seven (7) months—ten (10) clock hours         notarized; and
payable to the Department of Health and             (including a minimum of two and one-half              (D) Evidence satisfactory to the board of
Senior Services;                                    (2.5) patient care hours); or                      completion of ten (10) clock hours of contin-
   (B) His/her original wall license and all             4. Less than four (4) months—five (5)         uing education in the area of patient care.
other evidence of licensure or evidence satis-      clock hours (including a minimum of two and
factory to the board that the license has been      one-half (2.5) patient care hours).                (3) The board shall issue a new license to the
lost, stolen, or destroyed; and                                                                        licensee indicating that the license is inactive
   (C) One of the following:                        (6) If more than five (5) years have passed        once the board has received the required
      1. An affidavit that includes the date on     since the issuance of a retired license to a       information and has approved the request for
which the licensee retired from such practice       licensee, the licensee shall follow the proce-     inactive licensure status.
and such other facts the Board may require to       dures for initial licensure stated in section
verify the retirement; or                           344.030, RSMo.                                     (4) An inactive license shall expire on June
      2. Sign the request for retired status that                                                      30 of the year following the year of issuance
appears on the nursing home administrator           (7) No person shall act or serve in the capac-
                                                                                                       and every other year thereafter.
license renewal application and return such         ity of a nursing home administrator in this
application to the Board prior to the active        state or hold himself or herself out as a nurs-
                                                                                                       (5) Licensees seeking to renew shall, on or
license expiring on June 30 of the year of          ing home administrator if his or her license is
                                                                                                       before June 30, of the year of renewal, file an
renewal.                                            retired.
                                                                                                       application for renewal on forms furnished by
                                                    (8) Retired licensees shall remain subject to      the board that includes evidence satisfactory
(3) Information provided in the request for                                                            to the board of completion of ten (10) clock
retired status shall be given under oath sub-       disciplinary action for violations of Chapter
                                                    344, RSMo and the rules promulgated there-         hours of continuing education in the area of
ject to the penalties for making a false affi-
                                                    under.                                             patient care and shall be accompanied by a
davit. A sample Affidavit Requesting Retired
                                                                                                       renewal fee of fifty dollars ($50) made
Licensure Status is hereby incorporated by
                                                    AUTHORITY: section 344.070, RSMo Supp.             payable to the Department of Health and
reference as part of this rule.
                                                    2007.* This rule was previously filed as 13        Senior Services.
(4) The Board shall issue a new license to the      CSR 73-2.051. Original rule filed Oct. 24,
licensee indicating that the licensee is retired    2000, effective May 30, 2001. Moved and            (6) A license may be carried in inactive sta-
once the Board has received the required            amended: Filed Jan. 31, 2003, effective Aug.       tus for up to six (6) years from the date of
information and has approved the request for        30, 2003. Amended: Filed Dec. 28, 2007,            issuance. If the licensee does not reactivate
retired licensure status.                           effective Aug. 30, 2008.                           the license during the six (6)-year period, the
                                                                                                       license shall expire on the last day of the six
                                                    *Original authority: 344.070, RSMo 1969, amended   (6)-year period.
(5) A retired license may be reactivated with-      1979, 1993, 1995, 2007.
in five (5) years of the granting of the retired
license by filing the following information                                                            (7) An inactive license may be reactivated by
with the board:                                                                                        submitting a written request to the board,
                                                    19 CSR 73-2.053 Inactive Licensure Status
   (A) An affidavit requesting reactivation of                                                         accompanied by evidence satisfactory to the
the retired license;                                PURPOSE: This rule establishes the proce-          board of the completion of forty (40) clock
   (B) A fee of one hundred dollars ($100)          dures by which a currently licensed adminis-       hours of continuing education and a fee of
made payable to the Department of Health            trator may place his/her license on an inac-       one hundred dollars ($100) made payable to
and Senior Services; and                            tive status and the procedures for reactivating    the Department of Health and Senior Ser-
   (C) Satisfactory evidence of the completion      the license, pursuant to section 344.108,          vices. The forty (40) clock hours of continu-
of twenty (20) clock hours of board approved        RSMo.                                              ing education shall be earned no earlier than
continuing education (including clock hours                                                            six (6) months prior to the request for reacti-
carried forward from the last renewal date),        (1) Any nursing home administrator possess-        vation and no later than six (6) months after
as described in 19 CSR 73-2.050(2)(A) and           ing a current license to practice as a nursing     the inactive license has been reactivated. If
(B), for each calendar year the license was         home administrator in Missouri may request         the holder of an inactive license requests
retired. All clock hours must be completed          an inactive license.                               reactivation prior to completing the forty (40)
after the granting of the retired license or                                                           clock hours of continuing education, the
completed within the same licensure year the        (2) Licensees interested in requesting an inac-    board shall issue a six (6)-month interim
licensee was granted the retired license. The       tive license must submit the following infor-      license to the licensee. The interim license
board may prorate the required clock hours          mation to the board prior to June 30 of the        shall expire six (6) months from the date of
for any portion of a calendar year as follows:      year of renewal of the administrator’s active      issuance or at such earlier time as the
      1. Ten (10) months or more, but less          license.                                           licensee earns the forty (40) clock hours of
than twelve (12) months—twenty (20) clock              (A) A fee of fifty dollars ($50) made           continuing education and submits evidence

8                                                              CODE OF STATE REGULATIONS                           (7/31/08)      ROBIN CARNAHAN
                                                                                                                                  Secretary of State
Chapter 2—General Rules                                                                                                       19 CSR 73-2


satisfactory to the board of completion of the     (3) The licensee shall also supply the board            administrators or for the renewal of license as
required hours.                                    with a statement indicating employment sta-             nursing home administrators shall register
                                                   tus from the point the license expired through          with the board.
(8) A request for reactivation of an inactive      the filing of the application for late renewal.            (A) These entities shall complete the appli-
license shall show, under oath or affirmation      The licensee shall include in the statement             cation for registration as a training agency
of the nursing home administrator, a state-        written reasons as to why the license was not           and submit it to the board along with the sup-
ment that the nursing home administrator has       renewed prior to the expiration date of June            porting documentation required by the form.
not practiced during the inactive period and is    30.                                                        (B) This registration, if granted by the
not presently practicing in this state.                                                                    board, shall be established for up to twelve
                                                   (4) The board-approved continuing education             (12) months and notice of this registration
(9) No person shall practice as a nursing          must be obtained as described in 19 CSR 73-             and time periods will be made available to
home administrator or hold himself or herself      2.050(5)(A) and may include clock hours as              licensees by the executive secretary of the
out as a nursing home administrator in this        outlined in 19 CSR 73-2.050(5)(B)1.–4.                  board. The registration of any agency may be
state while his or her license is inactive.                                                                terminated at any time at the discretion of the
                                                   (5) Upon receipt of the required application,           board. The agency’s board approval number
(10) An inactive license shall remain subject      documentation and fee, the board may issue              must be printed in all program promotional
to discipline for violations of this chapter and   the license effective the date the late renewal         materials that are approved for nursing home
the rules promulgated there under.                 is approved by the board.                               administrators.
                                                                                                              (C) The program shall follow the long-
AUTHORITY: section 344.070, RSMo Supp.             (6) A person whose license has expired for a            term care core of knowledge areas as
2007.* Original rule filed Dec. 28, 2007,          period of more than twelve (12) months must             described in 19 CSR 73-2.031(2). All
effective Aug. 30, 2008.                           meet the requirements set out in 19 CSR 73-             approved training agencies must submit to the
                                                   2.020 for initial licensure.                            board office in advance, the following infor-
*Original authority: 344.070, RSMo 1969, amended                                                           mation regarding each program they wish to
1979, 1987, 1989, 2000, 2005, 2007.                (7) Upon expiration of the license, a licensee          approve for nursing home administrator clock
                                                   cannot act in the capacity of a nursing home            hours:
                                                   administrator. To do so is a violation of sec-                1. Date, time and location of presenta-
19 CSR 73-2.055 Renewal of Expired                 tion 344.020, RSMo and may be grounds for               tion broken down into specific time periods,
License                                            denial of the late renewal application or be            topic titles and speakers;
                                                   cause for discipline of the license.                          2. A program outline including the pur-
PURPOSE: This rule describes the condi-
                                                                                                           pose and content objectives;
tions and procedures for renewing a license        AUTHORITY: sections 344.040 and 344.070,                      3. Statements regarding presenter quali-
that has expired.                                  RSMo Supp. 2007.* This rule was previously              fications in his/her particular subject matter
                                                   filed as 13 CSR 73-2.055. Original rule filed           area;
(1) Any licensee who fails to submit the           June 28, 1990, effective Dec. 31, 1990.                       4. Number of clock hours requested,
required application, documentation and/or         Amended: Filed June 30, 1994, effective Feb.            deleting time allotted for breaks and lunch;
fee for license renewal prior to expiration of     1, 1995. Amended: Filed Jan. 31, 1996,                  and
that license on June 30, may be relicensed by      effective July 30, 1996. Moved and amended:                   5. For on-line courses, the program
meeting the requirements of this regulation        Filed Jan. 31, 2003, effective Aug. 30, 2003.           materials must also include:
provided that the license has not been expired     Amended: Filed Dec. 15, 2005, effective July                     A. Description of the total learning
for a period of more than twelve (12) months.      30, 2006. Amended: Filed Dec. 28, 2007,                 package including the method/rationale used
                                                   effective Aug. 30, 2008.                                for determining the number of study hours
(2) The licensee must complete and forward                                                                 required to complete the program. One (1)
to the board office a license renewal applica-     *Original authority: 344.040, RSMo 1969, amended
                                                                                                           clock hour will be awarded for each hour
tion (see 19 CSR 73-2.050(2) or (3), accord-       1979, 1987, 1989, 2000, 2005, 2007; and 344.070, RSMo
                                                   1969, amended 1979, 1993, 1995, 2007.                   needed to complete the course.
ingly to the date the license expired), along                                                                       B. Instruction for program comple-
with a renewal fee of one hundred dollars                                                                  tion; and
($100) for a two (2)-year license, plus a twen-    19 CSR 73-2.060 Registration of Training                         C. Post-test as part of the total learn-
ty-five dollar ($25) penalty fee. Satisfactory     Agencies and Single Offering Providers                  ing package. The information must demon-
evidence of board-approved continuing edu-                                                                 strate test security, include a minimum of five
cation, (as outlined in 19 CSR 73-2.050(2) or      PURPOSE: This rule sets forth the require-              (5) multiple choice or true/false questions per
(3), according to the date the license             ments for registration with the board for               clock hour, and require a grade of seventy-
expired), must also be submitted with the          training agencies and single offering                   five percent (75%) or higher in order to pass.
license renewal application. Information pro-      providers offering courses of study and train-             (D) If the training agency wishes to approve
vided in the application shall be attested to by   ing intended to qualify applicants for initial          a program but is not the sponsoring agency
signature to be true and correct to the best of    licensing or renewal of license as a nursing            and provider, the agency must submit the
the applicant’s knowledge and belief and           home administrator.                                     application for approval of a single offering as
include an attestation verifying that the                                                                  described in section (2) of this rule. No fee
licensee has completed the required number         (1) All organizations described in 19 CSR               will be charged for this process as referenced
of board-approved continuing education clock       73-2.010(8) which offer any course of study             in subsection (2)(B). If the application for a
hours obtained during the current licensure        or program of instruction and training to pre-          single offering is submitted less than forty-
period.                                            pare applicants for licensure as nursing home           five (45) days in advance of the presentation

        ROBIN CARNAHAN        (7/31/08)                        CODE OF STATE REGULATIONS                                                                  9
        Secretary of State
               19 CSR 73-2—DEPARTMENT OF HEALTH AND
                           SENIOR SERVICES                                            Division 73—Missouri Board of Nursing Home Administrators



but more than thirty (30) days in advance,         roster signed by each nursing home adminis-           (C) Failure to schedule and sit the exami-
there will be a nonrefundable late fee of fifty    trator attendee including license number and       nation(s) within the sixty (60)-day period will
dollars ($50).                                     number of clock hours issued to each               cause the applicant’s name to be removed
   (E) Thirty (30) days prior to the date the      licensee; and                                      from the eligibility list kept by the testing ser-
training agency status will expire, the agency        (C) Provide each nursing home administra-       vice. Applicants may reschedule by resubmit-
must make reapplication if the agency wishes       tor written evidence of his/her attendance         ting the NAB Application Forms and paying
to continue as an approved provider beyond         which shall include: title of offering, date of    any required fees.
the designated period. The training agency’s       offering, number of clock hours actually              (D) Applicants must comply with all crite-
ability to comply with the board’s rules and       attended and the board approval number.            ria and requirements established by the
policies for offering continuing education                                                            board, the National Association of Board of
programs to licensed nursing home adminis-         AUTHORITY: section 344.070, RSMo Supp.             Examiners of Long Term Care Administra-
trators will be carefully reviewed during the      2007.* This rule was previously filed as 13        tors (NAB), the testing service and the test-
reapplication process.                             CSR 73-2.060. Original rule filed May 13,          ing center.
                                                   1980, effective Aug. 11, 1980. Amended:
(2) Organizations or persons who do not            Filed Aug. 12, 1981, effective Nov. 12, 1981.      (4) Qualified applicants will be eligible to
qualify under 19 CSR 73-2.010(8) but who           Amended: Filed April 14, 1983, effective July      take the state examination administered by the
wish to sponsor education seminars shall sub-      11, 1983. Amended: Filed Oct. 16, 1985,            board once a written request and the one hun-
mit three (3) copies of the application for        effective March 14, 1986. Amended: Filed           dred dollar ($100) fee are received by the
approval of a single offering a minimum of         Oct. 1, 1987, effective Jan. 14, 1988.             board. The examination will be scheduled at
forty-five (45) days in advance of the presen-     Amended: Filed Dec. 4, 1989, effective             least monthly if one (1) or more applicants
tation. If the application for a single offering   March 1, 1990. Rescinded and readopted:            are awaiting examination.
is submitted less than forty-five (45) days in     Filed Jan. 3, 1992, effective May 14, 1992.
advance of the presentation but more than          Moved and amended: Filed Jan. 31, 2003,            (5) Individuals making initial application for
thirty (30) days in advance, there will be a       effective Aug. 30, 2003. Amended: Filed Dec.       licensure, within twenty-one (21) days of a
separate, nonrefundable late fee of fifty dol-     28, 2007, effective Aug. 30, 2008.                 board meeting date, may be required to wait
lars ($50).                                                                                           until a subsequent date to be evaluated.
   (A) The sponsoring agency and its role          *Original authority: 344.070, RSMo 1969, amended
must be clearly identified in the application.     1979, 1993, 1995, 2007.
                                                                                                      (6) Applicants shall obtain a passing score on
For first time single offering providers, the                                                         the examination(s) administered by the board.
organization’s mission statement/goals must                                                           The passing score shall be based upon the
be included.                                       19 CSR 73-2.070 Examination
                                                                                                      scale score passing point of one hundred thir-
   (B) There shall be a separate, nonrefund-                                                          teen (113) on the federal portion of the exam-
able fee of fifteen dollars ($15) per requested    PURPOSE: This rule describes the condi-
                                                   tions and procedures for examination.              ination and seventy-five percent (75%) on the
clock hour for each single offering applica-
                                                                                                      state portion of the examination.
tion filed with the board. The education and
training unit of any state agency, or a section    (1) The board shall approve the content and
                                                   form of all examinations administered to           (7) If an applicant fails to make a passing
of a department, will be exempt from these
                                                   applicants for licensure.                          grade on one or both of the required exami-
application fees.
                                                                                                      nations, the applicant may make application
   (C) The program shall follow the long-
                                                   (2) The examination(s) must be taken within        for reexamination and pay the required fees.
term care core of knowledge areas as
                                                   twelve (12) months of the written notice of        If an applicant fails only one of the required
described in 19 CSR 73-2.031(2).
                                                   board evaluation and qualification. Failure to     examinations and then fails to retake and pass
   (D) Applications approved by the board
                                                   do so will cause full reapplication to be nec-     the examination within a twelve (12)-month
must reflect the board approval number in the
program’s promotional materials.                   essary.                                            period, the applicant shall be required to take
                                                                                                      and pass both examinations before the board
(3) The education and training unit of the         (3) Qualified applicants will be eligible to       will issue the applicant a license.
Missouri Department of Health and Senior           take the national examination through the
Services, in order to provide topical educa-       testing service by following the procedures        (8) If an applicant fails either of the examina-
tion which may be of an immediate nature,          set forth in subsections (A)–(D).                  tion(s) a third time, the applicant must com-
shall be exempt from the forty-five (45)-day          (A) Applicants must submit the National         plete a course of instruction prescribed and
advance notice stipulation.                        Association of Boards of Examiners of Long         approved by the board. After completion of
                                                   Term Care Administrators (NAB) Applica-            the board-prescribed course of instruction,
(4) The training agency and single offering        tion Form for Computerized Testing and the         the applicant may reapply for board-approved
provider must—                                     required fees to NAB. The applicant will           examination(s). No applicant shall be
   (A) Record attendance accurately at each        receive from the testing service an authoriza-     licensed by the board after a third licensure
presentation, with the use of sign-in/out          tion letter including a list of testing center     examination failure unless the applicant suc-
sheets as needed, reflecting the number of         vendors, each center’s toll-free telephone         cessfully completes the board-prescribed
clock hours of actual attendance of each nurs-     number and instructions on the scheduling          course of instruction and passes the board-
ing home administrator;                            process.                                           approved examination(s). With regard to any
   (B) Submit, within thirty (30) days of the         (B) Applicants must schedule to sit the         nationally certified examination required for
conclusion of the approved program, to the         examination within sixty (60) days of the date     licensure, no examination scores from other
board office a composite evaluation and a          on the testing service’s authorization letter.     states shall be recognized by the board after

10                                                            CODE OF STATE REGULATIONS                           (7/31/08)       ROBIN CARNAHAN
                                                                                                                                  Secretary of State
Chapter 2—General Rules                                                                                                     19 CSR 73-2


the applicant has failed for a third time to       tor was not anticipated by the operator at the      expiration. Upon recommendation of the offi-
pass the examination.                              time the facility was licensed;                     cers of the Missouri Board of Nursing Home
                                                      (D) A complete initial application and a         Administrators, temporary emergency license
AUTHORITY: section 344.070, RSMo Supp.             fee for the person for whom the emergency           extensions may be issued for up to ninety (90)
2007.* This rule was previously filed as 13        license is requested;                               days. The extension may only be considered
CSR 73-2.070. Original rule filed May 13,             (E) A complete copy of the most recent           upon a showing that the person seeking the
1980, effective Aug. 11, 1980. Amended:            statement of deficiencies from the Missouri         renewal of a temporary emergency license
Filed Oct. 16, 1985, effective March 14,           Department of Health and Senior Services for        meets the qualifications for licensure and has
1986. Amended: Filed Oct. 1, 1987, effective       the facility where the emergency exists; and        filed an application for a regular license,
Jan. 14, 1988. Amended: Filed Dec. 4, 1989,           (F) Applications for a temporary emer-           accompanied by the application fee and the
effective March 1, 1990. Emergency amend-          gency license shall be filed with the board         applicant has taken the examination or exam-
ment filed Dec. 13, 1991, effective Dec. 23,       immediately upon notification of, or realiza-       inations but the results have not been received
1991, expired April 20, 1992. Amended:             tion by, the person making the application,         by the board. No temporary emergency
Filed Jan. 3, 1992, effective May 14, 1992.        but in no event more than ten (10) working          license may be renewed more than one (1)
Amended: Filed April 30, 1998, effective Oct.      days from the effective date referred to in         time.
30, 1998. Amended: Filed March 1, 1999,            subsection (1)(B).
effective Aug. 30, 1999. Emergency amend-                                                              AUTHORITY: sections 344.030.4 and
ment filed Nov. 17, 1999, effective Dec. 11,       (2) After receipt and review of the required        344.070, RSMo Supp. 2007.* This rule was
1999, expired June 7, 2000. Amended: Filed         information, the board may issue a tempo-           previously filed as 13 CSR 73-2.080. Origi-
November 1, 1999, effective April 30, 2000.        rary emergency license for a period not to          nal rule filed May 13, 1980, effective Aug.
Emergency amendment filed Nov. 30, 2001,           exceed ninety (90) days. The person to whom         11, 1980. Amended: Filed Dec. 10, 1984,
effective Jan. 1, 2002, expired June 29,           it is issued is fully responsible for the facili-   effective April 11, 1985. Amended: Filed Oct.
2002. Amended: Filed Nov. 30, 2001, effec-         ty as if initially licensed as a nursing home
tive June 30, 2002. Moved to 19 CSR 73-                                                                1, 1987, effective Jan. 14, 1988. Moved and
                                                   administrator and shall confirm his/her             amended: Filed Jan. 31, 2003, effective Aug.
2.070, effective March 3, 2003. Amended:           understanding of this fact in a statement upon
Filed Dec. 28, 2007, effective Aug. 30, 2008.                                                          30, 2003. Amended: Filed Dec. 28, 2007,
                                                   receipt of the temporary emergency license.
                                                                                                       effective Aug. 30, 2008.
*Original authority: 344.070, RSMo 1969, amended
1979, 1993, 1995, 2007.
                                                   (3) A temporary emergency license shall not         *Original authority: 344.030, RSMo 1969, amended
                                                   be granted by the board to an individual to act     1979, 1987, 1988, 1989, 1996, 2007; and 344.070, RSMo
                                                   as an administrator in a newly licensed facil-      1969, amended 1979, 1993, 1995, 2007.

19 CSR 73-2.080 Temporary Emergency                ity unless clear and convincing evidence is
Licenses                                           presented which, in the board’s best judge-
                                                   ment, demonstrates that the departure of the        19 CSR 73-2.085 Public Complaints
PURPOSE: This rule sets forth the procedure        previous administrator was not anticipated by
                                                   the operator at the time the facility was newly     PURPOSE: This rule establishes a procedure
for requesting an emergency license and
                                                   licensed. All individuals or entities intending     for receipt, handling and disposition of pub-
extension and the conditions which must be
                                                   either to build or become the operator of a         lic complaints by the board of nursing home
met.
                                                   facility must be familiar with the laws per-        administrators.
(1) Application for a temporary emergency          taining to licensure of nursing home adminis-
                                                                                                       (1) The State Board of Nursing Home
license shall be made to the executive secre-      trators and long-term care facilities and take
                                                                                                       Administrators shall receive and process each
tary of the board. The application shall           necessary steps to insure continued compli-
                                                                                                       complaint made against any licensed nursing
demonstrate that the applicant meets the           ance with the statutory and regulatory provi-
                                                                                                       home administrator, or other person or enti-
requirements for a temporary emergency             sions before becoming an operator.
                                                                                                       ty, which complaint alleges certain acts or
license as set forth in section 344.030.5,
                                                   (4) A temporary emergency license may be            practices which may constitute one (1) or
RSMo and shall include the following:
                                                   issued only to a person—                            more violations of the provisions of Chapter
   (A) The signature of the appropriate
authority at the facility where the emergency         (A) Twenty-one (21) years of age or over,        344, RSMo. Any member of the public or the
exists and of the person for whom the license      who is a high school graduate or equivalent         profession, or any federal, state or local offi-
is requested;                                      and is of good moral character;                     cial, may make and file a complaint with the
   (B) The name of the licensed administrator         (B) Who had been preceded in the position        board. Complaints received from sources
who has died, been removed or vacated the          by a fully licensed nursing home administra-        outside Missouri will be processed in the
position and the effective date of the death,      tor; and                                            same manner as those originating within Mis-
removal or vacancy;                                   (C) Who previously has not been denied a         souri. No members of the State Board of
   (C) A statement as to whether the facility      nursing home administrator’s license or has         Nursing Home Administrators shall file a
is newly licensed. Newly licensed shall mean       not had a nursing home administrator’s              complaint with this board while s/he holds
licensed, either initially or because of a         license suspended or revoked.                       that office, unless that member excuses
change of operator, within ninety (90) days                                                            him/herself from further board deliberations
prior to the request for an emergency license.     (5) Request for extension of a temporary            or activity concerning the matters alleged
If the facility has been newly licensed, the       emergency license shall be made in writing          within that complaint. Any staff member or
application shall also include a statement         and submitted to the executive secretary no         employee of the board may file a complaint
from the operator setting forth the reasons        later than twenty-one (21) days in advance of       pursuant to this rule in the same manner as
why the departure of the previous administra-      the temporary emergency license date of             any member of the public.

        ROBIN CARNAHAN        (7/31/08)                       CODE OF STATE REGULATIONS                                                                  11
        Secretary of State
              19 CSR 73-2—DEPARTMENT OF HEALTH AND
                          SENIOR SERVICES                                            Division 73—Missouri Board of Nursing Home Administrators



(2) Complaints should be mailed or delivered      upon information and belief, acting in             mission as provided by Chapter 621, RSMo.
to the following address: State Board of Nurs-    reliance on third-party information received       As an alternative to refusal to issue or renew
ing Home Administrators, PO Box 570, Jef-         by the board.                                      any certificate, registration or authority, per-
ferson City, MO 65102. However, actual                                                               mit or license, the board may, at its discre-
receipt of the complaint by the board at its      (6) Both the complaint and any information         tion, issue a license which is subject to pro-
administrative offices in any manner shall be     obtained as a result of the complaint investi-     bation for any one (1) or any combination of
sufficient. Complaints may be based upon          gation shall be considered a closed record of      causes stated in section (2) of this rule. The
personal knowledge, or upon information and       the board and shall not be available for           board’s order of probation shall contain a
belief, reciting information received from        inspection by the public.                          statement of the discipline imposed, the basis
other sources.                                                                                       therefore, the date such action shall become
                                                  (7) This rule shall not be deemed to limit the     effective, and a statement that the applicant
(3) All complaints shall be made in writing       board’s authority to file a complaint with the     has thirty (30) days to request in writing a
and shall fully identify their maker by name      Administrative Hearing Commission or with          hearing before the Administrative Hearing
and address. Complaints may be made on            a court, charging a licensee, permittee or         Commission. If the board issues a probation-
forms provided by the board, which shall be       other person or entity with any actionable         ary license to an applicant for licensure, the
available upon request. Complaints need not       conduct or violation, whether or not this
be made by affidavit, but oral or telephone                                                          applicant may file a written petition with the
                                                  complaint exceeds the scope of the acts            Administrative Hearing Commission within
communications will not be considered or          charged in a preliminary public complaint
processed as complaints. Any person attempt-                                                         thirty (30) days of the effective date of the
                                                  filed with the board and whether or not any        probationary license seeking review of
ing to make an oral or telephone complaint        public complaint has been filed with the
against an individual will be provided with a                                                        whether cause exists to discipline the licensee
                                                  board.
complaint form and requested to complete it                                                          under section (2) of this rule. If no written
and return it to the board. Any staff member                                                         request for a hearing is received by the
                                                  (8) The board interprets this rule, which is
or employee of the board may make and file                                                           Administrative Hearing Commission within
                                                  required by law, to exist for the benefit of
a complaint based upon information and                                                               the thirty (30)-day period, the right to seek
                                                  those members of the public who submit
belief, in reliance upon oral, telephone or       complaints to the board. This rule is not          review of the board’s decision shall be
written but unsigned communications               deemed to protect or to inure to the benefit of    waived.
received by the board, unless those commu-        those licensees, permit holders, registrants or
nications are believed by that staff member or    other persons or entities against whom the         (2) The board may cause a complaint to be
employee to be false.                             board has instituted or may institute adminis-     filed with the Administrative Hearing Com-
                                                  trative or judicial proceedings concerning         mission as provided by Chapter 621, RSMo,
(4) Each complaint received under this rule                                                          against any holder of any certificate of regis-
                                                  possible violations of the provisions of Chap-
shall be logged in a book maintained by the                                                          tration or authority, permit or license
                                                  ter 344, RSMo.
board for that purpose. Complaints shall be                                                          required by this chapter or any person who
logged in consecutive order as received. The      AUTHORITY: section 344.070, RSMo Supp.             has failed to renew or has surrendered his/her
logbook shall contain: a record of each com-      2007.* This rule was previously filed as 13        certificate or registration or authority, permit
plainant’s name and address; the name and         CSR 73-2.085. Original rule filed Oct. 4,          or license for any one (1) or any combination
address of the subject(s) of the complaint; the                                                      of the following causes:
                                                  1988, effective March 15, 1989. Amended:
date each complaint is received by the board;
                                                  Filed Jan. 3, 1992, effective May 14, 1992.           (A) Use or unlawful possession of any con-
a brief statement of the acts complained of,
                                                  Moved and amended: Filed Jan. 31, 2003,            trolled substance, as defined in Chapter 195,
including the name of any person injured or
                                                  effective Aug. 30, 2003. Amended: Filed Dec.       RSMo, or alcoholic beverage to an extent that
victimized by the alleged acts or practices; a
                                                  28, 2007, effective Aug. 30, 2008.                 this use impairs a person’s ability to perform
notation whether the complaint resulted in its
                                                                                                     the work of any profession licensed or regu-
dismissal by the board or in formal charges       *Original authority: 344.070, RSMo 1969, amended   lated by this chapter;
being filed with the Administrative Hearing       1979, 1993, 1995, 2007.
Commission; and the ultimate disposition of                                                             (B) Has been finally adjudicated and found
the complaint. This logbook shall be a closed                                                        guilty, or entered a plea of guilty or nolo con-
record of the board.                              19 CSR 73-2.090 Disciplinary Action                tendere, pursuant to criminal prosecution
                                                                                                     under the laws of any state or of the United
(5) Each complaint logged pursuant to this        PURPOSE: This rule describes the condition         States, for any offense reasonably related to
rule shall be acknowledged in writing. The        and procedure for disciplinary action, as          the qualifications, functions or duties of any
acknowledgment shall state that the com-          defined in section 344.050, RSMo, against          professional licensed or regulated under this
plaint is being investigated and shall be         licenses.                                          chapter, for any offense an essential element
referred to the board or an appropriate board                                                        of which is fraud, dishonesty or an act of vio-
subcommittee for consideration following the      (1) The board may refuse to issue or renew         lence, or for any offense involving moral
investigation. The complainant may be noti-       any certificate of registration or authority,      turpitude, whether or not sentence is
fied of the ultimate disposition of the com-      permit or license required pursuant to this        imposed;
plaint, excluding judicial appeals, and may be    chapter for one (1) or any combination of             (C) Use of fraud, deception, misrepresen-
provided with a copy of the decisions (if any)    causes stated in section (2) of this rule. The     tation or bribery in securing any certificate of
of the Administrative Hearing Commission          board shall notify the applicant in writing of     registration or authority, permit or license
and the board. The provisions of this section     the reasons for the refusal and shall advise       issued pursuant to this chapter or in obtaining
shall not apply to complaints filed by staff      the applicant of his/her right to file a com-      permission to take any examination given or
members or employees of the board, based          plaint with the Administrative Hearing Com-        required pursuant to this chapter;

12                                                           CODE OF STATE REGULATIONS                           (7/31/08)      ROBIN CARNAHAN
                                                                                                                                Secretary of State
Chapter 2—General Rules                                                                                                   19 CSR 73-2


   (D) Obtaining or attempting to obtain any        surrendered its license while under investiga-     must be maintained by the nursing home
fee, charge, tuition or other compensation by       tion.                                              administrator.
fraud, deception or misrepresentation;
   (E) Performing incompetent, misconduct,          (3) The Administrative Hearing Commission          (1) The administrator shall—
gross negligence, fraud, misrepresentation or       shall have no authority to require issuance of        (A) Be held responsible for informing
dishonesty in the performance of the func-          a license, pending a final determination by
                                                                                                       him/herself of the needs of the residents and
tions or duties of any profession licensed or       the commission, in any case in which an
                                                                                                       the needs of the facility and apprise the oper-
regulated by this chapter (refer to 19 CSR 73-      applicant is seeking initial licensure.
                                                                                                       ator of these needs on a routine basis;
2.095 for a partial listing of those functions
                                                    (4) No license may be suspended or revoked            (B) Be held responsible for the actions of
and duties);
   (F) Violating, assisting or enabling any         and no application for renewal of a license        all employees with regard to Chapter 198,
person to violate, any provision of this chap-      may be denied under this section until the         RSMo, unless—
ter, or of any lawful rule adopted pursuant to      licensee has been afforded an opportunity for            1. Upon learning of the violation, the
this chapter;                                       hearing after due notice as provided in sec-       administrator attempted to immediately cor-
   (G) Violation of, or assisting or enabling       tions 621.015–621.205, RSMo.                       rect the violation;
any person to violate, any provision of Chap-                                                                2. The administrator did not sanction the
                                                    (5) Upon a finding by the Administrative
ter 198, RSMo, or any lawful rule or regula-                                                           violation; and
                                                    Hearing Commission that the grounds, pro-
tion promulgated thereunder;                                                                                 3. The administrator did not attempt to
                                                    vided in section (2) of this rule, for discipli-
   (H) Impersonation of any person holding a                                                           avoid learning of the violation;
                                                    nary action are met, singly or in combina-
certificate of registration or authority, permit
                                                    tion, the board may censure or place the              (C) Establish and enforce policies and pro-
or license, or allowing any person to use such
                                                    person named in the complaint on probation         cedures to safeguard patient or resident care;
person’s certificate of registration or authori-
                                                    on such terms as the board deems appropri-            (D) Establish and enforce policies and pro-
ty, permit, license or diploma from any
                                                    ate, or may suspend or revoke the certificate,     cedures for the protection of residents rights,
school;                                             permit or license.
   (I) Disciplinary action against the holder of                                                       funds and property;
a license or other right to practice any pro-       (6) The board may exclude any application             (E) Establish and enforce policies and pro-
fession regulated by this chapter granted by        for up to five (5) years for any person who        cedures for all nursing home rules as stated in
another state, territory, federal agency or         has had his or her license revoked by the          19 CSR 30-82 through 19 CSR 30-89;
country upon grounds for which revocation           board or has surrendered his or her license to        (F) Not permit or allow another person to
or suspension is authorized in this state;          the board.                                         use his/her nursing home administrator
   (J) A person is finally adjudged incapaci-                                                          license for any purpose;
tated or disabled by a court of competent           AUTHORITY: section 344.070, RSMo Supp.                (G) Report through the proper channels the
jurisdiction;                                       2007.* This rule was previously filed as 13
                                                                                                       incompetent, unethical or illegal practice of
   (K) Assisting or enabling any person to          CSR 73-2.090. Original rule filed May 13,
practice or offer to practice any profession                                                           any health care professional; and
                                                    1980, effective Aug. 11, 1980. Amended:
licensed or regulated by this chapter who is        Filed Oct. 16, 1985, effective March 14,              (H) Devote reasonable time and attention
not registered and currently eligible to prac-      1986. Amended: Filed Oct. 1, 1987, effective       to the management of the health, safety and
tice under this chapter;                            Jan. 14, 1988. Amended: Filed Dec. 4, 1989,        welfare of the residents of the facility.
   (L) Issuance of a certificate of registration    effective March 1, 1990. Moved and amend-
or authority, permit or license based upon a        ed: Filed Jan. 31, 2003, effective Aug. 30,        (2) Failure of the licensee to comply with any
material mistake of fact;                           2003. Amended: Filed Dec. 28, 2007, effec-         of the provisions of section (1) of this rule in
   (M) Violation of the drug laws or rules and      tive Aug. 30, 2008.                                performing any of the acts covered by the
regulations of this state, any other state or the                                                      licensure law may be considered by the board
federal government;                                 *Original authority: 344.070, RSMo 1969, amended
                                                    1979, 1993, 1995, 2007.                            to be conduct which is detrimental to the
   (N) Knowingly failing to report abuse or                                                            interest of the public and may be deemed in
neglect of a resident in a long-term care facil-
                                                                                                       violation of the licensure law and shall be suf-
ity, as required by section 198.070, RSMo, of       19 CSR 73-2.095 Standards of Profession-           ficient cause for the board to pursue a com-
which he or she has actual knowledge that it        al Conduct
is abuse or neglect;                                                                                   plaint against the offending licensee to the
   (O) Violation of any professional trust or                                                          Administrative Hearing Commission.
                                                    PURPOSE: The Board of Nursing Home
confidence; or                                      Administrators is committed to high stan-
   (P) Having served as the administrator,                                                             AUTHORITY: section 344.070, RSMo 2000.*
                                                    dards of care for the aging population in Mis-
operator, or any principal involved in the          souri nursing homes. To assure that those          This rule was previously filed as 13 CSR 73-
operation of a facility licensed under Chapter      standards are met by licensed administrators       2.095. Original rule filed Jan. 19, 1988,
198, RSMo, and during such time the facili-         in Missouri, the board provides standards of       effective April 11, 1988. Amended: Filed
ty has had its license revoked under section        conduct consistent with accepted standards of      June 28, 1990, effective Dec. 31, 1990.
198.036, RSMo, has entered into a consent           the nursing home administration profession.        Moved and amended: Filed Jan. 31, 2003,
agreement to obtain a probationary license          Behavior (acts, knowledge and practice)            effective Aug. 30, 2003.
under subsection 5 of section 198.026,              which fails to conform to the accepted stan-
RSMo, has had a license denied under sub-           dards shall constitute unprofessional con-         *Original authority: 344.070, RSMo 1969, amended
section 2 of section 198.022, RSMo, or has          duct. This rule sets out those standards which     1979, 1993, 1995.


        ROBIN CARNAHAN         (7/31/08)                       CODE OF STATE REGULATIONS                                                            13
        Secretary of State
               19 CSR 73-2—DEPARTMENT OF HEALTH AND
                           SENIOR SERVICES                                            Division 73—Missouri Board of Nursing Home Administrators



19 CSR 73-2.100 Restoration and Rehabil-           tions as the board deems appropriate. These        Filed Oct. 16, 1985, effective March 14,
itation of Suspended/Revoked Licenses              conditions may include, but shall not be lim-      1986. Moved to 19 CSR 73-2.120, effective
                                                   ited to, satisfactory completion of certain        March 3, 2003. Amended: Filed Dec. 28,
PURPOSE: This rule describes the condi-            educational requirements, passage of a writ-       2007, effective Aug. 30, 2008.
tions and procedures for the restoration and       ten examination of the type given to appli-
rehabilitation of suspended/revoked licenses.      cants for licensure, making personal appear-       *Original authority: 344.070, RSMo 1969, amended
                                                                                                      1979, 1993, 1995, 2007.
                                                   ances before and periodic reports to the
(1) Each applicant seeking to restore to good      board, and restitution of money or property.
standing a license, issued under Chapter 344,                                                         19 CSR 73-2.130 Notice of Change of
RSMo, which has been revoked, suspended            AUTHORITY: section 344.070, RSMo Supp.
                                                                                                      Address
or if there has been a finding of cause for dis-   1993.* This rule was previously filed as 13
cipline, must present with his/her application     CSR 73-2.105. Original rule filed Oct. 4,
                                                                                                      PURPOSE: This rule describes the condi-
whatever evidence the board may have               1988, effective March 15, 1989. Moved to 19
                                                                                                      tions and procedures for reporting change of
required at the time of the revocation or sus-     CSR 73-2.105, effective March 3, 2003.
                                                                                                      address.
pension. The board may require whatever
steps as are rationally related to the cause of    *Original authority: 344.070, RSMo 1969, amended
                                                   1979, 1993.                                        (1) Each administrator shall notify the board
disciplinary action.                                                                                  office of a current mailing address within
                                                                                                      twenty-one (21) days of change of personal
AUTHORITY: section 344.070, RSMo Supp.             19 CSR 73-2.110 Display of License                 address, facility employment or both.
1993.* This rule was previously filed as 13
CSR 73-2.100. Original rule filed May 13,          PURPOSE: This rule describes the require-          AUTHORITY: section 344.070, RSMo Supp.
1980, effective Aug. 11, 1980. Amended:            ment for display of license.                       1993.* This rule was previously filed as 13
Filed Oct. 4, 1988, effective March 15, 1989.                                                         CSR 73-2.130. Original rule filed May 13,
Moved to 19 CSR 73-2.100, effective March          (1) Every person licensed as a nursing home        1980, effective Aug. 11, 1980. Amended:
3, 2003.                                           administrator shall display the license in a       Filed Oct. 17, 1985, effective March 14,
                                                   conspicuous place in the office or place of        1986. Moved to 19 CSR 73-2.130, effective
*Original authority: 344.070, RSMo 1969, amended   business of employment of that license.
1979, 1993.
                                                                                                      March 3, 2003.
                                                   Affixed to the license shall be verification
                                                   from the board of current renewal.                 *Original authority: 344.070, RSMo 1969, amended
                                                                                                      1979, 1993.
19 CSR 73-2.105 Disciplinary Proceedings           AUTHORITY: section 344.070, RSMo Supp.
                                                   1993.* This rule was previously filed as 13
PURPOSE: This rule describes the board’s
                                                   CSR 73-2.110. Original rule filed May 13,
procedure for the investigation of a complaint
                                                   1980, effective Aug. 11, 1980. Amended:
or referral and stipulates the conduct of dis-
                                                   Filed Oct. 16, 1985, effective March 14,
ciplinary hearings upon receipt of a ruling
                                                   1986. Moved to 19 CSR 73-2.110, effective
from the Administrative Hearing Commis-
                                                   March 3, 2003.
sion that a licensee has violated Chapter 344,
RSMo.                                              *Original authority: 344.070, RSMo 1969, amended
                                                   1979, 1993.
(1) Upon receipt of a complaint or referral,
the board shall investigate the actions of the
licensee against whom the complaint is made.       19 CSR 73-2.120 Duplicate License
In conducting an investigation, the board, in
its discretion, may request the licensee under     PURPOSE: This rule describes the condi-
investigation to answer the charges made           tions and procedure for obtaining a duplicate
against him/her in writing, and to produce         license.
relevant documentary evidence and may
request him/her to appear before the board.        (1) In the event a license is lost or stolen,
A copy of any written answer of the licensee       mutilated or destroyed, the administrator is
may be furnished to the complainant.               required to report the loss immediately to the
                                                   board office. Upon receipt of satisfactory evi-
(2) Upon final ruling by the Administrative        dence that a license has been lost, mutilated
Hearing Commission that the acts of a              or destroyed, the board may issue a duplicate
licensee constitute a violation of the licensure   license upon payment of a fee of ten dollars
law or these rules, the board shall proceed to     ($10). Satisfactory evidence is construed to
revoke or suspend the license of the offending     be a notarized affidavit stating facts of the
licensee or take other authorized action as it     loss, mutilation or destruction of the license.
shall deem appropriate.
                                                   AUTHORITY: section 344.070, RSMo Supp.
(3) After the hearing, the board, singly or in     2007.* This rule was previously filed as 13
combination, may censure or place the              CSR 73-2.120. Original rule filed May 13,
licensee on probation on terms and condi-          1980, effective Aug. 11, 1980. Amended:

14                                                            CODE OF STATE REGULATIONS                           (7/31/08)      ROBIN CARNAHAN
                                                                                                                                 Secretary of State

				
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