1. Program Definition and Services Provided 

Skilled nursing services in Missouri are provided by skilled nursing facilities (SNFs) that offer 24-hour care and medical services. These services include skilled nursing care, intermediate care, rehabilitation, and therapeutic care. Examples of skilled nursing care include administration of medications, wound care, IV therapy, and physical, occupational, and speech therapy 

2. Regulations 

Current regulations governing skilled nursing services in Missouri include: 

• 19 CSR 30-83.010: Defines skilled nursing care and facilities. 

• 19 CSR 30-82.010: General licensure requirements for long-term care facilities, including SNFs. 

• Sections 198.003–198.096, RSMo: Statutes governing long-term care facilities. 

3. Licensing or Certification 

To operate a skilled nursing facility in Missouri, you must obtain a state license from the Department of Health and Senior Services. Certification for Medicare and Medicaid participation is also required for reimbursement 

4. Responsible State Agency 

The Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation, is responsible for issuing licenses and certifications for skilled nursing facilities. 

5. Application Process 

The application process involves submitting the Application for License to Operate a Long-Term Care Facility (MO 580-2631) to the Department of Health and Senior Services. Applications can be obtained from their website or by mail 

6. Required Documentation 

• Application Form: MO 580-2631. 

• License Fee: Varies based on facility capacity. 

• Approved Nursing Home Bond or Noncancelable Escrow Agreement: If personal funds of residents are held in trust. 

• Proof of Financial Capacity: To operate the facility. 

• Certificate of Need: If required. 

• Compliance with Licensure Rules and Laws: Documentation showing substantial compliance. 

7. Timeline for Approval 

The approval process typically involves several months, including review of the application, inspections, and verification of compliance with regulations. 

8. Pre-Application Process 

There is no formal pre-application process, but applicants should ensure they meet all eligibility criteria and have necessary documents ready. 

9. Pre-Application Training 

No specific pre-application training is required, but staff must meet licensing standards and ongoing training requirements once licensed. 

10. Additional Notes 

• Skilled nursing facilities must maintain compliance with federal and state regulations, including staffing ratios and resident rights. 

• Facilities must provide written descriptions of resident rights and follow strict documentation standards for care plans and medication management