Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This rule establishes the general licensure
and application procedures, fees and the rights of applicants for licensure of
adult day care programs.
(1)
Any person who establishes, maintains or operates an adult day care program, or
advertises or holds himself or herself out as being able to perform any adult
day care service, shall obtain the proper license from the division, except as
provided in section (5) of this rule.
(2) An applicant shall submit the following
documents to the division for each proposed associated or freestanding adult
day care program:
(A) A fully completed,
properly signed and notarized Application for License to Operate an Adult Day
Care Program, included herein; and
(B) The required licensure fee.
(3) Every adult day care program
that includes an Alzheimer's special care unit or program as defined in section
198.505, RSMo, shall
submit to the division, as part of the licensure application or renewal, the
following:
(A) A completed Alzheimer's
Special Care Services Disclosure form (MO Form 886-3548), available at
http://www.oa.state.mo.us/gs/form/fm_indiv.htm, stating how the care is
different from the rest of the program in the following areas:
1. The Alzheimer's special care unit's or
program's written statement of its overall philosophy and mission which
reflects the needs of participants afflicted with dementia;
2. The process and criteria for placement in,
or discharge from, the program;
3.
The process used for assessment and establishment of the plan of care and its
implementation, including the method by which the plan of care evolves and is
responsive to changes in condition;
4. Staff training and continuing education
practices;
5. The physical
environment and design features appropriate to support the functioning of
cognitively impaired participants;
6. The frequency and types of participant
activities;
7. The involvement of
families and the availability of family support programs;
8. The costs of care and any additional fees;
and
9. Safety and security
measures; and
(B) A
document approved by the division which contains, but is not limited to,
updated information on selecting an Alzheimer's special care unit or
program.
(4) A
nonrefundable fee shall accompany each adult day care program application for
license according to the following schedule for licensed capacity which is the
number of program participants who may be present at any one time:
(A) For eight (8) participants or fewer, the
fee is twenty-five dollars ($25);
(B) For nine through sixteen (9-16)
participants, the fee is fifty dollars ($50);
(C) For seventeen through twenty-four (17-24)
participants, the fee is seventy-five dollars ($75); and
(D) For twenty-five (25) or more
participants, the fee is one hundred dollars ($100).
(5) Unless the program has voluntarily
submitted to licensure in accordance with section
660.409, RSMo, adult
day care licensure requirements shall not apply to any:
(A) Adult day care program operated by a
person in which care is offered for no more than two (2) hours per
day;
(B) Adult day care program
maintained or operated by the federal government except where care is provided
through a management contract;
(C)
Person who cares solely for persons related to the adult day care provider or
who has been designated as guardian of that person;
(D) Adult day care program which cares for no
more than four (4) persons who are not related to the adult day care provider
as defined in 19 CSR 30-90.010;
(E)
Adult day care program licensed by the Department of Mental Health under
Chapter 630, RSMo, which provides care, treatment and habilitation exclusively
to adults who have a primary diagnosis of mental disorder, mental illness,
mental retardation or developmental disability; or
(F) Adult day care program administered or
maintained by a religious not-for-profit organization serving a social or
religious function if the adult day care program does not hold itself out as
providing the prescription or usage of physical or medical therapeutic
activities or as providing or administering medicines or drugs.
(6) The division shall review each
application and investigate each applicant and adult day care program to
determine if they comply with the adult day care licensure law and these
regulations and to insure that the health and safety of the participants are
protected.
(7) If the adult day
care program and the applicant are found to be in compliance, a regular license
will be issued for a period not to exceed two (2) years for the premises and
persons named in the application.
(8) If an adult day care program is not
currently meeting all of the requirements for licensure but demonstrates the
potential capacity to meet the full requirements for licensure, a provisional
license may be issued if there is no detriment to the health, safety and
welfare of the participants in the program. The provisional license is
nonrenewable and will be valid for a maximum of six (6) months. Any regular
license issued subsequent to a provisional license will be valid for a period
not to exceed two (2) years from the date that the provisional license was
issued.
(9) Licensure renewal
applications will be sent to adult day care providers at least sixty (60) days
prior to the expiration date of the current license. Renewal applications must
be accompanied by the required nonrefundable fee and be postmarked at least
thirty (30) days prior to the expiration date of the current license.
(10) A regular or provisional license may be
revoked or suspended for failure to comply with statutory or regulatory
requirements. The division may revoke or suspend a license in any case in which
it finds that the adult day care provider:
(A)
Failed to comply with any lawful request from the division to inspect the
premises or investigate any complaint to determine compliance with sections
660.403 through
660.420,
RSMo;
(B) Falsified documents,
records or any relevant information relating to the operation of the adult day
care program;
(C) Placed
participants in immediate danger whether or not the adult day care program or
adult day care provider corrected the situation which placed participants in
immediate danger; or
(D) Failed to
achieve substantial compliance with statutory and regulatory requirements after
being given a reasonable opportunity and period of time in which to correct the
deficiencies cited by the division.
(11) If any person is refused a license, or a
license is suspended or revoked, or other official action by the division is
detrimental to the provider of an adult day care program, a determination from
the Administrative Hearing Commission may be requested pursuant to provisions
of section
621.045,
RSMo et seq. This action must be taken within thirty (30) calendar days of
official notification of the adverse action taken by the division.
(12) The license, or provisional license,
issued to the adult day care provider, shall not be transferable when there is
a change of ownership or when the program is moved to another location,
building or premises.
(13) The
application for an adult day care program license shall be signed by the
applicant's owner, chairman of the board or chief executive officer and shall
be notarized.
(14) The division
may, subject to the considerations noted below, grant exceptions for specified
periods of time to any rule imposed by the division if the division determines
that the exception to the rule would not potentially endanger the health,
safety or welfare of any participant in the adult day care program.
(A) The owner or operator of the adult day
care program shall make requests for exceptions in writing to the director of
the division. The requests shall contain:
1.
If the exception request is being made due to a deficiency being cited, a copy
of the latest Letter of Notification which indicates the violation;
2. The section number and text of the rule
for which the exception is being requested;
3. Specific reasons why compliance with the
rule would impose an undue hardship on the operator, including an estimate of
any additional cost that might be involved;
4. An explanation of the relevant or
extenuating factors; and
5. A
complete description of the individual characteristics of the premises,
program, participants or other factors that would safeguard the health, safety
and welfare of the participants if the exception were granted.
(B) The division shall issue a
written decision stating the reasons for approval or denial of the request for
an exception. If approved, the length of time the exception will be in effect
and any additional corrective factors upon which the exception is granted shall
be stated in the decision.
(C) The
division shall only grant exceptions to licensure requirements set out in rules
imposed by the division and cannot grant exceptions to requirements established
by state statutes, federal regulations or state regulations of other state
agencies.
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*Original authority: 660.050, RSMo 1984, amended 1988,
1992, 1993, 1994, 1995, 2001 and 660.418, RSMo 1984, amended 1993,
1994.
