198.006. As used in sections 198.003 to 198.186, unless the contextclearly indicates otherwise, the following terms mean:
(1) "Abuse", the infliction of physical, sexual, or emotional injury orharm;
(2) "Activities of daily living" or "ADL", one or more of the followingactivities of daily living:
(a) Eating;
(b) Dressing;
(c) Bathing;
(d) Toileting;
(e) Transferring; and
(f) Walking;
(3) "Administrator", the person who is in general administrative chargeof a facility;
(4) "Affiliate":
(a) With respect to a partnership, each partner thereof;
(b) With respect to a limited partnership, the general partner and eachlimited partner with an interest of five percent or more in the limitedpartnership;
(c) With respect to a corporation, each person who owns, holds or hasthe power to vote five percent or more of any class of securities issued bythe corporation, and each officer and director;
(d) With respect to a natural person, any parent, child, sibling, orspouse of that person;
(5) "Appropriately trained and qualified individual", an individual whois licensed or registered with the state of Missouri in a health care-relatedfield or an individual with a degree in a health care-related field or anindividual with a degree in a health care, social services, or human servicesfield or an individual licensed under chapter 344, RSMo, and who has receivedfacility orientation training under 19 CSR 30-86042(18), and dementia trainingunder section 660.050, RSMo, and twenty-four hours of additional training,approved by the department, consisting of definition and assessment ofactivities of daily living, assessment of cognitive ability, service planning,and interview skills;
(6) "Assisted living facility", any premises, other than a residentialcare facility, intermediate care facility, or skilled nursing facility, thatis utilized by its owner, operator, or manager to provide twenty-four-hourcare and services and protective oversight to three or more residents who areprovided with shelter, board, and who may need and are provided with thefollowing:
(a) Assistance with any activities of daily living and any instrumentalactivities of daily living;
(b) Storage, distribution, or administration of medications; and
(c) Supervision of health care under the direction of a licensedphysician, provided that such services are consistent with a social model ofcare;
Such term shall not include a facility where all of the residents are relatedwithin the fourth degree of consanguinity or affinity to the owner, operator,or manager of the facility;
(7) "Community-based assessment", documented basic information andanalysis provided by appropriately trained and qualified individualsdescribing an individual's abilities and needs in activities of daily living,instrumental activities of daily living, vision/hearing, nutrition, socialparticipation and support, and cognitive functioning using an assessment toolapproved by the department of health and senior services that is designed forcommunity-based services and that is not the nursing home minimum data set;
(8) "Dementia", a general term for the loss of thinking, remembering,and reasoning so severe that it interferes with an individual's dailyfunctioning, and may cause symptoms that include changes in personality, mood,and behavior;
(9) "Department", the Missouri department of health and senior services;
(10) "Emergency", a situation, physical condition or one or morepractices, methods or operations which presents imminent danger of death orserious physical or mental harm to residents of a facility;
(11) "Facility", any residential care facility, assisted livingfacility, intermediate care facility, or skilled nursing facility;
(12) "Health care provider", any person providing health care servicesor goods to residents and who receives funds in payment for such goods orservices under Medicaid;
(13) "Instrumental activities of daily living", or "IADL", one or moreof the following activities:
(a) Preparing meals;
(b) Shopping for personal items;
(c) Medication management;
(d) Managing money;
(e) Using the telephone;
(f) Housework; and
(g) Transportation ability;
(14) "Intermediate care facility", any premises, other than aresidential care facility, assisted living facility, or skilled nursingfacility, which is utilized by its owner, operator, or manager to providetwenty-four-hour accommodation, board, personal care, and basic health andnursing care services under the daily supervision of a licensed nurse andunder the direction of a licensed physician to three or more residentsdependent for care and supervision and who are not related within the fourthdegree of consanguinity or affinity to the owner, operator or manager of thefacility;
(15) "Manager", any person other than the administrator of a facilitywho contracts or otherwise agrees with an owner or operator to supervise thegeneral operation of a facility, providing such services as hiring andtraining personnel, purchasing supplies, keeping financial records, and makingreports;
(16) "Medicaid", medical assistance under section 208.151, RSMo, etseq., in compliance with Title XIX, Public Law 89-97, 1965 amendments to theSocial Security Act (42 U.S.C. 301, et seq.), as amended;
(17) "Neglect", the failure to provide, by those responsible for thecare, custody, and control of a resident in a facility, the services which arereasonable and necessary to maintain the physical and mental health of theresident, when such failure presents either an imminent danger to the health,safety or welfare of the resident or a substantial probability that death orserious physical harm would result;
(18) "Operator", any person licensed or required to be licensed underthe provisions of sections 198.003 to 198.096 in order to establish, conductor maintain a facility;
(19) "Owner", any person who owns an interest of five percent or morein:
(a) The land on which any facility is located;
(b) The structure or structures in which any facility is located;
(c) Any mortgage, contract for deed, or other obligation secured inwhole or in part by the land or structure in or on which a facility islocated; or
(d) Any lease or sublease of the land or structure in or on which afacility is located.
"Owner" does not include a holder of a debenture or bond purchased at publicissue nor does it include any regulated lender unless the entity or persondirectly or through a subsidiary operates a facility;
(20) "Protective oversight", an awareness twenty-four hours a day of thelocation of a resident, the ability to intervene on behalf of the resident,the supervision of nutrition, medication, or actual provisions of care, andthe responsibility for the welfare of the resident, except where the residentis on voluntary leave;
(21) "Resident", a person who by reason of aging, illness, disease, orphysical or mental infirmity receives or requires care and services furnishedby a facility and who resides or boards in or is otherwise kept, cared for,treated or accommodated in such facility for a period exceeding twenty-fourconsecutive hours;
(22) "Residential care facility", any premises, other than an assistedliving facility, intermediate care facility, or skilled nursing facility,which is utilized by its owner, operator or manager to providetwenty-four-hour care to three or more residents, who are not related withinthe fourth degree of consanguinity or affinity to the owner, operator, ormanager of the facility and who need or are provided with shelter, board, andwith protective oversight, which may include storage and distribution oradministration of medications and care during short-term illness orrecuperation, except that, for purposes of receiving supplemental welfareassistance payments under section 208.030, RSMo, only any residential carefacility licensed as a residential care facility II immediately prior toAugust 28, 2006, and that continues to meet such licensure requirements for aresidential care facility II licensed immediately prior to August 28, 2006,shall continue to receive after August 28, 2006, the payment amount allocatedimmediately prior to August 28, 2006, for a residential care facility II undersection 208.030;
(23) "Skilled nursing facility", any premises, other than a residentialcare facility, an assisted living facility, or an intermediate care facility,which is utilized by its owner, operator or manager to provide fortwenty-four-hour accommodation, board and skilled nursing care and treatmentservices to at least three residents who are not related within the fourthdegree of consanguinity or affinity to the owner, operator or manager of thefacility. Skilled nursing care and treatment services are those servicescommonly performed by or under the supervision of a registered professionalnurse for individuals requiring twenty-four-hours-a-day care by licensednursing personnel including acts of observation, care and counsel of the aged,ill, injured or infirm, the administration of medications and treatments asprescribed by a licensed physician or dentist, and other nursing functionsrequiring substantial specialized judgment and skill;
(24) "Social model of care", long-term care services based on theabilities, desires, and functional needs of the individual delivered in asetting that is more home-like than institutional and promotes the dignity,individuality, privacy, independence, and autonomy of the individual. Anyfacility licensed as a residential care facility II prior to August 28, 2006,shall qualify as being more home-like than institutional with respect toconstruction and physical plant standards;
(25) "Vendor", any person selling goods or services to a health careprovider;
(26) "Voluntary leave", an off-premise leave initiated by:
(a) A resident that has not been declared mentally incompetent orincapacitated by a court; or
(b) A legal guardian of a resident that has been declared mentallyincompetent or incapacitated by a court.
198.006. As used in sections 198.003 to 198.186, unless the contextclearly indicates otherwise, the following terms mean:
(1) "Abuse", the infliction of physical, sexual, or emotional injury orharm;
(2) "Activities of daily living" or "ADL", one or more of the followingactivities of daily living:
(a) Eating;
(b) Dressing;
(c) Bathing;
(d) Toileting;
(e) Transferring; and
(f) Walking;
(3) "Administrator", the person who is in general administrative chargeof a facility;
(4) "Affiliate":
(a) With respect to a partnership, each partner thereof;
(b) With respect to a limited partnership, the general partner and eachlimited partner with an interest of five percent or more in the limitedpartnership;
(c) With respect to a corporation, each person who owns, holds or hasthe power to vote five percent or more of any class of securities issued bythe corporation, and each officer and director;
(d) With respect to a natural person, any parent, child, sibling, orspouse of that person;
(5) "Appropriately trained and qualified individual", an individual whois licensed or registered with the state of Missouri in a health care-relatedfield or an individual with a degree in a health care-related field or anindividual with a degree in a health care, social services, or human servicesfield or an individual licensed under chapter 344, RSMo, and who has receivedfacility orientation training under 19 CSR 30-86042(18), and dementia trainingunder section 660.050, RSMo, and twenty-four hours of additional training,approved by the department, consisting of definition and assessment ofactivities of daily living, assessment of cognitive ability, service planning,and interview skills;
(6) "Assisted living facility", any premises, other than a residentialcare facility, intermediate care facility, or skilled nursing facility, thatis utilized by its owner, operator, or manager to provide twenty-four-hourcare and services and protective oversight to three or more residents who areprovided with shelter, board, and who may need and are provided with thefollowing:
(a) Assistance with any activities of daily living and any instrumentalactivities of daily living;
(b) Storage, distribution, or administration of medications; and
(c) Supervision of health care under the direction of a licensedphysician, provided that such services are consistent with a social model ofcare;
Such term shall not include a facility where all of the residents are relatedwithin the fourth degree of consanguinity or affinity to the owner, operator,or manager of the facility;
(7) "Community-based assessment", documented basic information andanalysis provided by appropriately trained and qualified individualsdescribing an individual's abilities and needs in activities of daily living,instrumental activities of daily living, vision/hearing, nutrition, socialparticipation and support, and cognitive functioning using an assessment toolapproved by the department of health and senior services that is designed forcommunity-based services and that is not the nursing home minimum data set;
(8) "Dementia", a general term for the loss of thinking, remembering,and reasoning so severe that it interferes with an individual's dailyfunctioning, and may cause symptoms that include changes in personality, mood,and behavior;
(9) "Department", the Missouri department of health and senior services;
(10) "Emergency", a situation, physical condition or one or morepractices, methods or operations which presents imminent danger of death orserious physical or mental harm to residents of a facility;
(11) "Facility", any residential care facility, assisted livingfacility, intermediate care facility, or skilled nursing facility;
(12) "Health care provider", any person providing health care servicesor goods to residents and who receives funds in payment for such goods orservices under Medicaid;
(13) "Instrumental activities of daily living", or "IADL", one or moreof the following activities:
(a) Preparing meals;
(b) Shopping for personal items;
(c) Medication management;
(d) Managing money;
(e) Using the telephone;
(f) Housework; and
(g) Transportation ability;
(14) "Intermediate care facility", any premises, other than aresidential care facility, assisted living facility, or skilled nursingfacility, which is utilized by its owner, operator, or manager to providetwenty-four-hour accommodation, board, personal care, and basic health andnursing care services under the daily supervision of a licensed nurse andunder the direction of a licensed physician to three or more residentsdependent for care and supervision and who are not related within the fourthdegree of consanguinity or affinity to the owner, operator or manager of thefacility;
(15) "Manager", any person other than the administrator of a facilitywho contracts or otherwise agrees with an owner or operator to supervise thegeneral operation of a facility, providing such services as hiring andtraining personnel, purchasing supplies, keeping financial records, and makingreports;
(16) "Medicaid", medical assistance under section 208.151, RSMo, etseq., in compliance with Title XIX, Public Law 89-97, 1965 amendments to theSocial Security Act (42 U.S.C. 301, et seq.), as amended;
(17) "Neglect", the failure to provide, by those responsible for thecare, custody, and control of a resident in a facility, the services which arereasonable and necessary to maintain the physical and mental health of theresident, when such failure presents either an imminent danger to the health,safety or welfare of the resident or a substantial probability that death orserious physical harm would result;
(18) "Operator", any person licensed or required to be licensed underthe provisions of sections 198.003 to 198.096 in order to establish, conductor maintain a facility;
(19) "Owner", any person who owns an interest of five percent or morein:
(a) The land on which any facility is located;
(b) The structure or structures in which any facility is located;
(c) Any mortgage, contract for deed, or other obligation secured inwhole or in part by the land or structure in or on which a facility islocated; or
(d) Any lease or sublease of the land or structure in or on which afacility is located.
"Owner" does not include a holder of a debenture or bond purchased at publicissue nor does it include any regulated lender unless the entity or persondirectly or through a subsidiary operates a facility;
(20) "Protective oversight", an awareness twenty-four hours a day of thelocation of a resident, the ability to intervene on behalf of the resident,the supervision of nutrition, medication, or actual provisions of care, andthe responsibility for the welfare of the resident, except where the residentis on voluntary leave;
(21) "Resident", a person who by reason of aging, illness, disease, orphysical or mental infirmity receives or requires care and services furnishedby a facility and who resides or boards in or is otherwise kept, cared for,treated or accommodated in such facility for a period exceeding twenty-fourconsecutive hours;
(22) "Residential care facility", any premises, other than an assistedliving facility, intermediate care facility, or skilled nursing facility,which is utilized by its owner, operator or manager to providetwenty-four-hour care to three or more residents, who are not related withinthe fourth degree of consanguinity or affinity to the owner, operator, ormanager of the facility and who need or are provided with shelter, board, andwith protective oversight, which may include storage and distribution oradministration of medications and care during short-term illness orrecuperation, except that, for purposes of receiving supplemental welfareassistance payments under section 208.030, RSMo, only any residential carefacility licensed as a residential care facility II immediately prior toAugust 28, 2006, and that continues to meet such licensure requirements for aresidential care facility II licensed immediately prior to August 28, 2006,shall continue to receive after August 28, 2006, the payment amount allocatedimmediately prior to August 28, 2006, for a residential care facility II undersection 208.030;
(23) "Skilled nursing facility", any premises, other than a residentialcare facility, an assisted living facility, or an intermediate care facility,which is utilized by its owner, operator or manager to provide fortwenty-four-hour accommodation, board and skilled nursing care and treatmentservices to at least three residents who are not related within the fourthdegree of consanguinity or affinity to the owner, operator or manager of thefacility. Skilled nursing care and treatment services are those servicescommonly performed by or under the supervision of a registered professionalnurse for individuals requiring twenty-four-hours-a-day care by licensednursing personnel including acts of observation, care and counsel of the aged,ill, injured or infirm, the administration of medications and treatments asprescribed by a licensed physician or dentist, and other nursing functionsrequiring substantial specialized judgment and skill;
(24) "Social model of care", long-term care services based on theabilities, desires, and functional needs of the individual delivered in asetting that is more home-like than institutional and promotes the dignity,individuality, privacy, independence, and autonomy of the individual. Anyfacility licensed as a residential care facility II prior to August 28, 2006,shall qualify as being more home-like than institutional with respect toconstruction and physical plant standards;
(25) "Vendor", any person selling goods or services to a health careprovider;
(26) "Voluntary leave", an off-premise leave initiated by:
(a) A resident that has not been declared mentally incompetent orincapacitated by a court; or
(b) A legal guardian of a resident that has been declared mentallyincompetent or incapacitated by a court.
198.006. As used in sections 198.003 to 198.186, unless the contextclearly indicates otherwise, the following terms mean:
(1) "Abuse", the infliction of physical, sexual, or emotional injury orharm;
(2) "Activities of daily living" or "ADL", one or more of the followingactivities of daily living:
(a) Eating;
(b) Dressing;
(c) Bathing;
(d) Toileting;
(e) Transferring; and
(f) Walking;
(3) "Administrator", the person who is in general administrative chargeof a facility;
(4) "Affiliate":
(a) With respect to a partnership, each partner thereof;
(b) With respect to a limited partnership, the general partner and eachlimited partner with an interest of five percent or more in the limitedpartnership;
(c) With respect to a corporation, each person who owns, holds or hasthe power to vote five percent or more of any class of securities issued bythe corporation, and each officer and director;
(d) With respect to a natural person, any parent, child, sibling, orspouse of that person;
(5) "Appropriately trained and qualified individual", an individual whois licensed or registered with the state of Missouri in a health care-relatedfield or an individual with a degree in a health care-related field or anindividual with a degree in a health care, social services, or human servicesfield or an individual licensed under chapter 344, RSMo, and who has receivedfacility orientation training under 19 CSR 30-86042(18), and dementia trainingunder section 660.050, RSMo, and twenty-four hours of additional training,approved by the department, consisting of definition and assessment ofactivities of daily living, assessment of cognitive ability, service planning,and interview skills;
(6) "Assisted living facility", any premises, other than a residentialcare facility, intermediate care facility, or skilled nursing facility, thatis utilized by its owner, operator, or manager to provide twenty-four-hourcare and services and protective oversight to three or more residents who areprovided with shelter, board, and who may need and are provided with thefollowing:
(a) Assistance with any activities of daily living and any instrumentalactivities of daily living;
(b) Storage, distribution, or administration of medications; and
(c) Supervision of health care under the direction of a licensedphysician, provided that such services are consistent with a social model ofcare;
Such term shall not include a facility where all of the residents are relatedwithin the fourth degree of consanguinity or affinity to the owner, operator,or manager of the facility;
(7) "Community-based assessment", documented basic information andanalysis provided by appropriately trained and qualified individualsdescribing an individual's abilities and needs in activities of daily living,instrumental activities of daily living, vision/hearing, nutrition, socialparticipation and support, and cognitive functioning using an assessment toolapproved by the department of health and senior services that is designed forcommunity-based services and that is not the nursing home minimum data set;
(8) "Dementia", a general term for the loss of thinking, remembering,and reasoning so severe that it interferes with an individual's dailyfunctioning, and may cause symptoms that include changes in personality, mood,and behavior;
(9) "Department", the Missouri department of health and senior services;
(10) "Emergency", a situation, physical condition or one or morepractices, methods or operations which presents imminent danger of death orserious physical or mental harm to residents of a facility;
(11) "Facility", any residential care facility, assisted livingfacility, intermediate care facility, or skilled nursing facility;
(12) "Health care provider", any person providing health care servicesor goods to residents and who receives funds in payment for such goods orservices under Medicaid;
(13) "Instrumental activities of daily living", or "IADL", one or moreof the following activities:
(a) Preparing meals;
(b) Shopping for personal items;
(c) Medication management;
(d) Managing money;
(e) Using the telephone;
(f) Housework; and
(g) Transportation ability;
(14) "Intermediate care facility", any premises, other than aresidential care facility, assisted living facility, or skilled nursingfacility, which is utilized by its owner, operator, or manager to providetwenty-four-hour accommodation, board, personal care, and basic health andnursing care services under the daily supervision of a licensed nurse andunder the direction of a licensed physician to three or more residentsdependent for care and supervision and who are not related within the fourthdegree of consanguinity or affinity to the owner, operator or manager of thefacility;
(15) "Manager", any person other than the administrator of a facilitywho contracts or otherwise agrees with an owner or operator to supervise thegeneral operation of a facility, providing such services as hiring andtraining personnel, purchasing supplies, keeping financial records, and makingreports;
(16) "Medicaid", medical assistance under section 208.151, RSMo, etseq., in compliance with Title XIX, Public Law 89-97, 1965 amendments to theSocial Security Act (42 U.S.C. 301, et seq.), as amended;
(17) "Neglect", the failure to provide, by those responsible for thecare, custody, and control of a resident in a facility, the services which arereasonable and necessary to maintain the physical and mental health of theresident, when such failure presents either an imminent danger to the health,safety or welfare of the resident or a substantial probability that death orserious physical harm would result;
(18) "Operator", any person licensed or required to be licensed underthe provisions of sections 198.003 to 198.096 in order to establish, conductor maintain a facility;
(19) "Owner", any person who owns an interest of five percent or morein:
(a) The land on which any facility is located;
(b) The structure or structures in which any facility is located;
(c) Any mortgage, contract for deed, or other obligation secured inwhole or in part by the land or structure in or on which a facility islocated; or
(d) Any lease or sublease of the land or structure in or on which afacility is located.
"Owner" does not include a holder of a debenture or bond purchased at publicissue nor does it include any regulated lender unless the entity or persondirectly or through a subsidiary operates a facility;
(20) "Protective oversight", an awareness twenty-four hours a day of thelocation of a resident, the ability to intervene on behalf of the resident,the supervision of nutrition, medication, or actual provisions of care, andthe responsibility for the welfare of the resident, except where the residentis on voluntary leave;
(21) "Resident", a person who by reason of aging, illness, disease, orphysical or mental infirmity receives or requires care and services furnishedby a facility and who resides or boards in or is otherwise kept, cared for,treated or accommodated in such facility for a period exceeding twenty-fourconsecutive hours;
(22) "Residential care facility", any premises, other than an assistedliving facility, intermediate care facility, or skilled nursing facility,which is utilized by its owner, operator or manager to providetwenty-four-hour care to three or more residents, who are not related withinthe fourth degree of consanguinity or affinity to the owner, operator, ormanager of the facility and who need or are provided with shelter, board, andwith protective oversight, which may include storage and distribution oradministration of medications and care during short-term illness orrecuperation, except that, for purposes of receiving supplemental welfareassistance payments under section 208.030, RSMo, only any residential carefacility licensed as a residential care facility II immediately prior toAugust 28, 2006, and that continues to meet such licensure requirements for aresidential care facility II licensed immediately prior to August 28, 2006,shall continue to receive after August 28, 2006, the payment amount allocatedimmediately prior to August 28, 2006, for a residential care facility II undersection 208.030;
(23) "Skilled nursing facility", any premises, other than a residentialcare facility, an assisted living facility, or an intermediate care facility,which is utilized by its owner, operator or manager to provide fortwenty-four-hour accommodation, board and skilled nursing care and treatmentservices to at least three residents who are not related within the fourthdegree of consanguinity or affinity to the owner, operator or manager of thefacility. Skilled nursing care and treatment services are those servicescommonly performed by or under the supervision of a registered professionalnurse for individuals requiring twenty-four-hours-a-day care by licensednursing personnel including acts of observation, care and counsel of the aged,ill, injured or infirm, the administration of medications and treatments asprescribed by a licensed physician or dentist, and other nursing functionsrequiring substantial specialized judgment and skill;
(24) "Social model of care", long-term care services based on theabilities, desires, and functional needs of the individual delivered in asetting that is more home-like than institutional and promotes the dignity,individuality, privacy, independence, and autonomy of the individual. Anyfacility licensed as a residential care facility II prior to August 28, 2006,shall qualify as being more home-like than institutional with respect toconstruction and physical plant standards;
(25) "Vendor", any person selling goods or services to a health careprovider;
(26) "Voluntary leave", an off-premise leave initiated by:
(a) A resident that has not been declared mentally incompetent orincapacitated by a court; or
(b) A legal guardian of a resident that has been declared mentallyincompetent or incapacitated by a court.
