Intermediate Care and Skilled Nursing Facility Standards

About 14 of every 50 questions on a Missouri NHA State Exam practice exam come from this topic.

Sources checked November 13, 2026

What to know

Chapter 85 of 19 CSR 30 sets the operating standards for Missouri intermediate care and skilled nursing facilities. The administrator must be licensed, employed full-time and must delegate authority in writing before leaving; an absence over 30 consecutive days, allowed once in 12 months, needs a licensed administrator in charge. Rules cover admissions (no one under 17 unless the home serves mainly minors), licensed capacity, written agreements with outside resources, orientation from the first day, nursing assistant certification within four months, staff ages and badges, and record retention (personnel one year, clinical five years from discharge, financial seven years). A skilled facility needs an RN director of nursing and an RN on the day shift; an intermediate facility with an LPN director needs an RN consultant four hours a week. Medication rules address orders, who may give injections, monthly drug regimen review, locked and double-locked storage, and destruction within 30 days. Resident care rules set two-hour repositioning, restraint checks every 30 minutes, and seven-day communicable disease reports. Separate rules cover meals and menus, fire drills and alarms, room sizes, water and air temperatures, and construction plan approval.

Where it comes from

• 19 CSR 30-85.012
• 19 CSR 30-85.022
• 19 CSR 30-85.032
• 19 CSR 30-85.042
• 19 CSR 30-85.052

Try a practice question

Ready for a full run? The Missouri Nursing Home Administrator State Exam Practice Test is 50 questions in 120 minutes, scored at 75%. For the official exam's details, see Missouri Nursing Home Administrator License Exam Requirements.