Nursing Homes--How They’re Inspected

How Many Nursing Homes and Other Care facilities are there?  Missouri’s nursing homes and other long term care facilities provide different levels of care depending upon a person’s needs. Generally, people who live in skilled nursing homes need a lot of care while those in residential care facilities do not.  Of the 1,146 facilities, 495 are skilled nursing (SNF), 35 are intermediate care (ICF), 471 are residential care facilities (RCF and RCF*), 145 are assisted living facilities (ALF and ALF**) and 29 are hospital-based long-term care units. Approximately 466 participate in the Federal Medicaid and/or Medicare programs.

How are Long-Term Care Facilities Inspected?
The Department of Health and Senior Services (DHSS) inspects and licenses these facilities. DHSS also certifies intermediate care and skilled nursing facilities for Medicare and Medicaid. Facilities must meet additional requirements to participate in bo th federal programs. DHSS also investigates complaints about long-term care facilities and resident abuse or neglect.

State law requires that DHSS inspect each long-term care facility twice in a fiscal year. The fiscal year is July 1 – June 30. A federal inspection is also required every 9 to 15 months for Medicare- and/or Medicaid-certified faciliti es. DHSS does both the state and federal inspection. Both inspections usually occur at the same time and are unannounced.

The Inspection Process Before an inspection, a DHSS team reviews the facility’s records and previous survey and complaint investigation results. The team then visits the facility to observe and evaluate resident care and services and facility safety. Inspectors also interview facility staff, residents and residents' family members.

Inspectors may cite the facility with one or more deficiencies if it is not in compliance with federal and/or state regulations. One deficiency may violate both a federal and a state regulation. If so, the facility is cited twice—at b oth the federal and state level. Every federal deficiency cited is assigned a scope and severity. Scope indicates how many residents are affected. Severity in dicates the level of harm. State deficiencies are classified as a Class I, II, or III, with I being the most severe and III being the least severe.

DHSS sends a written Statement of Deficiencies (SOD) to non-compliant facilities describing each violation. Facility administrators are required to prepare a written Plan of Correction (POC) explaining how and when they intend to correct th e deficiencies. DHSS must approve the POC. DHSS may conduct up to three facility revisits to ensure the required corrections are implemented appropriately and on time.

Information on the Web site
The DHSS Web site contains information on annual federal recertification and state licensure inspections conducted since January 1, 2004. Annual inspection information is available on the Web site approximately 30 to 120 days after the annual inspection is completed.

Explanation of the Inspection Results ‘Date Corrected’ Column: For federal- recertification inspections, one of two dates can appear in the ‘Date Corrected’ column: 1) the date the deficiency was co rrected according to the facility's Plan of Correction or, 2) the revisit date which confirms the correction. For state-licensure-only-inspections, the revisit date appears in the ‘Date Corrected’ column. Sometimes, a deficiency may not includ e a date in the ‘Date Corrected’ column. Here’s why:

Life-safety code deficiencies - A correction date will not appear for life-safety code citations if the facility has implemented alternative measures to meet the intent of the regulation.

Deficiencies that do not require correction - If a state-licensure inspection results in less than twenty Class III state violations and no Class I or Class II violations, the violations do not have to be corrected. This means a correcti on date may not appear in the ‘Date Corrected’ column. Likewise, if a federal-recertification inspection results in violations where "no actual harm with potential for minimal harm" occurred, a correction date is not required.

To Obtain More Information
To request more information, inquire if a facility has been the subject of a complaint investigation, or undergone a recent annual inspection not yet posted to the Web site, please contact:

For stand-alone long-term care facilities, (573) 522-1516.

For long-term care units operating inside hospitals, (573) 751-6303.

All long-term care facilities are also required to have their latest inspection results available for public inspection.

Disclaimer
Information on this Web page should not be construed as an endorsement or advertisement for any long-term care facility. Information obtained from this Web site should not be used as the sole criteria for selecting a nursing facility. Please see Selecting a Nursing Home or Long-Term Care Facility for more information.

To search for inspection results for a particular long-term care facility, by county, city, or 5- digit zip code, visit Show-Me Long-Term Care.