About Assisted Living in Missouri

Missouri not only boasts that it’s one of the friendliest places in the United States, but it retains characteristics of the Midwest, the South, and the West, making it culturally diverse. The overall cost of living is less than the national average, and the cost nursing home and assisted living care is also lower than average.

What Options are Available for Assisted Living?

In the state of Missouri an assisted living facility (ALF) provides 24 hour care and protective oversight to 3 or more unrelated residents. A residential care facility (RCF) provides the same services with the exception that all residents must be physically and mentally capable of negotiating a path to safety unassisted or with the use of assistive devices.

Both ALFs and RCFs are required to disclose information regarding services and costs, as well as statements of resident rights, a copy of any facility policies on conduct and responsibilities, and information about community-based services that are available. They must also provide care or treatment information for Alzheimer’s and related dementias if a special care unit is available.

ALFs and RCFs must comply with National Fire Protection Association codes and standards, including the use of smoke detectors, fire sprinklers, and extinguishers, as well as fire safety measures, including training, drills, and written preparedness plans to meet potential emergencies or disasters.

What are the Alzheimer’s Requirements for Assisted Living Facilities in Missouri?

Any facility that has Alzheimer’s special care must provide documentation to any person seeking information about the unit. Both ALFs and RCFs can provide Alzheimer’s care but they must disclose all of the following:

  • Philosophy and mission in relation to dementia.
  • Criteria for admittance or transfer into special care.
  • Staff training and continuous education requirements.
  • Physical environment and design in regards to resident safety.
  • Types and frequency of activities.
  • Family involvement and support programs.
  • Cost of care, including additional fees and services.
  • Safety and security measures.

Senior Assisted Living Details and Costs for Cities in Missouri

Found below are some of the larger cities in Missouri. Each city page provides details on assisted living facilities, independent living, senior apartments and homes, and memory care facilities. Details may include amenities, services offered and other useful information.

What Training is Required for Facility Staff?

All new employees are required to complete orientation specific to their jobs - 1 hour for RCFs and 2 for ALFs. Orientation not only includes job responsibilities and functions, but also emergency response procedures, infection control, confidentiality, abuse/neglect and reporting, resident rights and protection of property, and working with mental illness. ALFs require additional training on appropriate ways to transfer a resident. Both ALF and RCF employees are required to complete fire safety training.

All staff who provide direct care to Alzheimer’s or other cognitively impaired residents must have at least 3 hours of dementia-specific orientation training. All other’s working in a special care unit must have 1 hour of dementia-specific training. All staff must complete ongoing in-service dementia training.

Is an Assessment Required Before Move-In?

A pre-move-in screening is required for ALFs prior to move-in, and within 5 days after admission a community-based assessment must be completed. Within 10 days of admission a physical exam by a licensed physician must also be completed and documented, including any orders for ongoing care. The assessment will be reviewed anytime there’s a significant change in the resident’s condition or semiannually.

For RCFs a physical examination must be performed by a licensed physician no later than 10 days of admission. Documentation of the resident’s current medical status and special orders and procedures should be followed and a monthly review will be made to make sure the residents needs are being met.

What Care is Available in an Assisted Living Facility?

  • Room and board.
  • Assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).
  • Storage, distribution, or administration of medications.
  • Supervision of health care under the direct of a licensed physician.

How is Medication Managed?

Both ALFs and RCF require professional review of medications and regimen every 1 to 3 months depending on the facility. In both facilities, all staff who administer medication must be a Level I Medication Aide (LIMA), and are required to have a safe and effective system for medication control and use.

What are the Bathroom Requirements for Assisted Living and Residential Care Facilities?

Both ALFs and RCFs require at least 1 tub or shower for every 20 residents and 1 toilet and sink for every 6. Separate bathing facilities must be provided if the facility houses more than 20 residents.

What are the Move-in or Move-out Requirements?

ALFs and RCFs can only admit residents whose needs can be met by the facility, and may not admit nor retain residents who:

  • Poses a threat to themselves or others.
  • Requires physical or chemical restraints.
  • Requires skilled nursing care.
  • Requires more than one person to provide physical assistance.
  • Is bed-bound.
  • Under the age of 16 years.
  • Is unable to pay for services.

Both ALFs and RCFs are required to give a 30-day notice to transfer or discharge a resident, and both are required to keep detailed records as to why the resident is being discharged or transferred.

Are Assisted Living and Residential Care Facilities Covered by Medicaid in the State of Missouri?

Yes. The Medicaid state plan covers bother personal care and advanced personal care services.

Who can I contact for more information?

Department of Health and Senior Services, Division of Regulation and Licensure, Section for Long Term Care Regulation
Missouri Department of Health and Senior Services
(573) 751-6400