Rules of Department of Health and Senior Services Division 30—Division of Regulation and Licensure Chapter 20—Hospitals Title Page 19 CSR 30-20.001 Anesthesiologist Assistants in Hospitals ....................................................3 19 CSR 30-20.011 Definitions Relating to Hospitals ............................................................3 19 CSR 30-20.015 Administration of the Hospital Licensing Program .......................................5 19 CSR 30-20.021 Organization and Management for Hospitals (Rescinded February 29, 2008) ............................................................11 19 CSR 30-20.030 Construction Standards for New Hospitals ...............................................11 19 CSR 30-20.040 Definitions Relating to Long-Term Care Units in Hospitals...........................25 19 CSR 30-20.050 Standards for the Operation of Long-Term Care Units in Hospitals .................26 19 CSR 30-20.060 Construction Standards for New Long-Term Care Units in Hospitals ...............29 19 CSR 30-20.070 Standards for Registration as a Hospital Infectious Waste Generator ................30 19 CSR 30-20.080 Governing Body of Hospitals ...............................................................32 19 CSR 30-20.082 Chief Executive Officer in Hospitals ......................................................32 19 CSR 30-20.084 Patients’ Rights in Hospitals ................................................................33 19 CSR 30-20.086 Medical Staff in Hospitals...................................................................34 19 CSR 30-20.088 Central Services in Hospitals ...............................................................35 19 CSR 30-20.090 Dietary Services in Hospitals ...............................................................35 19 CSR 30-20.092 Emergency Services in Hospitals...........................................................36 19 CSR 30-20.094 Medical Records in Hospitals...............................................................37 19 CSR 30-20.096 Nursing Services in Hospitals...............................................................38 JASON KANDER (12/31/13) CODE OF STATE REGULATIONS 1 Secretary of State 19 CSR 30-20.097 Safe Patient Handling and Movement in Hospitals......................................40 19 CSR 30-20.098 Pathology and Medical Laboratory Services .............................................41 19 CSR 30-20.100 Pharmacy Services and Medication Management in Hospitals........................42 19 CSR 30-20.102 Radiology Services in Hospitals ............................................................44 19 CSR 30-20.104 Social Work Services in Hospitals .........................................................45 19 CSR 30-20.106 Inpatient Care Units in Hospitals...........................................................45 19 CSR 30-20.108 Fire Safety, General Safety and Operating Features for Hospitals....................45 19 CSR 30-20.110 Orientation and Continuing Education ....................................................45 19 CSR 30-20.112 Quality Assessment and Performance Improvement Program .........................46 19 CSR 30-20.114 Environmental Waste Management and Support Services..............................46 19 CSR 30-20.116 Infection Control in Hospitals ..............................................................48 19 CSR 30-20.118 Outpatient Services in Hospitals............................................................48 19 CSR 30-20.120 Anesthesia Services in Hospitals ...........................................................48 19 CSR 30-20.122 Home-Care Services in Hospitals (Rescinded January 30, 2014).....................49 19 CSR 30-20.124 Medical Services ..............................................................................49 19 CSR 30-20.125 Unlicensed Assistive Personnel Training Program ......................................49 19 CSR 30-20.126 Obstetrical and Newborn Services in Hospitals..........................................50 19 CSR 30-20.128 Pediatric Services in Hospitals..............................................................51 19 CSR 30-20.130 Post-Anesthesia Recovery Services in Hospitals .........................................51 19 CSR 30-20.132 Psychiatric Services in Hospitals ...........................................................51 19 CSR 30-20.134 Rehabilitation Services in Hospitals .......................................................52 19 CSR 30-20.136 Respiratory Care Services in Hospitals ...................................................52 19 CSR 30-20.138 Special Patient Care Services in Hospitals................................................53 19 CSR 30-20.140 Surgical Services in Hospitals ..............................................................53 19 CSR 30-20.142 Variance Requests .............................................................................53 2 CODE OF STATE REGULATIONS (12/31/13) JASON KANDER Secretary of State Chapter 20—Hospitals 19 CSR 30-20 Title 19—DEPARTMENT OF (1) ACLS—The American Heart Associa- fication as a nurse anesthetist by the Council HEALTH AND SENIOR SERVICES tion’s advanced cardiac life support program. on Certification of Nurse Anesthetists. Division 30—Division of Regulation and Licensure (2) Anesthetizing location—An area or room (10) Chief executive officer—The individual Chapter 20—Hospitals in which it is intended to administer any appointed by the governing body to act in its flammable or nonflammable inhalation anes- behalf in the overall management of the hos- 19 CSR 30-20.001 Anesthesiologist Assis- thetic agents in the course of examination or pital. Job titles may include administrator, tants in Hospitals treatment. superintendent, director, executive director, president, vice president and executive vice PURPOSE: This rule allows the use of anes- (3) APLS—The American College of Emer- president. thesiologist assistants in hospitals. gency Physician’s advanced pediatric life sup- port program. APLS may be used inter- (11) Chief operating officer—The individual (1) Anesthesiologist assistant—A person who changeably with PALS where required. appointed by the chief executive officer on meets each of the following conditions: behalf of the governing body or the individu- (A) Has graduated from an anesthesiolo- (4) ATLS—The American College of Sur- al who is responsible for the management of gist assistant program accredited by the geon’s advanced trauma life support pro- one (1) hospital in a multi-hospital organiza- American Medical Association’s Committee gram. tion under the direction of the chief executive on Allied Health Education and Accreditation officer of the organization. — or by its successor agency; (5) Authenticate To prove authorship, for (B) Has passed the certifying examination example, by written signature, identifiable (12) Class II biological safety cabinet—A administered by the National Commission on initials or computer key. The use of rubber ventilated cabinet for personnel, product and Certification of Anesthesiologist Assistants; stamp signatures is acceptable only under the environmental protection having an open (C) Has active certification by the Nation- following conditions: front with inward airflow for personnel pro- al Commission on Certification of Anesthesi- (A) The individual whose signature the tection, high-efficiency-particulate-air (HEPA)- ologist Assistants; rubber stamp represents is the only one who filtered laminar airflow for product protection (D) Is currently licensed as an anesthesiol- has possession of the stamp and is the only and HEPA-filtered exhausted air for environ- ogist assistant in the state of Missouri; and one who uses it; and mental protection. (E) Provides health care services delegated (B) The individual places in the adminis- by a licensed anesthesiologist. trative office of the hospital, with a copy to (13) Class 100 environment—An atmospher- the medical records director, a signed state- ic environment which contains less than one (2) Notwithstanding any other rule in this ment to the effect that s/he is the only one hundred (100) particles five-tenths (0.5) chapter, anesthesia in hospitals shall be who has the stamp and is the only one who microns or larger in diameter per cubic foot administered only by qualified anesthesiolo- will use it. of air, according to federal standard 209E. gists, physicians or dentists trained in anes- (14) Dentist—An individual who has received thesia, certified nurse anesthetists, anesthesi- (6) Biological safety cabinet—A containment a Doctor of Dental Surgery or Doctor of ologist assistants or supervised students in an unit suitable for the preparation of low to Dental Medicine degree and is currently approved educational program. Notwith- moderate risk agents where there is a need licensed to practice dentistry in Missouri. standing the provisions of sections 334.400 to for protection of the product, personnel and 334.430, RSMo, or the rules of the Missouri environment, according to National Safety (15) Department—Missouri Department of State Board of Registration for the Healing Foundation, Standard 49. Health and Senior Services. Arts, the governing body of every hospital (7) Board-admissible—That a physician has shall have full authority to limit the functions applied to a specialty board and has received (16) Hospital emergency transfer policy—A and activities that an anesthesiologist assis- a ruling that s/he has fulfilled the require- document that represents the usual and cus- tant performs