Inspections

PURPOSE: This rule outlines inspections, complaints, and requirements of a supplemental health care services agency. (1) The department may conduct unannounced in-person or virtual registration or complaint inspection visits to an agency’s office or records repository. (2) An agency shall be available during the agency’s regular operating hours and shall maintain and make immediately available the following business records for inspection by the department— (A) Copies of articles and bylaws, if applicable; (B) An individual file or account information for each health care personnel, including independent contractors, including— 1. Personnel’s name and address, Social Security number, and date of birth; 2. Documentation of each personnel’s or independent contractor’s employment history, health, and medical records. A. Personnel and independent contractors must have received the necessary testing and immunizations required or requested by each health care facility. B. Drug screening of personnel and including independent contractors must be performed before referral by the agency to a health care facility, if the health care facility requires drug screening of facility employees; 3. Evidence of the personnel’s or independent contractor’s skills, qualifications, education, and training to demonstrate compliance with the provisions of section 198.644.1, RSMo; 4. Current copies of licenses, transcripts, certificates, or statements evidencing competency for the position held; 5. Two (2) or more references and documentation of two (2) or more reference checks of each personnel or independent contractor, completed before referral by the agency; 6. Documentation of submission for background screening and background screening results pursuant to sections 192.2490 and 192.2495, RSMo; and 7. Copy of any good cause waiver, granted by the department, if applicable; (C) Documentation of any complaints known to the agency involving any of its health care personnel or independent contractors, and any follow-up action taken with respect to such complaints; (D) Records documenting the work performed by each health care personnel or including independent contractor, including date of personnel referral by the agency or request by an independent contractor and the dates and locations of each personnel and independent contractor placement. Copies of time records or invoices identifying the services provided are acceptable documentation for this requirement; (E) Copies of any written employment contracts or other agreements entered into between the agency and each health care personnel or independent contractor. Such contract or agreement shall specifically and clearly advise if the personnel is an employee of the agency or is an independent contractor referred by the agency. If the personnel is retained as an independent contractor, the contract or agreement shall specifically state that the independent contractor is responsible for paying federal income taxes. Prior to placement in a health care facility, the agency shall provide a document to each health care personnel or independent contractor, for his or her signature or digital acceptance, which states that the personnel understands his or her relationship with the agency, either as an employee or independent contractor. The signed or accepted document shall be filed in each personnel’s file or account; (F) Copies of records required by the United States Internal Revenue Services to be prepared by the agency for each personnel or independent contractor; (G) Documentation to verify each personnel’s or independent contractor’s employment eligibility in compliance with the immigration laws of the United States; (H) Copies of contracts, if any, between an agency and a health care facility setting forth terms and conditions under which the agency will provide specific health services staff to the facility. Such contracts shall state whether the staff provided by the agency are referred as employees of the agency or as independent contractors; (I) Most recently released annual or quarterly financial reports; (J) Evidence of medical malpractice insurance (professional liability insurance is acceptable); and (K) Evidence of current worker’s compensation coverage as required by Chapter 287, RSMo, or if the personnel provided are independent contractors, maintain evidence of occupational accident insurance. (3) Agencies shall retain personnel records for at least ten (10) years following termination of employment or independent contractor relationship from the agency. (4) The agency shall make all records requested by the department immediately available. (5) Personnel and independent contractors of an agency who report potential violations by an agency to the department may not be subjected to retaliation of any kind, including termination, demotion, or other adverse employment action as a result of their report. (6) If statutory or regulatory violations are identified by the department during an inspection or investigation, the department shall provide a report of findings and violation(s) to the agency. (A) The agency shall then submit to the department a plan of correction for the identified violations within thirty (30) days of the receipt of the report of findings and violation(s), unless an alternative time frame is required or approved by the department in writing. (B) Upon the department’s acceptance of the agency’s plan of correction, the department may conduct an unannounced follow-up inspection or off-site review to verify correction of deficiencies at any time. (C) If the violations are not corrected within the required time frame, the department may suspend or revoke the agency’s registration. AUTHORITY: section 198.648, RSMo Supp. 2022.* Original rule filed Feb. 8, 2023, effective Sept. 30, 2023. *Original authority: 198.648, RSMo 2022. SENIOR SERVICES