Emergency plan rules in Missouri
One license type researched, regulated by Missouri Dept. of Health & Senior Services — Section for Long-Term Care Regulation. Every requirement below carries the rule that imposes it.
Assisted living / residential care
Licensed in Missouri as Assisted Living Facility / Residential Care Facility, by Missouri Dept. of Health & Senior Services — Section for Long-Term Care Regulation.
19 CSR 30-86.022 (fire safety and emergency preparedness, RCF and ALF); 19 CSR 30-85.022 for intermediate care and skilled nursing
A minimum of twelve fire drills a year, at least one every three months on each shift. At least four of them must be UNANNOUNCED to residents and staff — excluding the staff assigned to evaluate the response — and the drills must include an actual resident evacuation at least once a year.
That is more often than 78% of the other states we have confirmed a figure for.
The drill record must show the time, the date, the personnel taking part, the LENGTH OF TIME taken to complete the drill, and a narrative note of any special problems. Missouri, like Wisconsin, wants the number, not just the fact that a drill happened.
19 CSR 30-86.022- Missouri carries a separate rule — 19 CSR 30-86.045 — for assisted living facilities serving residents whose physical or cognitive impairment prevents them evacuating with minimal assistance. If that describes any of your residents, that rule stacks on top of this one.
Reviewed 2026-07-30
What this page is
The requirements Missouri places on a facility emergency preparedness plan, taken from the state’s own rules rather than a national template. Where we have confirmed something against primary text it is stated plainly; where we have not, it says so and names what to check. Nothing here is inferred from what other states do.
The part that is the same everywhere
The federal layer does not vary by state, and it is narrower than it is usually described. OSHA 29 CFR §1910.38 does not bind every employer on its own — by its applicability paragraph it governs an emergency action plan whenever another OSHA standard requires the employer to have one, and it then settles what that plan must contain. The CMS emergency preparedness rule applies by certified provider type rather than by building. That layer, plus the exit-route, alarm and first-aid rules and the fire code’s plan structure, is covered in the main crash course rather than repeated on all fifty state pages.
Write the plan
The Emergency Plan Builder produces the document itself and is driven by this same research, so the two cannot disagree about what Missouri requires. The Compliance Calendar puts the drills and inspections on dates.