Emergency plan rules in Missouri
One license type researched, regulated by Missouri Dept. of Health & Senior Services — Division of Regulation and Licensure. 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 — Division of Regulation and Licensure.
19 CSR 30-86.022 (fire safety and emergency preparedness, RCF and ALF); RSMo 198.073 (ALF disaster plan and residents who cannot evacuate with minimal assistance)
At least twelve fire drills a year, with at least one every three months on each shift. At least four must be unannounced to residents and staff, excluding the staff assigned to evaluate the response. The drills include a resident evacuation at least once a year. The fire alarm is activated during all drills unless the drill is held between 9 p.m. and 6 a.m.
No filing with an emergency management agency or with DHSS was found. The facility must request consultation and assistance from a local fire unit every year to review its fire and evacuation plans.
Authority: Local fire unit
Cadence: Annually
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.
19 CSR 30-86.022(5)(E)Keep a written plan to meet potential emergencies or disasters. It covers a phased response (relocation within the facility, an area of refuge if applicable, then total building evacuation), written evacuation instructions for each floor with a floor plan showing exits, pull stations, extinguishers and areas of refuge, the safety and comfort of evacuated residents, staffing assignments, and instructions for staff to call alternative resources for housing residents.
19 CSR 30-86.022(5)(A)-(B)The plan must be accessible at all times, and an evacuation diagram must be posted in a conspicuous place on each floor.
19 CSR 30-86.022(5)(C)All employees receive fire-safety training at orientation, at least every six months, and whenever drill evaluations identify a need.
19 CSR 30-86.022(6)(A)If there is a fire in the facility or on the premises, notify DHSS immediately after the emergency is addressed, and submit a complete written fire report to DHSS within 7 days.
19 CSR 30-86.022(2)(C)An assisted living facility keeps a written plan for protecting all residents in a disaster, covering keeping residents in place, evacuating them to areas of refuge, evacuating the building, or other methods suited to the disaster and the building design.
RSMo 198.073.4(3)An assisted living facility that accepts or retains such residents must have sufficient staff present and awake 24 hours a day to assist in evacuation, an individualized evacuation plan in each such resident's service plan, measures that give residents the opportunity to explore the facility and grounds, and a personal electronic monitoring device for a resident when the resident's physician recommends one.
RSMo 198.073.6- Missouri has a separate rule, 19 CSR 30-86.045, for assisted living facilities serving residents whose physical, cognitive or other impairment prevents them from safely evacuating the facility with minimal assistance. If that describes any of your residents, that rule applies in addition to this one.
Reviewed 2026-09-28
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. It reads the same research as this page, but it does not yet carry every requirement here into the plan it writes, so check the plan against this page before you rely on it for Missouri. The Compliance Calendar puts the drills and inspections on dates.