MO SB1794

Requires certificate of need for ownership transfers of assisted living facilities, intermediate care facilities, residential care facilities, and skilled nursing facilities, removing these from the existing exemption for health facility ownership transfers

Mandates assisted living facility license applications disclose all facility owners, trustees, and companies providing administrative, clinical, and financial services, including real estate investment trusts

Establishes minimum staffing requirements for assisted living facilities: 0.55 hours per resident day by registered nurses, at least one RN on site 24/7, and 2.44 hours per resident day by certified nursing assistants

Requires assisted living facilities to electronically submit staffing data to CMS using the Payroll-Based Journal System, with compliance determinations based on quarterly data

Allows hardship exemptions from staffing requirements for facilities in areas with nursing workforce shortages (20-40% below national average) located at least 20 miles from another assisted living facility, if they demonstrate recruitment difficulties despite offering prevailing wages