Retired Application Form .pdf - .doc
- Any current licensed administrator may request to retire the license if s/he has maintained an active Missouri license at least ten (10) years and has retired from the practice of long-term care administration.
- Licensees interested in making application must submit the following information to the board:
- The fee of $50.00;
- His/her original wall license and all other evidence of licensure or a letter attesting to the board that the license has been lost, stolen, or destroyed;
- The completed Retired License Application Form available above and submit prior to the active license expiring on June 30 of the year of renewal.
- A retired license may be reactivated within five (5) years of the granting of the retired license by filing the following information with the board:
- An Application for License Renewal (please see the appropriate tab for your license type);
- The reactivation fee of $100.00; and
- Satisfactory evidence of the completion of twenty (20) clock hours of board approved continuing education, as described in 19 CSR 73-2.050, for each calendar year the license was retired. All clock hours must be completed after the granting of the retired license or completed within the same licensure year the licensee was granted the retired license. The board may prorate the required clock hours for any portion of a calendar year as follows:
- Ten (10) months or more, but less than twelve (12) months-twenty (20) clock hours (including a minimum of five (5) patient care hours);
- Seven (7) months or more, but less than ten (10) months-fifteen (15) clock hours (including a minimum of five (5) patient care hours);
- Four (4) months or more, but less than seven (7) months-ten (10) clock hours (including a minimum of two and one-half (2.5) patient care hours); or
- Less than four (4) months-five (5) clock hours (including a minimum of two and one-half (2.5) patient care hours).
- If more than five (5) years have passed since the issuance of a retired license to a licensee, the licensee shall follow the procedures for initial licensure stated in section 344.030, RSMo. Please refer to tab for which type of license you wish to apply for as an initial applicant.
- No person shall act or serve in the capacity of an administrator in this state or hold himself or herself out as an administrator if his or her license is retired.
- Retired licensees shall remain subject to disciplinary action for violations of Chapter 344, RSMo and the rules promulgated thereunder.
Retired Licensee Report