At Sandberg Phoenix, our Long-Term Care defense team reads proposed legislation the way cardiologists read EKGs — looking for irregular rhythms that could turn into major events. Senate Bill 910 (2026) has a few, and if you operate a skilled nursing facility in Missouri, you may want to keep one eye on your residents and the other on Jefferson City.
For the third consecutive legislative session, lawmakers have proposed significant changes to financial responsibility requirements and public reporting obligations for long-term care facilities. If passed, SB 910 could affect not only how cases are defended, but how they are valued, perceived, and negotiated long before anyone steps into a courtroom.
First, SB 910 would require facilities to carry at least $1 million in liability insurance for claims involving abuse, neglect, or wrongful death, unless the facility maintains a reserve account in that amount. The failure of facilities to comply with the new requirement could, independently, subject facilities to licensure revocations.
Missouri has not historically imposed a universal liability insurance minimum like this. For some operators, the requirement would be business as usual. For others, SB 910 may require internal restructuring. From a defense-litigation standpoint, although Missouri already has statutory caps on medical malpractice damages in many cases, litigation is a human enterprise – knowledge of insurance can influence strategy, demand letters, and sometimes verdict psychology.
Second, SB 910 would also expand how information about deficiencies, complaints, and findings are displayed on Missouri Department of Health & Senior Services (MoDHSS) websites, like the Show Me Long Term Care in Missouri interface. Under SB 910, MoDHSS will be required to display a “standardized graphic symbol” in close proximity to the facility’s name, alerting the public the facility received a “substantiated finding” of abuse or neglect in the past thirty-six (36) months.
Although the Missouri General Assembly’s quest to ensure greater transparency may appear admirable, public labeling, like that proposed in SB 910, can have consequences that outpace the underlying facts. In litigation, perception frequently arrives long before nuance, and SB 910 would shine a spotlight on every deficiency survey, putting a lot of public pressure on nursing homes before any causation or damages are even proven in court.
Missouri has roughly 500 Medicare- and Medicaid-participating facilities, many already operating on tight margins and in a challenging staffing environment, particularly after the COVID-19 Pandemic. SB 910 is more than a regulatory tweak. It has the potential to change the litigation landscape, and all providers should be aware. For facilities, that means preparation cannot begin when a lawsuit is filed – it starts now with evaluating coverage, reviewing compliance systems, and understanding how publicly available information may be used in future claims. Idiomatically, an ounce of prevention has always been worth a pound of cure, but SB 910 might make it worth a ton.
