Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 88 - Resident's Rights and Handling Resident Funds and Property in Long-Term Care Facilities › Section 19 CSR 30-88.020 - Residents' Funds and Property

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes standards for
				  protecting residents' personal funds and property in all types of licensed
				  long-term care facilities.
AGENCY NOTE: All rules relating to long-term care
				  facilities licensed by the Department of Health and Senior Services are
				  followed by a Roman Numeral notation which refers to the class (either Class I,
				  II, or III) of standard as designated in section
				  198.085,
				  RSMo.
(1) No operator is
				required by this rule or by section
				198.090,
				RSMo, to hold, manage, safeguard, or account for any personal funds or money in
				trust unless some other governmental agency placing residents in the facility
				makes this a requirement. The record keeping and other requirements of this
				section apply only to those personal possessions and funds which the facility
				accepts to hold in trust for the resident as provided in the facility's
				policy.
(2) The operator or other
				designated person shall use the personal funds of the resident exclusively for
				the use of the resident and only when authorized in writing by the resident,
				his/her designee, guardian and conservator, or conservator. A designee shall
				not be the administrator or an employee of the facility. With written
				authorization, the operator may purchase a burial policy for the resident.
				II/III
(3) When a resident is
				admitted, the resident, his/her designee, guardian and conservator, or
				conservator shall be provided with a statement explaining the facility's
				policies and resident's rights regarding personal funds. If the facility
				handles residents' funds, this statement shall include an explanation of the
				procedure for deposit or withdrawals of funds from any source to the resident
				or to the resident's account. The facility shall allow the residents access to
				their personal possessions and funds during regular business hours, Monday
				through Friday, excluding banking holidays. III
(4) The separate account(s) required to be
				maintained by section 198.090.1.(3), RSMo, shall be maintained in a bank or
				savings and loan association and if any interest is accrued it shall be
				credited to each resident's account at least monthly. II/III
(5) A petty cash fund of up to fifty dollars
				($50) for each resident for whom the facility is holding funds may be kept in
				the facility and shall be maintained separately from the facility's funds.
				II/III
(6) A written account for
				each resident, showing receipts to and disbursements from the personal funds of
				each resident, shall be maintained. If the facility policy provides, or if
				required by another governmental agency, multiple personal funds accounts may
				be kept for residents. III
(7)
				Receipt of a resident's funds or personal possessions held in trust shall be
				acknowledged by a written receipt or cancelled check. III
(8) Receipts for any purchases made by the
				operator and paid for from the resident's personal funds shall be kept pursuant
				to sections (15) and (16) of this rule and be available to the resident,
				his/her designee, guardian and conservator, or conservator. III
(9) All written accounts of the residents'
				funds shall be reconciled monthly and a written statement showing the current
				balance and all transactions shall be given to the resident, his/her designee,
				guardian and conservator, or conservator on a quarterly basis. II/III
(10) Within five (5) calendar days of the
				discharge of a resident, the resident, his/her designee, guardian and
				conservator, or conservator shall be given an up-to-date accounting of the
				resident's personal funds and the balance of the funds and all personal
				possessions shall be returned to the resident. This requirement shall not apply
				for residents discharged due to death, or for residents discharged to hospitals
				when those residents are expected to return to the facility. The operator shall
				have a receipt for all funds and possessions returned to the resident, his/her
				designee, guardian and conservator, or conservator. II/III
(11) Upon the death of a resident, the
				operator shall contact the Department of Social Services (DSS), MO HealthNet
				Division, Third Party Liability Unit, to determine if the deceased resident is
				a MO HealthNet participant or has been a recipient of aid, assistance, care,
				services, or if the resident has had moneys expended on his/her behalf by DSS.
				The facility shall document the contact(s) with and response(s) from DSS.
				II/III
(A) If the deceased resident is a MO
				HealthNet participant or has been a recipient of aid, assistance, care,
				services, or the resident has had moneys expended on his/her behalf by DSS, the
				operator shall provide DSS within sixty (60) days of the resident's death, a
				complete account of all the resident's remaining personal funds and the name
				and address of the resident's designee, guardian and conservator, or
				conservator, fiduciary of the resident's estate, or the individual who was
				designated to receive the quarterly accounting of all financial transactions
				made. Personal funds for the purpose of this regulation shall include all the
				resident's remaining funds with the facility, in any account, with whatever
				title the account(s) may be known. II/III
(B) None of the resident's personal funds
				shall be paid to an operator, fiduciary, guardian and conservator, conservator,
				or other person until the operator has fully complied with section 198.090.1.,
				RSMo, except that funeral expenses may be paid from a resident's personal funds
				held by a facility if no other funds are available to cover the cost. If funds
				are used for this purpose, this fact and the amount used shall be noted on the
				account report submitted to DSS and documentation of payment shall be attached.
				II/III
(C) DSS will determine the
				amount of aid, care, assistance, or services paid and will notify the operator
				of the amount determined to have been paid on behalf of the deceased recipient
				within sixty (60) days of receipt of the facility operator's
				accounting.
(D) The operator may
				make a special request for expedited response if there is a need to comply with
				a contractual or regulatory obligation of another governmental agency. The
				amount specified in the notification shall be considered as a claim upon the
				funds held by the operator.
(E) The
				operator shall pay DSS any remaining personal funds in the resident's personal
				fund account up to the amount determined by DSS. Payment shall be made as
				instructed by DSS within sixty (60) working days of the receipt of the demand
				for payment. If additional funds are received by the facility after the initial
				claim has been filed, the operator shall immediately inform DSS.
				II/III
(F) DSS will notify in
				writing the resident's guardian and conservator, conservator, fiduciary of the
				resident's estate, or the individual who was designated to receive the
				quarterly accounting of all financial transactions of the amount determined to
				have been paid by DSS on behalf of the deceased resident.