19 CSR 30-88.020 - Residents' Funds and Property
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
(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.
(12) Upon the death of a resident who has not
been a recipient of aid, assistance, care, services, or who has not had moneys
expended on the resident's behalf by DSS or DSS has not made claim on the
funds, the operator shall provide the fiduciary of resident's estate, at the
fiduciary's request, a complete account of all the resident's personal funds
and possessions and deliver to the fiduciary all possessions of the resident
and the balance of the resident's funds. II/III
(A) If, after one (1) year from the date of
death, no fiduciary makes claim on funds or possessions, the operator shall
notify the Department of Health and Senior Services (department ) in writing,
Attention: Licensure and Certification Unit, PO Box 570, Jefferson City, MO
65102-0570 that the funds remain unclaimed. This notice shall be sent by the
operator within sixty (60) days. The notice shall include the resident's name,
Social Security number, date of death, and the amount of resident funds or
possessions being held belonging to the deceased resident. II/III
1. If unclaimed funds in the resident's fund
accounts or possessions have a value of one hundred fifty dollars ($150) or
less, the funds or proceeds of the sale of the possessions shall be deposited
in a fund for the benefit of all residents of the facility for social and
educational activities. II/III
2.
If unclaimed funds in the resident's fund accounts or possessions have a value
of more than one hundred fifty dollars ($150), these funds or possessions shall
be considered abandoned property under sections 447.500-447.585, RSMo. The
operator shall report and return the abandoned property to the Missouri State
Treasurer in accordance with sections 447.539-447.543, RSMo. II/III
(B) The operator shall keep an
accounting of these funds with documentation and receipts and disbursements of
these funds which will be subject to inspection and audit by the department .
II/III
(13) Any owner,
operator, manager, employee, or affiliate of an owner or operator receiving
personal property or anything with a value of ten dollars ($10) or more from a
resident shall make a written statement giving the date of receipt, estimated
value, and the name of the person making the gift. These statements shall be
retained by the operator and made available to the department or Department of
Mental Health as appropriate and to the resident, his/her designee, guardian
and conservator, or conservator. No owner, operator, manager, employee, or
affiliate of an owner or operator shall in one (1) calendar year receive any
personal property or anything of value from the residents of any facility which
have a total value over one hundred dollars ($100). These requirements shall
not apply to matters deemed exceptions under state law. II
(14) The bond required by section
198.096, RSMo, for operators
holding personal funds of residents shall be in a form approved by the
department and shall provide that residents who allege that they have been
wrongfully deprived of moneys held in trust may bring an action for recovery
directly against the surety. The bond shall be in an amount equal to at least
one and one-half (1 1/2) times the average monthly balance of the residents'
personal funds, including residents' petty cash, or the average total of the
monthly balances for the preceding twelve (12) months. The average monthly
balance(s) or the average total of the monthly balance(s) shall be rounded to
the nearest one thousand dollars ($1,000). One (1) bond may be used to cover
the residents' funds in more than one (1) facility operated by the same
operator, if the facility is a multilicensed facility on the same premises. If
not on the same premises, then one (1) bond may be used if the bond specifies
the amount of coverage provided for each individual facility and the coverage
for each facility is a minimum of one thousand dollars ($1,000).
II/III
(15) All records and
receipts required to be maintained under this rule and under section
198.090, RSMo shall be
maintained for at least seven (7) years from the end of the fiscal year during
which the records were originally made. II/III
(16) Records related to resident funds shall
be maintained in the facility or shall be available for review and copying, in
their entirety, within twenty-four (24) hours of a request for access by the
department or its authorized representative. Records kept for the prior seven
(7) years, as required in section (15) and under section
198.090, RSMo, shall be
transferred to a new operator who assumes responsibility for a facility, and if
not transferred in their entirety, the department shall be notified immediately
by the new operator. II/III
(17) If
an operator chooses to place a cash deposit in a lending institution in lieu of
a bond as referenced in section 198.096.5., RSMo, the amount must be equal to
the amount of the bond required and shall be deposited with an insured lending
institution pursuant to a noncancellable escrow agreement. The written
agreement shall be submitted to the department and shall be approved prior to
license issuance. II
Notes
*Original authority: 198.090, RSMo 1979, amended 1982, 1989, 1992, 1993.
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