Missouri Revised Statutes
Chapter 192
Department of Health and Senior Services
←192.2470
Section 192.2475.1
192.2475→
August 28, 2015
Beginning January 1, 2017--Report of abuse or neglect of in-home services or home health agency client, duty--penalty--contents of report--investigation, procedure--confidentiality of report--immunity--retaliation prohibited, penalty--employee disqualification list--safe at home evaluations, procedure.
192.2475. 1. When any adult day care worker; chiropractor; Christian
Science practitioner; coroner; dentist; embalmer; employee of the
departments of social services, mental health, or health and senior
services; employee of a local area agency on aging or an organized area
agency on aging program; funeral director; home health agency or home
health agency employee; hospital and clinic personnel engaged in
examination, care, or treatment of persons; in-home services owner,
provider, operator, or employee; law enforcement officer; long-term care
facility administrator or employee; medical examiner; medical resident or
intern; mental health professional; minister; nurse; nurse practitioner;
optometrist; other health practitioner; peace officer; pharmacist; physical
therapist; physician; physician's assistant; podiatrist; probation or
parole officer; psychologist; or social worker has reasonable cause to
believe that an in-home services client has been abused or neglected, as a
result of in-home services, he or she shall immediately report or cause a
report to be made to the department. If the report is made by a physician
of the in-home services client, the department shall maintain contact with
the physician regarding the progress of the investigation.
2. When a report of deteriorating physical condition resulting in
possible abuse or neglect of an in-home services client is received by the
department, the client's case manager and the department nurse shall be
notified. The client's case manager shall investigate and immediately
report the results of the investigation to the department nurse. The
department may authorize the in-home services provider nurse to assist the
case manager with the investigation.
3. If requested, local area agencies on aging shall provide volunteer
training to those persons listed in subsection 1 of this section regarding
the detection and report of abuse and neglect pursuant to this section.
4. Any person required in subsection 1 of this section to report or
cause a report to be made to the department who fails to do so within a
reasonable time after the act of abuse or neglect is guilty of a class A
misdemeanor.
5. The report shall contain the names and addresses of the in-home
services provider agency, the in-home services employee, the in-home
services client, the home health agency, the home health agency employee,
information regarding the nature of the abuse or neglect, the name of the
complainant, and any other information which might be helpful in an
investigation.
6. In addition to those persons required to report under subsection 1
of this section, any other person having reasonable cause to believe that
an in-home services client or home health patient has been abused or
neglected by an in-home services employee or home health agency employee
may report such information to the department.
7. If the investigation indicates possible abuse or neglect of an
in-home services client or home health patient, the investigator shall
refer the complaint together with his or her report to the department
director or his or her designee for appropriate action. If, during the
investigation or at its completion, the department has reasonable cause to
believe that immediate action is necessary to protect the in-home services
client or home health patient from abuse or neglect, the department or the
local prosecuting attorney may, or the attorney general upon request of the
department shall, file a petition for temporary care and protection of the
in-home services client or home health patient in a circuit court of
competent jurisdiction. The circuit court in which the petition is filed
shall have equitable jurisdiction to issue an ex parte order granting the
department authority for the temporary care and protection of the in-home
services client or home health patient, for a period not to exceed thirty
days.
8. Reports shall be confidential, as provided under section 192.2500.
9. Anyone, except any person who has abused or neglected an in-home
services client or home health patient, who makes a report pursuant to this
section or who testifies in any administrative or judicial proceeding
arising from the report shall be immune from any civil or criminal
liability for making such a report or for testifying except for liability
for perjury, unless such person acted negligently, recklessly, in bad
faith, or with malicious purpose.
10. Within five working days after a report required to be made under
this section is received, the person making the report shall be notified in
writing of its receipt and of the initiation of the investigation.
11. No person who directs or exercises any authority in an in-home
services provider agency or home health agency shall harass, dismiss or
retaliate against an in-home services client or home health patient, or an
in-home services employee or a home health agency employee because he or
she or any member of his or her family has made a report of any violation
or suspected violation of laws, standards or regulations applying to the
in-home services provider agency or home health agency or any in-home
services employee or home health agency employee which he or she has
reasonable cause to believe has been committed or has occurred.
12. Any person who abuses or neglects an in-home services client or
home health patient is subject to criminal prosecution under section
565.184. If such person is an in-home services employee and has been found
guilty by a court, and if the supervising in-home services provider
willfully and knowingly failed to report known abuse by such employee to
the department, the supervising in-home services provider may be subject to
administrative penalties of one thousand dollars per violation to be
collected by the department and the money received therefor shall be paid
to the director of revenue and deposited in the state treasury to the
credit of the general revenue fund. Any in-home services provider which
has had administrative penalties imposed by the department or which has had
its contract terminated may seek an administrative review of the
department's action pursuant to chapter 621. Any decision of the
administrative hearing commission may be appealed to the circuit court in
the county where the violation occurred for a trial de novo. For purposes
of this subsection, the term "violation" means a determination of guilt by
a court.
13. The department shall establish a quality assurance and
supervision process for clients that requires an in-home services provider
agency to conduct random visits to verify compliance with program standards
and verify the accuracy of records kept by an in-home services employee.
14. The department shall maintain the employee disqualification list
and place on the employee disqualification list the names of any persons
who have been finally determined by the department, pursuant to section
192.2490, to have recklessly, knowingly or purposely abused or neglected an
in-home services client or home health patient while employed by an in-home
services provider agency or home health agency. For purposes of this
section only, "knowingly" and "recklessly" shall have the meanings that are
ascribed to them in this section. A person acts "knowingly" with respect
to the person's conduct when a reasonable person should be aware of the
result caused by his or her conduct. A person acts "recklessly" when the
person consciously disregards a substantial and unjustifiable risk that the
person's conduct will result in serious physical injury and such disregard
constitutes a gross deviation from the standard of care that a reasonable
person would exercise in the situation.
15. At the time a client has been assessed to determine the level of
care as required by rule and is eligible for in-home services, the
department shall conduct a "Safe at Home Evaluation" to determine the
client's physical, mental, and environmental capacity. The department
shall develop the safe at home evaluation tool by rule in accordance with
chapter 536. The purpose of the safe at home evaluation is to assure that
each client has the appropriate level of services and professionals
involved in the client's care. The plan of service or care for each
in-home services client shall be authorized by a nurse. The department may
authorize the licensed in-home services nurse, in lieu of the department
nurse, to conduct the assessment of the client's condition and to establish
a plan of services or care. The department may use the expertise,
services, or programs of other departments and agencies on a case-by-case
basis to establish the plan of service or care. The department may, as
indicated by the safe at home evaluation, refer any client to a mental
health professional, as defined in 9 CSR 30-4.030, for evaluation and
treatment as necessary.
16. Authorized nurse visits shall occur at least twice annually to
assess the client and the client's plan of services. The provider nurse
shall report the results of his or her visits to the client's case manager.
If the provider nurse believes that the plan of service requires
alteration, the department shall be notified and the department shall make
a client evaluation. All authorized nurse visits shall be reimbursed to
the in-home services provider. All authorized nurse visits shall be
reimbursed outside of the nursing home cap for in-home services clients
whose services have reached one hundred percent of the average statewide
charge for care and treatment in an intermediate care facility, provided
that the services have been preauthorized by the department.
17. All in-home services clients shall be advised of their rights by
the department or the department's designee at the initial evaluation. The
rights shall include, but not be limited to, the right to call the
department for any reason, including dissatisfaction with the provider or
services. The department may contract for services relating to receiving
such complaints. The department shall establish a process to receive such
nonabuse and neglect calls other than the elder abuse and neglect hotline.
18. Subject to appropriations, all nurse visits authorized in
sections 192.2400 to 192.2475 shall be reimbursed to the in-home services
provider agency.
(L. 1992 S.B. 573 & 634, A.L. 2003 S.B. 556 & 311, A.L. 2003 2nd Ex.
Sess. S.B. 4, A.L. 2010 S.B. 842, et al. merged with S.B. 1007,
A.L. 2014 H.B. 1299 Revision § 192.1102 merged with S.B. 491 §
197.1030)
Effective 1-01-17
*Transferred 2014; formerly 660.300
2010
2010
192.2475. 1. When any adult day care worker; chiropractor; Christian
Science practitioner; coroner; dentist; embalmer; employee of the
departments of social services, mental health, or health and senior
services; employee of a local area agency on aging or an organized area
agency on aging program; funeral director; home health agency or home
health agency employee; hospital and clinic personnel engaged in
examination, care, or treatment of persons; in-home services owner,
provider, operator, or employee; law enforcement officer; long-term care
facility administrator or employee; medical examiner; medical resident or
intern; mental health professional; minister; nurse; nurse practitioner;
optometrist; other health practitioner; peace officer; pharmacist; physical
therapist; physician; physician's assistant; podiatrist; probation or
parole officer; psychologist; or social worker has reasonable cause to
believe that an in-home services client has been abused or neglected, as a
result of in-home services, he or she shall immediately report or cause a
report to be made to the department. If the report is made by a physician
of the in-home services client, the department shall maintain contact with
the physician regarding the progress of the investigation.
2. When a report of deteriorating physical condition resulting in
possible abuse or neglect of an in-home services client is received by the
department, the client's case manager and the department nurse shall be
notified. The client's case manager shall investigate and immediately
report the results of the investigation to the department nurse. The
department may authorize the in-home services provider nurse to assist the
case manager with the investigation.
3. If requested, local area agencies on aging shall provide volunteer
training to those persons listed in subsection 1 of this section regarding
the detection and report of abuse and neglect pursuant to this section.
4. Any person required in subsection 1 of this section to report or
cause a report to be made to the department who fails to do so within a
reasonable time after the act of abuse or neglect is guilty of a class A
misdemeanor.
5. The report shall contain the names and addresses of the in-home
services provider agency, the in-home services employee, the in-home
services client, the home health agency, the home health agency employee,
information regarding the nature of the abuse or neglect, the name of the
complainant, and any other information which might be helpful in an
investigation.
6. In addition to those persons required to report under subsection 1
of this section, any other person having reasonable cause to believe that
an in-home services client or home health patient has been abused or
neglected by an in-home services employee or home health agency employee
may report such information to the department.
7. If the investigation indicates possible abuse or neglect of an
in-home services client or home health patient, the investigator shall
refer the complaint together with his or her report to the department
director or his or her designee for appropriate action. If, during the
investigation or at its completion, the department has reasonable cause to
believe that immediate action is necessary to protect the in-home services
client or home health patient from abuse or neglect, the department or the
local prosecuting attorney may, or the attorney general upon request of the
department shall, file a petition for temporary care and protection of the
in-home services client or home health patient in a circuit court of
competent jurisdiction. The circuit court in which the petition is filed
shall have equitable jurisdiction to issue an ex parte order granting the
department authority for the temporary care and protection of the in-home
services client or home health patient, for a period not to exceed thirty
days.
8. Reports shall be confidential, as provided under section 660.320.
9. Anyone, except any person who has abused or neglected an in-home
services client or home health patient, who makes a report pursuant to this
section or who testifies in any administrative or judicial proceeding
arising from the report shall be immune from any civil or criminal
liability for making such a report or for testifying except for liability
for perjury, unless such person acted negligently, recklessly, in bad
faith, or with malicious purpose.
10. Within five working days after a report required to be made under
this section is received, the person making the report shall be notified in
writing of its receipt and of the initiation of the investigation.
11. No person who directs or exercises any authority in an in-home
services provider agency or home health agency shall harass, dismiss or
retaliate against an in-home services client or home health patient, or an
in-home services employee or a home health agency employee because he or
any member of his or her family has made a report of any violation or
suspected violation of laws, standards or regulations applying to the
in-home services provider agency or home health agency or any in-home
services employee or home health agency employee which he has reasonable
cause to believe has been committed or has occurred.
12. Any person who abuses or neglects an in-home services client or
home health patient is subject to criminal prosecution under section
565.180, 565.182, or 565.184. If such person is an in-home services
employee and has been found guilty by a court, and if the supervising
in-home services provider willfully and knowingly failed to report known
abuse by such employee to the department, the supervising in-home services
provider may be subject to administrative penalties of one thousand dollars
per violation to be collected by the department and the money received
therefor shall be paid to the director of revenue and deposited in the
state treasury to the credit of the general revenue fund. Any in-home
services provider which has had administrative penalties imposed by the
department or which has had its contract terminated may seek an
administrative review of the department's action pursuant to chapter 621.
Any decision of the administrative hearing commission may be appealed to
the circuit court in the county where the violation occurred for a trial de
novo. For purposes of this subsection, the term "violation" means a
determination of guilt by a court.
13. The department shall establish a quality assurance and
supervision process for clients that requires an in-home services provider
agency to conduct random visits to verify compliance with program standards
and verify the accuracy of records kept by an in-home services employee.
14. The department shall maintain the employee disqualification list
and place on the employee disqualification list the names of any persons
who have been finally determined by the department, pursuant to section
660.315, to have recklessly, knowingly or purposely abused or neglected an
in-home services client or home health patient while employed by an in-home
services provider agency or home health agency. For purposes of this
section only, "knowingly" and "recklessly" shall have the meanings that are
ascribed to them in this section. A person acts "knowingly" with respect
to the person's conduct when a reasonable person should be aware of the
result caused by his or her conduct. A person acts "recklessly" when the
person consciously disregards a substantial and unjustifiable risk that the
person's conduct will result in serious physical injury and such disregard
constitutes a gross deviation from the standard of care that a reasonable
person would exercise in the situation.
15. At the time a client has been assessed to determine the level of
care as required by rule and is eligible for in-home services, the
department shall conduct a "Safe at Home Evaluation" to determine the
client's physical, mental, and environmental capacity. The department
shall develop the safe at home evaluation tool by rule in accordance with
chapter 536. The purpose of the safe at home evaluation is to assure that
each client has the appropriate level of services and professionals
involved in the client's care. The plan of service or care for each
in-home services client shall be authorized by a nurse. The department may
authorize the licensed in-home services nurse, in lieu of the department
nurse, to conduct the assessment of the client's condition and to establish
a plan of services or care. The department may use the expertise,
services, or programs of other departments and agencies on a case-by-case
basis to establish the plan of service or care. The department may, as
indicated by the safe at home evaluation, refer any client to a mental
health professional, as defined in 9 CSR 30-4.030, for evaluation and
treatment as necessary.
16. Authorized nurse visits shall occur at least twice annually to
assess the client and the client's plan of services. The provider nurse
shall report the results of his or her visits to the client's case manager.
If the provider nurse believes that the plan of service requires
alteration, the department shall be notified and the department shall make
a client evaluation. All authorized nurse visits shall be reimbursed to
the in-home services provider. All authorized nurse visits shall be
reimbursed outside of the nursing home cap for in-home services clients
whose services have reached one hundred percent of the average statewide
charge for care and treatment in an intermediate care facility, provided
that the services have been preauthorized by the department.
17. All in-home services clients shall be advised of their rights by
the department or the department's designee at the initial evaluation. The
rights shall include, but not be limited to, the right to call the
department for any reason, including dissatisfaction with the provider or
services. The department may contract for services relating to receiving
such complaints. The department shall establish a process to receive such
nonabuse and neglect calls other than the elder abuse and neglect hotline.
18. Subject to appropriations, all nurse visits authorized in
sections 660.250 to 660.300 shall be reimbursed to the in-home services
provider agency.
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