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Section: 193.0145 Death certificate--electronic system--contents, filing, locale, duties of certain persons, time allowed--certificate marked presumptive, when. RSMO 193.145


Published: 2015

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Missouri Revised Statutes













Chapter 193

Vital Statistics

←193.135

Section 193.145.1

193.155→

August 28, 2015

Death certificate--electronic system--contents, filing, locale, duties of certain persons, time allowed--certificate marked presumptive, when.

193.145. 1. A certificate of death for each death which occurs in

this state shall be filed with the local registrar, or as otherwise

directed by the state registrar, within five days after death and shall be

registered if such certificate has been completed and filed pursuant to

this section. All data providers in the death registration process,

including, but not limited to, the state registrar, local registrars, the

state medical examiner, county medical examiners, coroners, funeral

directors or persons acting as such, embalmers, sheriffs, attending

physicians and resident physicians, physician assistants, assistant

physicians, advanced practice registered nurses, and the chief medical

officers of licensed health care facilities, and other public or private

institutions providing medical care, treatment, or confinement to persons,

shall be required to use and utilize any electronic death registration

system required and adopted under subsection 1 of section 193.265 within

six months of the system being certified by the director of the department

of health and senior services, or the director's designee, to be

operational and available to all data providers in the death registration

process. However, should the person or entity that certifies the cause of

death not be part of, or does not use, the electronic death registration

system, the funeral director or person acting as such may enter the

required personal data into the electronic death registration system and

then complete the filing by presenting the signed cause of death

certification to the local registrar, in which case the local registrar

shall issue death certificates as set out in subsection 2 of section

193.265. Nothing in this section shall prevent the state registrar from

adopting pilot programs or voluntary electronic death registration programs

until such time as the system can be certified; however, no such pilot or

voluntary electronic death registration program shall prevent the filing of

a death certificate with the local registrar or the ability to obtain

certified copies of death certificates under subsection 2 of section

193.265 until six months after such certification that the system is

operational.



2. If the place of death is unknown but the dead body is found in

this state, the certificate of death shall be completed and filed pursuant

to the provisions of this section. The place where the body is found shall

be shown as the place of death. The date of death shall be the date on

which the remains were found.



3. When death occurs in a moving conveyance in the United States and

the body is first removed from the conveyance in this state, the death

shall be registered in this state and the place where the body is first

removed shall be considered the place of death. When a death occurs on a

moving conveyance while in international waters or air space or in a

foreign country or its air space and the body is first removed from the

conveyance in this state, the death shall be registered in this state but

the certificate shall show the actual place of death if such place may be

determined.



4. The funeral director or person in charge of final disposition of

the dead body shall file the certificate of death. The funeral director or

person in charge of the final disposition of the dead body shall obtain or

verify and enter into the electronic death registration system:



(1) The personal data from the next of kin or the best qualified

person or source available;



(2) The medical certification from the person responsible for such

certification if designated to do so under subsection 5 of this section;

and



(3) Any other information or data that may be required to be placed

on a death certificate or entered into the electronic death certificate

system including, but not limited to, the name and license number of the

embalmer.



5. The medical certification shall be completed, attested to its

accuracy either by signature or an electronic process approved by the

department, and returned to the funeral director or person in charge of

final disposition within seventy-two hours after death by the physician,

physician assistant, assistant physician, advanced practice registered

nurse in charge of the patient's care for the illness or condition which

resulted in death. In the absence of the physician, physician assistant,

assistant physician, advanced practice registered nurse or with the

physician's, physician assistant's, assistant physician's, or advanced

practice registered nurse's approval the certificate may be completed and

attested to its accuracy either by signature or an approved electronic

process by the physician's associate physician, the chief medical officer

of the institution in which death occurred, or the physician who performed

an autopsy upon the decedent, provided such individual has access to the

medical history of the case, views the deceased at or after death and death

is due to natural causes. The person authorized to complete the medical

certification may, in writing, designate any other person to enter the

medical certification information into the electronic death registration

system if the person authorized to complete the medical certificate has

physically or by electronic process signed a statement stating the cause of

death. Any persons completing the medical certification or entering data

into the electronic death registration system shall be immune from civil

liability for such certification completion, data entry, or determination

of the cause of death, absent gross negligence or willful misconduct. The

state registrar may approve alternate methods of obtaining and processing

the medical certification and filing the death certificate. The Social

Security number of any individual who has died shall be placed in the

records relating to the death and recorded on the death certificate.



6. When death occurs from natural causes more than thirty-six hours

after the decedent was last treated by a physician, physician assistant,

assistant physician, advanced practice registered nurse, the case shall be

referred to the county medical examiner or coroner or physician or local

registrar for investigation to determine and certify the cause of death.

If the death is determined to be of a natural cause, the medical examiner

or coroner or local registrar shall refer the certificate of death to the

attending physician, physician assistant, assistant physician, advanced

practice registered nurse for such certification. If the attending

physician, physician assistant, assistant physician, advanced practice

registered nurse refuses or is otherwise unavailable, the medical examiner

or coroner or local registrar shall attest to the accuracy of the

certificate of death either by signature or an approved electronic process

within thirty-six hours.



7. If the circumstances suggest that the death was caused by other

than natural causes, the medical examiner or coroner shall determine the

cause of death and shall complete and attest to the accuracy either by

signature or an approved electronic process the medical certification

within seventy-two hours after taking charge of the case.



8. If the cause of death cannot be determined within seventy-two

hours after death, the attending medical examiner, coroner, attending

physician, physician assistant, assistant physician, advanced practice

registered nurse, or local registrar shall give the funeral director, or

person in charge of final disposition of the dead body, notice of the

reason for the delay, and final disposition of the body shall not be made

until authorized by the medical examiner, coroner, attending physician,

physician assistant, assistant physician, advanced practice registered

nurse, or local registrar.



9. When a death is presumed to have occurred within this state but

the body cannot be located, a death certificate may be prepared by the

state registrar upon receipt of an order of a court of competent

jurisdiction which shall include the finding of facts required to complete

the death certificate. Such a death certificate shall be marked

"Presumptive", show on its face the date of registration, and identify the

court and the date of decree.



10. (1) The department of health and senior services shall notify

all physicians, physician assistants, assistant physicians, and advanced

practice registered nurses licensed under chapters 334 and 335 of the

requirements regarding the use of the electronic vital records system

provided for in this section.



(2) On or before August 30, 2015, the department of health and senior

services, division of community and public health shall create a working

group comprised of representation from the Missouri electronic vital

records system users and recipients of death certificates used for

professional purposes to evaluate the Missouri electronic vital records

system, develop recommendations to improve the efficiency and usability of

the system, and to report such findings and recommendations to the general

assembly no later than January 1, 2016.



(L. 1984 S.B. 574, A.L. 1989 S.B. 389, A.L. 1997 S.B. 361, A.L. 2005

S.B. 74 & 49, A.L. 2010 H.B. 1692, et al. merged with S.B. 754,

A.L. 2013 S.B. 186, A.L. 2015 H.B. 618)



*Effective 10-16-15, see § 21.250. H.B. 618 was vetoed on July 10,

2015. The veto was overridden September 16, 2015.





2013

2010

2005

1997



2013



193.145. 1. A certificate of death for each death which occurs in

this state shall be filed with the local registrar, or as otherwise

directed by the state registrar, within five days after death and shall be

registered if such certificate has been completed and filed pursuant to

this section. All data providers in the death registration process,

including, but not limited to, the state registrar, local registrars, the

state medical examiner, county medical examiners, coroners, funeral

directors or persons acting as such, embalmers, sheriffs, attending

physicians and resident physicians, and the chief medical officers of

licensed health care facilities, and other public or private institutions

providing medical care, treatment, or confinement to persons, shall be

required to use and utilize any electronic death registration system

required and adopted under subsection 1 of section 193.265 within six

months of the system being certified by the director of the department of

health and senior services, or the director's designee, to be operational

and available to all data providers in the death registration process.

However, should the person or entity that certifies the cause of death not

be part of, or does not use, the electronic death registration system, the

funeral director or person acting as such may enter the required personal

data into the electronic death registration system and then complete the

filing by presenting the signed cause of death certification to the local

registrar, in which case the local registrar shall issue death certificates

as set out in subsection 2 of section 193.265. Nothing in this section

shall prevent the state registrar from adopting pilot programs or voluntary

electronic death registration programs until such time as the system can be

certified; however, no such pilot or voluntary electronic death

registration program shall prevent the filing of a death certificate with

the local registrar or the ability to obtain certified copies of death

certificates under subsection 2 of section 193.265 until six months after

such certification that the system is operational.



2. If the place of death is unknown but the dead body is found in

this state, the certificate of death shall be completed and filed pursuant

to the provisions of this section. The place where the body is found shall

be shown as the place of death. The date of death shall be the date on

which the remains were found.



3. When death occurs in a moving conveyance in the United States and

the body is first removed from the conveyance in this state, the death

shall be registered in this state and the place where the body is first

removed shall be considered the place of death. When a death occurs on a

moving conveyance while in international waters or air space or in a

foreign country or its air space and the body is first removed from the

conveyance in this state, the death shall be registered in this state but

the certificate shall show the actual place of death if such place may be

determined.



4. The funeral director or person in charge of final disposition of

the dead body shall file the certificate of death. The funeral director or

person in charge of the final disposition of the dead body shall obtain or

verify:



(1) The personal data from the next of kin or the best qualified

person or source available; and



(2) The medical certification from the person responsible for such

certification.



5. The medical certification shall be completed, attested to its

accuracy either by signature or an electronic process approved by the

department, and returned to the funeral director or person in charge of

final disposition within seventy-two hours after death by the physician in

charge of the patient's care for the illness or condition which resulted in

death. In the absence of the physician or with the physician's approval

the certificate may be completed and attested to its accuracy either by

signature or an approved electronic process by the physician's associate

physician, the chief medical officer of the institution in which death

occurred, or the physician who performed an autopsy upon the decedent,

provided such individual has access to the medical history of the case,

views the deceased at or after death and death is due to natural causes.

The state registrar may approve alternate methods of obtaining and

processing the medical certification and filing the death certificate. The

Social Security number of any individual who has died shall be placed in

the records relating to the death and recorded on the death certificate.



6. When death occurs from natural causes more than thirty-six hours

after the decedent was last treated by a physician, the case shall be

referred to the county medical examiner or coroner or physician or local

registrar for investigation to determine and certify the cause of death.

If the death is determined to be of a natural cause, the medical examiner

or coroner or local registrar shall refer the certificate of death to the

attending physician for such physician's certification. If the attending

physician refuses or is otherwise unavailable, the medical examiner or

coroner or local registrar shall attest to the accuracy of the certificate

of death either by signature or an approved electronic process within

thirty-six hours.



7. If the circumstances suggest that the death was caused by other

than natural causes, the medical examiner or coroner shall determine the

cause of death and shall complete and attest to the accuracy either by

signature or an approved electronic process the medical certification

within seventy-two hours after taking charge of the case.



8. If the cause of death cannot be determined within seventy-two

hours after death, the attending medical examiner or coroner or attending

physician or local registrar shall give the funeral director, or person in

charge of final disposition of the dead body, notice of the reason for the

delay, and final disposition of the body shall not be made until authorized

by the medical examiner or coroner, attending physician or local registrar.



9. When a death is presumed to have occurred within this state but

the body cannot be located, a death certificate may be prepared by the

state registrar upon receipt of an order of a court of competent

jurisdiction which shall include the finding of facts required to complete

the death certificate. Such a death certificate shall be marked

"Presumptive", show on its face the date of registration, and identify the

court and the date of decree.



2010



193.145. 1. A certificate of death for each death which occurs in

this state shall be filed with the local registrar, or as otherwise

directed by the state registrar, within five days after death and shall be

registered if such certificate has been completed and filed pursuant to

this section. All data providers in the death registration process,

including, but not limited to, the state registrar, local registrars, the

state medical examiner, county medical examiners, coroners, funeral

directors or persons acting as such, embalmers, sheriffs, attending

physicians and resident physicians, and the chief medical officers of

licensed health care facilities, and other public or private institutions

providing medical care, treatment, or confinement to persons, shall be

required to use and utilize any electronic death registration system

required and adopted under subsection 1 of section 193.265 within six

months of the system being certified by the director of the department of

health and senior services, or the director's designee, to be operational

and available to all data providers in the death registration process.

Nothing in this section* shall prevent the state registrar from adopting

pilot programs or voluntary electronic death registration programs until

such time as the system can be certified; however, no such pilot or

voluntary electronic death registration program shall prevent the filing of

a death certificate with the local registrar or the ability to obtain

certified copies of death certificates** under subsection 2 of section

193.265 until six months after such*** certification that the system is

operational.



2. If the place of death is unknown but the dead body is found in

this state, the certificate of death shall be completed and filed pursuant

to the provisions of this section. The place where the body is found shall

be shown as the place of death. The date of death shall be the date on

which the remains were found.



3. When death occurs in a moving conveyance in the United States and

the body is first removed from the conveyance in this state, the death

shall be registered in this state and the place where the body is first

removed shall be considered the place of death. When a death occurs on a

moving conveyance while in international waters or air space or in a

foreign country or its air space and the body is first removed from the

conveyance in this state, the death shall be registered in this state but

the certificate shall show the actual place of death if such place may be

determined.



4. The funeral director or person in charge of final disposition of

the dead body shall file the certificate of death. The funeral director or

person in charge of the final disposition of the dead body shall obtain or

verify:



(1) The personal data from the next of kin or the best qualified

person or source available; and



(2) The medical certification from the person responsible for such

certification.



5. The medical certification shall be completed, attested to its

accuracy either by signature or an electronic process approved by the

department, and returned to the funeral director or person in charge of

final disposition within seventy-two hours after death by the physician in

charge of the patient's care for the illness or condition which resulted in

death. In the absence of the physician or with the physician's approval

the certificate may be completed and attested to its accuracy either by

signature or an approved electronic process by the physician's associate

physician, the chief medical officer of the institution in which death

occurred, or the physician who performed an autopsy upon the decedent,

provided such individual has access to the medical history of the case,

views the deceased at or after death and death is due to natural causes.

The state registrar may approve alternate methods of obtaining and

processing the medical certification and filing the death certificate. The

Social Security number of any individual who has died shall be placed in

the records relating to the death and recorded on the death certificate.



6. When death occurs from natural causes more than thirty-six hours

after the decedent was last treated by a physician, the case shall be

referred to the county medical examiner or coroner or physician or local

registrar for investigation to determine and certify the cause of death.

If the death is determined to be of a natural cause, the medical examiner

or coroner or local registrar shall refer the certificate of death to the

attending physician for such physician's certification. If the attending

physician refuses or is otherwise unavailable, the medical examiner or

coroner or local registrar shall attest to the accuracy of the certificate

of death either by signature or an approved electronic process within

thirty-six hours.



7. If the circumstances suggest that the death was caused by other

than natural causes, the medical examiner or coroner shall determine the

cause of death and shall complete and attest to the accuracy either by

signature or an approved electronic process the medical certification

within seventy-two hours after taking charge of the case.



8. If the cause of death cannot be determined within seventy-two

hours after death, the attending medical examiner or coroner or attending

physician or local registrar shall give the funeral director, or person in

charge of final disposition of the dead body, notice of the reason for the

delay, and final disposition of the body shall not be made until authorized

by the medical examiner or coroner, attending physician or local registrar.



9. When a death is presumed to have occurred within this state but

the body cannot be located, a death certificate may be prepared by the

state registrar upon receipt of an order of a court of competent

jurisdiction which shall include the finding of facts required to complete

the death certificate. Such a death certificate shall be marked

"Presumptive", show on its face the date of registration, and identify the

court and the date of decree.



2005



193.145. 1. A certificate of death for each death which occurs in

this state shall be filed with the local registrar, or as otherwise

directed by the state registrar, within five days after death and shall be

registered if such certificate has been completed and filed pursuant to

this section.



2. If the place of death is unknown but the dead body is found in

this state, the certificate of death shall be completed and filed pursuant

to the provisions of this section. The place where the body is found shall

be shown as the place of death. The date of death shall be the date on

which the remains were found.



3. When death occurs in a moving conveyance in the United States and

the body is first removed from the conveyance in this state, the death

shall be registered in this state and the place where the body is first

removed shall be considered the place of death. When a death occurs on a

moving conveyance while in international waters or air space or in a

foreign country or its air space and the body is first removed from the

conveyance in this state, the death shall be registered in this state but

the certificate shall show the actual place of death if such place may be

determined.



4. The funeral director or person in charge of final disposition of

the dead body shall file the certificate of death. The funeral director or

person in charge of the final disposition of the dead body shall obtain or

verify:



(1) The personal data from the next of kin or the best qualified

person or source available; and



(2) The medical certification from the person responsible for such

certification.



5. The medical certification shall be completed, attested to its

accuracy either by signature or an electronic process approved by the

department, and returned to the funeral director or person in charge of

final disposition within seventy-two hours after death by the physician in

charge of the patient's care for the illness or condition which resulted in

death. In the absence of the physician or with the physician's approval

the certificate may be completed and attested to its accuracy either by

signature or an approved electronic process by the physician's associate

physician, the chief medical officer of the institution in which death

occurred, or the physician who performed an autopsy upon the decedent,

provided such individual has access to the medical history of the case,

views the deceased at or after death and death is due to natural causes.

The state registrar may approve alternate methods of obtaining and

processing the medical certification and filing the death certificate. The

Social Security number of any individual who has died shall be placed in

the records relating to the death and recorded on the death certificate.



6. When death occurs from natural causes more than thirty-six hours

after the decedent was last treated by a physician, the case shall be

referred to the county medical examiner or coroner or physician or local

registrar for investigation to determine and certify the cause of death.

If the death is determined to be of a natural cause, the medical examiner

or coroner or local registrar shall refer the certificate of death to the

attending physician for such physician's certification. If the attending

physician refuses or is otherwise unavailable, the medical examiner or

coroner or local registrar shall attest to the accuracy of the certificate

of death either by signature or an approved electronic process within

thirty-six hours.



7. If the circumstances suggest that the death was caused by other

than natural causes, the medical examiner or coroner shall determine the

cause of death and shall complete and attest to the accuracy either by

signature or an approved electronic process the medical certification

within seventy-two hours after taking charge of the case.



8. If the cause of death cannot be determined within seventy-two

hours after death, the attending medical examiner or coroner or attending

physician or local registrar shall give the funeral director, or person in

charge of final disposition of the dead body, notice of the reason for the

delay, and final disposition of the body shall not be made until authorized

by the medical examiner or coroner, attending physician or local registrar.



9. When a death is presumed to have occurred within this state but

the body cannot be located, a death certificate may be prepared by the

state registrar upon receipt of an order of a court of competent

jurisdiction which shall include the finding of facts required to complete

the death certificate. Such a death certificate shall be marked

"Presumptive", show on its face the date of registration, and identify the

court and the date of decree.



1997



193.145. 1. A certificate of death for each death which occurs in

this state shall be filed with the local registrar, or as otherwise

directed by the state registrar, within five days after death and shall be

registered if such certificate has been completed and filed pursuant to

this section.



2. If the place of death is unknown but the dead body is found in

this state, the certificate of death shall be completed and filed pursuant

to the provisions of this section. The place where the body is found shall

be shown as the place of death. The date of death shall be the date on

which the remains were found.



3. When death occurs in a moving conveyance in the United States and

the body is first removed from the conveyance in this state, the death

shall be registered in this state and the place where the body is first

removed shall be considered the place of death. When a death occurs on a

moving conveyance while in international waters or air space or in a

foreign country or its air space and the body is first removed from the

conveyance in this state, the death shall be registered in this state but

the certificate shall show the actual place of death if such place may be

determined.



4. The funeral director or person acting as such in charge of final

disposition of the dead body shall file the certificate of death. The

funeral director shall obtain:



(1) The personal data from the next of kin or the best qualified

person or source available; and



(2) The medical certification from the person responsible for such

certification.



5. The medical certification shall be completed, signed, and returned

to the funeral director or person acting as such within seventy-two hours

after death by the physician in charge of the patient's care for the

illness or condition which resulted in death. In the absence of the

physician or with the physician's approval the certificate may be completed

and signed by the physician's associate physician, the chief medical

officer of the institution in which death occurred, or the physician who

performed an autopsy upon the decedent, provided such individual has access

to the medical history of the case, views the deceased at or after death

and death is due to natural causes. The Social Security number of any

individual who has died shall be placed in the records relating to the

death and recorded on the death certificate.



6. When death occurs from natural causes more than thirty-six hours

after the decedent was last treated by a physician, the case shall be

referred to the county medical examiner or coroner or physician or local

registrar for investigation to determine and certify the cause of death.

If the death is determined to be of a natural cause, the medical examiner

or coroner or local registrar shall refer the certificate of death to the

attending physician for such physician's certification. If the attending

physician refuses or is otherwise unavailable, the medical examiner or

coroner or local registrar shall sign the certificate of death within

thirty-six hours.



7. If the circumstances suggest that the death was caused by other

than natural causes, the medical examiner or coroner shall determine the

cause of death and shall complete and sign the medical certification within

seventy-two hours after taking charge of the case.



8. If the cause of death cannot be determined within seventy-two

hours after death, the attending medical examiner or coroner or attending

physician or local registrar shall give the funeral director, or person

acting as such, notice of the reason for the delay, and final disposition

of the body shall not be made until authorized by the medical examiner or

coroner, attending physician or local registrar.



9. When a death is presumed to have occurred within this state but

the body cannot be located, a death certificate may be prepared by the

state registrar upon receipt of an order of a court of competent

jurisdiction which shall include the finding of facts required to complete

the death certificate. Such a death certificate shall be marked

"Presumptive", show on its face the date of registration, and identify the

court and the date of decree.



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