- Introduced -

SB 311 - This act modifies various provisions relating to the protection of the elderly. Section 187.010 provides the necessary definitions relating to long-term care facilities and elder abuse.

Certain mandated reporters must report suspected abuse and neglect of eligible adults or persons sixty years of age and older to the Department within 24 hours. Any required person failing to make a report within a reasonable time will be guilty of a Class A misdemeanor. Any person purposefully filing a false report of elder abuse and neglect will be guilty of a Class A misdemeanor (Section 187.020).

Reports involving the abuse and neglect of residents of long-term care facilities must contain the name and address of the facility, the name of the resident, the nature of the abuse and neglect, and the name of the complainant. Any person who knowingly abuses or neglects a resident of a facility will be guilty of a Class D felony (Section 187.024).

Reports involving the abuse and neglect of eligible adults not residing in a facility must contain the name and address of the facility, the name of the resident, the nature of the abuse and neglect, and the name of the complainant. Any person who knowingly abuses or neglects an eligible adult not residing in a facility will be guilty of a Class D felony (Section 187.028).

The Department must promptly refer all cases of suspected abuse to the appropriate law enforcement agency. The Department and law enforcement must share resources for training (Section 187.030). Subject to conditions, any statement made by a person sixty years or older or a disabled person shall be admissible in a criminal, civil, or administrative proceeding (Section 187.032).

Any person or institution making a report pursuant to Section 187.020 to Section 187.050 shall be immune from any civil or criminal liability (Section 187.034). Any person, who has reasonable cause to believe that the misappropriation of property or funds of an eligible adult not residing in a facility has occurred, must report such information to the Department. Retaliation against an eligible adult not residing in a facility for reporting any violations of standards is prohibited (Section 187.050).

Section 187.080 details the requirements of the employee disqualification list. Providers must request a criminal background check prior to allowing any full-time, part-time, or temporary employee to have contact with a patient or resident. Providers may have a private investigator, rather than the highway patrol, conduct the criminal background check (Section 187.084).

Section 187.087 specifies that confidential reports filed pursuant to Sections 187.020 to 187.034 and Sections 187.050 to 187.080 will not be deemed public records.

The Director has the authority to require answers to written interrogatories and require production of any papers or records that are relevant to an inspection and investigation (Section 187.090). The Departments of Social Services, Health and Senior Services, and Mental Health shall work together in the investigation of abuse, neglect, and financial exploitation (Section 187.102).

Section 197.317 and Section 197.318 restore the moratorium on the certificate of need expenditure minimum until January 1, 2007.

Section 197.416 details requirements for the Department when issuing or renewing the license of a home health agency. Applications for a license must include an affidavit regarding the exercise of due diligence in observing the condition and operation of the facility (Section 198.018).

Section 198.019 details requirements for the Department when issuing or renewing the license of a facility. Section 198.022 requires the Department to make two inspections of a facility per year, except as provided in Section 198.526.

The Department must promulgate rules requiring facilities to submit information as to their actual staffing and staff retention patterns. The information shall be available to the public by July 1, 2004 (Section 198.024).

Every residential care facility I or II, intermediate care facility, or skilled nursing facility shall post the most recent inspection report in conspicuous location in a facility (Section 198.031).

The Department of Social Services may access the records of Medicaid patients in order to perform constitutional and statutory duties. The use of unsubstantiated inspection reports by insurance carriers for the purpose of underwriting is prohibited (Section 198.032).

Section 198.036 allows the Department to revoke a license if a facility fails to comply with class I standards on two occasions within a 24-month period. The Department may revoke the license of a operator for any of the reasons that an application for a license is denied pursuant to Section 198.022.

An operator of a facility that has been cited for violations shall be liable for up to $75,000 for each day the violations existed, regardless of whether the violations were corrected. The Elderly Home-Delivered Meals Trust Fund will receive 25% of the penalties collected and the remaining 75% of penalties collected will be deposited into the Nursing Facility Quality of Care Fund. Civil penalties cannot be sold, transferred, or otherwise assigned. The General Assembly specifically intends for the civil penalties specified to be imposed, regardless of any subsequent correction (Section 198.067).

The administrator of a facility must contact the local coroner immediately upon the death of a resident. The Department must receive a written report containing the information provided to the coroner within one business day of the resident's death. Hospitals must immediately notify the administrator of a facility upon the death of a resident that was transferred to the emergency room or inpatient unit (Section 198.071).

Section 198.093 allows residents to file written complaints regarding the deprivation of rights or estates within two years of the alleged violation.

Nursing home districts are prohibited from evicting, harassing, or retaliating against a resident or employee because of any reported violations made by the resident, resident's family, or employee of the facility. Residents and employees of a facility may obtain information regarding their rights and protections from the Department's telephone referral and information line (Section 198.301).

Section 198.525 requires facility inspections twice per year, unless otherwise provided pursuant to Section 198.526. The frequency of inspections will be reduced to once a year, provided that during an 18-month period the facility had no class I deficiencies or class II violations and had no substantiated complaints or changes in ownership in the preceding year. Any employee of the Department that discloses an inspection time to a facility will be immediately terminated and guilty of a Class A misdemeanor (Section 198.526).

The patient care expenditure component of the nursing facility Medicaid per diem rate will include salaries and supplies for physical, occupational, speech and inhalation therapy (Section 208.159).

The Department shall have access to all financial, medical, mental health and judicial records with restrictions (Section 660.251).

All Medicaid participation agreements entered into by the Department and an in-home services agency shall include training on abuse and neglect (Section 660.252).

Section 660.270 allows the Department to petition the court to enjoin interference with an investigation. Section 660.310 requires the Department to give written notice of any proposed suspension, probation or termination. The Administrative Hearing Commission will have the authority to hear complaints and appeals.

The Department must not disclose any personally identifiable medical, social, personal or financial records of an eligible adult being served by the Division of Senior Services (Section 660.321).

This act is identical to HB 186 (2003).

LORIE TOWE