HB 186 -- Protection of the Elderly

Co-Sponsors:  Jolly, Willoughby, Abel, Johnson (90), Sager,
LeVota, Curls, Carnahan, Burnett, Wilson (42), Zweifel, Harris
(23), Muckler, Green, Donnelly, Yaeger, Bishop, Haywood, Henke,
Walker, Meiners, Jones, Hampton, Campbell, Spreng, Fraser,
Ransdall, Schoemehl, Wildberger, Dougherty, Bland, Selby, Villa,
Lowe, Davis (122), McKenna, Barnitz, Seigfreid, Shoemyer (9),
Young, Liese, Riback Wilson (25), Ward

This bill modifies the law relating to protection of the elderly.
In its major provisions, the bill:

(1)  Creates a new chapter on protection of the elderly and
transfers several existing statutory sections to this chapter;

(2)  Expands the list of persons required to report suspected
elder abuse to the Department of Health and Senior Services and
mandates that suspected abuse be reported within 24 hours;

(3)  Requires reports of suspected elder abuse to be referred to
the appropriate law enforcement agency.  Current law requires
only substantiated reports to be referred.  The department is
also required to investigate immediately any report of elder
abuse or neglect that involves a threat of imminent harm;

(4)  Requires the department and law enforcement agencies to
cross-train personnel in investigating cases of suspected elder
abuse;

(5)  Allows statements by adults 60 years of age or older or with
a disability that are related to an offense, crime, or misconduct
to be admitted into evidence under certain conditions;

(6)  Requires that persons or institutions who make reports or
cooperate with the department in investigations and who have not
committed elder abuse be immune from civil or criminal liability
unless they have done so negligently, recklessly, in bad faith,
or with malicious purpose;

(7)  Requires emergency medical services and hospital employees
who abuse, neglect, or financially exploit the elderly to be
placed on the employee disqualification list;

(8)  Allows the department to require the production of
documentation and other information for use in investigations and
inspections under penalty of refusal, suspension, or revocation
of a license or contract;

(9)  Requires the departments of Health and Senior Services,
Mental Health, and Social Services to cooperate in abuse and
neglect investigations;

(10)  Extends the moratorium on issuing certificates of need for
long-term care beds until July 1, 2007, and extends the no
minimum expenditure provisions for facilities that can apply for
certificates of need until January 1, 2007;

(11)  Requires the department to consider in issuing or renewing
a license the compliance history of the operator of a home health
agency, the compliance history of any agency in which the
operator or owner has had a financial interest, and any home
health agency responses to survey findings in the official review
made by the department.  Any application must include a sworn
affidavit attesting to the agency's substantial compliance with
all state and federal laws and regulations;

(12)  Requires the department to consider in issuing or renewing
a license the compliance history of the operator of a long-term
care facility (LTCF), the compliance history of any LTCF in which
the operator or owner has had a financial interest, and any
facility responses to survey findings in the official review made
by the department;

(13)  Requires the department to require LTCFs to submit
information on staffing and retention and to post this
information publicly on its web site;

(14)  Requires all residential care facilities I, residential
care facilities II, intermediate care facilities, and skilled
nursing facilities to post their most recent inspection report
conspicuously in their facilities;

(15)  Permits the disclosure of confidential personal records
without court order only to specific state agencies in order to
perform their constitutional and statutory duties or to the
resident or the resident's guardian or conservator;

(16)  Prohibits insurance carriers from considering
unsubstantiated inspection reports and reports of investigations
of complaints for underwriting purposes;

(17)  Allows the department to revoke a nursing home license for
any reason for which they may deny an application for licensure;

(18)  Increases the civil penalties for violation of state laws
and regulations for nursing homes and stresses that these
penalties are to be imposed in cases where there have been
multiple violations regardless of any subsequent correction of
the violations by a facility;

(19)  Requires nursing homes and hospitals receiving transfers
from nursing homes to notify the local coroner immediately upon
the death of any resident and notify the department within one
business day of the death;

(20)  Protects residents and their families from retaliation from
nursing homes if they have made reports of violations that they
have reasonable cause to believe have occurred;

(21)  Allows the department to decrease the frequency of
inspections of licensed facilities from twice a year to once a
year based on the facility's compliance record;

(22)  Requires salaries for physical, occupational, speech, and
inhalation therapy to be included in the patient care expenditure
component of the nursing facility Medicaid per diem rate;

(23)  Prohibits persons from claiming any privilege as a defense
for failing to report suspected elder abuse except for those
afforded to attorneys and members of the clergy;

(24)  Permits the department access to all financial and medical
records related directly to investigations of alleged misconduct;

(25)  Requires all Medicaid participation agreements with in-home
service provider agencies to include a requirement for abuse and
neglect training and training in dealing with Alzheimer's
patients when applicable;

(26)  Allows the department to seek injunction for interference
with an investigation or inspection;

(27)  Requires the department to provide specific written notice
to in-home service provider agencies in cases where contracts are
denied, placed on probation, or terminated.  The provider will
have 30 days to file a complaint requesting a hearing before the
Administrative Hearing Commission, where the burden of proof will
be on the provider; and

(28)  Allows the department to issue letters of censure or
warning without notice.

Missouri House of Representatives
Last Updated July 25, 2003 at 10:11 am