660.300. 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 proh
Report of abuse or neglect of in-home services or home health agencyclient, duty--penalty--contents of report--investigation,procedure--confidentiality of report--immunity--retaliationprohibited, penalty--employee disqualification list--safe at homeevaluations, procedure.
660.300. 1. When any adult day care worker; chiropractor; ChristianScience practitioner; coroner; dentist; embalmer; employee of the departmentsof social services, mental health, or health and senior services; employee ofa local area agency on aging or an organized area agency on aging program;funeral director; home health agency or home health agency employee; hospitaland clinic personnel engaged in examination, care, or treatment of persons;in-home services owner, provider, operator, or employee; law enforcementofficer; long-term care facility administrator or employee; medical examiner;medical resident or intern; mental health professional; minister; nurse; nursepractitioner; optometrist; other health practitioner; peace officer;pharmacist; physical therapist; physician; physician's assistant; podiatrist;probation or parole officer; psychologist; or social worker has reasonablecause 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 areport to be made to the department. If the report is made by a physician ofthe in-home services client, the department shall maintain contact with thephysician regarding the progress of the investigation.
2. When a report of deteriorating physical condition resulting inpossible abuse or neglect of an in-home services client is received by thedepartment, the client's case manager and the department nurse shall benotified. The client's case manager shall investigate and immediately reportthe results of the investigation to the department nurse. The department mayauthorize the in-home services provider nurse to assist the case manager withthe investigation.
3. If requested, local area agencies on aging shall provide volunteertraining to those persons listed in subsection 1 of this section regarding thedetection and report of abuse and neglect pursuant to this section.
4. Any person required in subsection 1 of this section to report orcause a report to be made to the department who fails to do so within areasonable time after the act of abuse or neglect is guilty of a class Amisdemeanor.
5. The report shall contain the names and addresses of the in-homeservices provider agency, the in-home services employee, the in-home servicesclient, the home health agency, the home health agency employee, informationregarding the nature of the abuse or neglect, the name of the complainant, andany other information which might be helpful in an investigation.
6. In addition to those persons required to report under subsection 1 ofthis section, any other person having reasonable cause to believe that anin-home services client or home health patient has been abused or neglected byan in-home services employee or home health agency employee may report suchinformation to the department.
7. If the investigation indicates possible abuse or neglect of anin-home services client or home health patient, the investigator shall referthe complaint together with his or her report to the department director orhis or her designee for appropriate action. If, during the investigation orat its completion, the department has reasonable cause to believe thatimmediate action is necessary to protect the in-home services client or homehealth patient from abuse or neglect, the department or the local prosecutingattorney may, or the attorney general upon request of the department shall,file a petition for temporary care and protection of the in-home servicesclient or home health patient in a circuit court of competent jurisdiction.The circuit court in which the petition is filed shall have equitablejurisdiction to issue an ex parte order granting the department authority forthe temporary care and protection of the in-home services client or homehealth 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-homeservices client or home health patient, who makes a report pursuant to thissection or who testifies in any administrative or judicial proceeding arisingfrom the report shall be immune from any civil or criminal liability formaking such a report or for testifying except for liability for perjury,unless such person acted negligently, recklessly, in bad faith, or withmalicious purpose.
10. Within five working days after a report required to be made underthis section is received, the person making the report shall be notified inwriting of its receipt and of the initiation of the investigation.
11. No person who directs or exercises any authority in an in-homeservices provider agency or home health agency shall harass, dismiss orretaliate against an in-home services client or home health patient, or anin-home services employee or a home health agency employee because he or anymember of his or her family has made a report of any violation or suspectedviolation of laws, standards or regulations applying to the in-home servicesprovider agency or home health agency or any in-home services employee or homehealth agency employee which he has reasonable cause to believe has beencommitted or has occurred.
12. Any person who abuses or neglects an in-home services client or homehealth patient is subject to criminal prosecution under section 565.180,565.182, or 565.184, RSMo. If such person is an in-home services employee andhas been found guilty by a court, and if the supervising in-home servicesprovider willfully and knowingly failed to report known abuse by such employeeto the department, the supervising in-home services provider may be subject toadministrative penalties of one thousand dollars per violation to be collectedby the department and the money received therefor shall be paid to thedirector of revenue and deposited in the state treasury to the credit of thegeneral revenue fund. Any in-home services provider which has hadadministrative penalties imposed by the department or which has had itscontract terminated may seek an administrative review of the department'saction pursuant to chapter 621, RSMo. Any decision of the administrativehearing commission may be appealed to the circuit court in the county wherethe 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 supervisionprocess for clients that requires an in-home services provider agency toconduct random visits to verify compliance with program standards and verifythe accuracy of records kept by an in-home services employee.
14. The department shall maintain the employee disqualification list andplace on the employee disqualification list the names of any persons who havebeen finally determined by the department, pursuant to section 660.315, tohave recklessly, knowingly or purposely abused or neglected an in-homeservices client or home health patient while employed by an in-home servicesprovider agency or home health agency. For purposes of this section only,"knowingly" and "recklessly" shall have the meanings that are ascribed to themin this section. A person acts "knowingly" with respect to the person'sconduct when a reasonable person should be aware of the result caused by hisor her conduct. A person acts "recklessly" when the person consciouslydisregards a substantial and unjustifiable risk that the person's conduct willresult in serious physical injury and such disregard constitutes a grossdeviation from the standard of care that a reasonable person would exercise inthe situation.
15. At the time a client has been assessed to determine the level ofcare as required by rule and is eligible for in-home services, the departmentshall conduct a "Safe at Home Evaluation" to determine the client's physical,mental, and environmental capacity. The department shall develop the safe athome evaluation tool by rule in accordance with chapter 536, RSMo. Thepurpose of the safe at home evaluation is to assure that each client has theappropriate level of services and professionals involved in the client's care. The plan of service or care for each in-home services client shall beauthorized by a nurse. The department may authorize the licensed in-homeservices nurse, in lieu of the department nurse, to conduct the assessment ofthe client's condition and to establish a plan of services or care. Thedepartment may use the expertise, services, or programs of other departmentsand 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 anyclient to a mental health professional, as defined in 9 CSR 30-4.030, forevaluation and treatment as necessary.
16. Authorized nurse visits shall occur at least twice annually toassess the client and the client's plan of services. The provider nurse shallreport the results of his or her visits to the client's case manager. If theprovider nurse believes that the plan of service requires alteration, thedepartment shall be notified and the department shall make a clientevaluation. All authorized nurse visits shall be reimbursed to the in-homeservices provider. All authorized nurse visits shall be reimbursed outside ofthe nursing home cap for in-home services clients whose services have reachedone hundred percent of the average statewide charge for care and treatment inan intermediate care facility, provided that the services have beenpreauthorized by the department.
17. All in-home services clients shall be advised of their rights by thedepartment at the initial evaluation. The rights shall include, but not belimited to, the right to call the department for any reason, includingdissatisfaction with the provider or services. The department shall establisha process to receive such nonabuse and neglect calls other than the elderabuse and neglect hotline.
18. Subject to appropriations, all nurse visits authorized in sections660.250 to 660.300 shall be reimbursed to the in-home services provideragency.
(L. 1992 S.B. 573 & 634, A.L. 2003 S.B. 556 & 311, A.L. 2003 2nd Ex. Sess. S.B. 4)Effective 9-15-03