Residents’ Funds and Property

PURPOSE: This rule establishes standards for protecting residents’ personal funds and property in all types of licensed long-term care facilities. AGENCY NOTE: All rules relating to longterm care facilities licensed by the Department of Health and Senior Services are followed by a Roman Numeral notation which refers to the class (either Class I, II, or III) of standard as designated in section 198.085, RSMo. (1) No operator is required by this rule or by section 198.090, RSMo, to hold, manage, safeguard, or account for any personal funds or money in trust unless some other governmental agency placing residents in the facility makes this a requirement. The record keeping and other requirements of this section apply only to those personal possessions and funds which the facility accepts to hold in trust for the resident as provided in the facility’s policy. (2) The operator or other designated person shall use the personal funds of the resident exclusively for the use of the resident and only when authorized in writing by the resident, his/her designee, guardian and conservator, or conservator. A designee shall not be the administrator or an employee of the facility. With written authorization, the operator may purchase a burial policy for the resident. II/III (3) When a resident is admitted, the resident, his/her designee, guardian and conservator, or conservator shall be provided with a statement explaining the facility’s policies and resident’s rights regarding personal funds. If the facility handles residents’ funds, this statement shall include an explanation of the procedure for deposit or withdrawals of funds from any source to the resident or to the resident’s account. The facility shall allow the residents access to their personal possessions and funds during regular business hours, Monday through Friday, excluding banking holidays. III (4) The separate account(s) required to be maintained by section 198.090.1.(3), RSMo, shall be maintained in a bank or savings and loan association and if any interest is accrued it shall be credited to each resident’s account at least monthly. II/III (5) A petty cash fund of up to fifty dollars ($50) for each resident for whom the facility is holding funds may be kept in the facility and shall be maintained separately from the facility's funds. II/III (6) A written account for each resident, showing receipts to and disbursements from the personal funds of each resident, shall be maintained. If the facility policy provides, or if required by another governmental agency, multiple personal funds accounts may be kept for residents. III (7) Receipt of a resident’s funds or personal possessions held in trust shall be acknowledged by a written receipt or cancelled check. III (8) Receipts for any purchases made by the operator and paid for from the resident’s personal funds shall be kept pursuant to sections (15) and (16) of this rule and be available to the resident, his/her designee, guardian and conservator, or conservator. III (9) All written accounts of the residents’ funds shall be reconciled monthly and a written statement showing the current balance and all transactions shall be given to the resident, his/her designee, guardian and conservator, or conservator on a quarterly basis. II/III (10) Within five (5) calendar days of the discharge of a resident, the resident, his/her designee, guardian and conservator, or conservator shall be given an up-to-date accounting of the resident’s personal funds and the balance of the funds and all personal possessions shall be returned to the resident. This requirement shall not apply for residents discharged due to death, or for residents discharged to hospitals when those residents are expected to return to the facility. The operator shall have a receipt for all funds and possessions returned to the resident, his/her designee, guardian and conservator, or conservator. II/III (11) Upon the death of a resident, the operator shall contact the Department of Social Services (DSS), MO HealthNet Division, Third Party Liability Unit, to determine if the deceased resident is a MO HealthNet participant or has been a recipient of aid, assistance, care, services, or if the resident has had moneys expended on his/her behalf by DSS. The facility shall document the contact(s) with and response(s) from DSS. II/III (A) If the deceased resident is a MO HealthNet participant or has been a recipient of aid, assistance, care, services, or the resident has had moneys expended on his/her behalf by DSS, the operator shall provide DSS within sixty (60) days of the resident’s death, a complete account of all the resident’s remaining personal funds and the name and address of the resident’s designee, guardian and conservator, or conservator, fiduciary of the resident’s estate, or the individual who was designated to receive the quarterly accounting of all financial transactions made. Personal funds for the purpose of this regulation shall include all the resident’s remaining funds with the facility, in any account, with whatever title the account(s) may be known. II/III (B) None of the resident’s personal funds shall be paid to an operator, fiduciary, guardian and conservator, conservator, or other person until the operator has fully complied with section 198.090.1., RSMo, except that funeral expenses may be paid from a resident’s personal funds held by a facility if no other funds are available to cover the cost. If funds are used for this purpose, this fact and the amount used shall be noted on the account report submitted to DSS and documentation of payment shall be attached. II/III (C) DSS will determine the amount of aid, care, assistance, or services paid and will notify the operator of the amount determined to have been paid on behalf of the deceased recipient within sixty (60) days of receipt of the facility operator’s accounting. (D) The operator may make a special request for expedited response if there is a need to comply with a contractual or regulatory obligation of another governmental agency. The amount specified in the notification shall be considered as a claim upon the funds held by the operator. (E) The operator shall pay DSS any remaining personal funds in the resident’s personal fund account up to the amount determined by DSS. Payment shall be made as instructed by DSS within sixty (60) working days of the receipt of the demand for payment. If additional funds are received by the facility after the initial claim has been filed, the operator shall immediately inform DSS. II/III (F) DSS will notify in writing the resident’s guardian and conservator, conservator, fiduciary of the resident’s estate, or the individual who was designated to receive the quarterly accounting of all financial transactions of the amount determined to have been paid by DSS on behalf of the deceased resident. (12) Upon the death of a resident who has not been a recipient of aid, assistance, care, Property in Long-Term Care Facilities services, or who has not had moneys expended on the resident’s behalf by DSS or DSS has not made claim on the funds, the operator shall provide the fiduciary of resident’s estate, at the fiduciary’s request, a complete account of all the resident’s personal funds and possessions and deliver to the fiduciary all possessions of the resident and the balance of the resident’s funds. II/III (A) If, after one (1) year from the date of death, no fiduciary makes claim on funds or possessions, the operator shall notify the Department of Health and Senior Services (department) in writing, Attention: Licensure and Certification Unit, PO Box 570, Jefferson City, MO 65102-0570 that the funds remain unclaimed. This notice shall be sent by the operator within sixty (60) days. The notice shall include the resident’s name, Social Security number, date of death, and the amount of resident funds or possessions being held belonging to the deceased resident. II/III 1. If unclaimed funds in the resident’s fund accounts or possessions have a value of one hundred fifty dollars ($150) or less, the funds or proceeds of the sale of the possessions shall be deposited in a fund for the benefit of all residents of the facility for social and educational activities. II/III 2. If unclaimed funds in the resident’s fund accounts or possessions have a value of more than one hundred fifty dollars ($150), these funds or possessions shall be considered abandoned property under sections 447.500–447.585, RSMo. The operator shall report and return the abandoned property to the Missouri State Treasurer in accordance with sections 447.539–447.543, RSMo. II/III (B) The operator shall keep an accounting of these funds with documentation and receipts and disbursements of these funds which will be subject to inspection and audit by the department. II/III (13) Any owner, operator, manager, employee, or affiliate of an owner or operator receiving personal property or anything with a value of ten dollars ($10) or more from a resident shall make a written statement giving the date of receipt, estimated value, and the name of the person making the gift. These statements shall be retained by the operator and made available to the department or Department of Mental Health as appropriate and to the resident, his/her designee, guardian and conservator, or conservator. No owner, operator, manager, employee, or affiliate of an owner or operator shall in one (1) calendar year receive any personal property or anything of value from the residents of any facility which have a total value over one hundred dollars ($100). These requirements shall not apply to matters deemed exceptions under state law. II (14) The bond required by section 198.096, RSMo, for operators holding personal funds of residents shall be in a form approved by the department and shall provide that residents who allege that they have been wrongfully deprived of moneys held in trust may bring an action for recovery directly against the surety. The bond shall be in an amount equal to at least one and one-half (1 1/2) times the average monthly balance of the residents’ personal funds, including residents’ petty cash, or the average total of the monthly balances for the preceding twelve (12) months. The average monthly balance(s) or the average total of the monthly balance(s) shall be rounded to the nearest one thousand dollars ($1,000). One (1) bond may be used to cover the residents’ funds in more than one (1) facility operated by the same operator, if the facility is a multilicensed facility on the same premises. If not on the same premises, then one (1) bond may be used if the bond specifies the amount of coverage provided for each individual facility and the coverage for each facility is a minimum of one thousand dollars ($1,000). II/III (15) All records and receipts required to be maintained under this rule and under section 198.090, RSMo shall be maintained for at least seven (7) years from the end of the fiscal year during which the records were originally made. II/III (16) Records related to resident funds shall be maintained in the facility or shall be available for review and copying, in their entirety, within twenty-four (24) hours of a request for access by the department or its authorized representative. Records kept for the prior seven (7) years, as required in section (15) and under section 198.090, RSMo, shall be transferred to a new operator who assumes responsibility for a facility, and if not transferred in their entirety, the department shall be notified immediately by the new operator. II/III (17) If an operator chooses to place a cash deposit in a lending institution in lieu of a bond as referenced in section 198.096.5., RSMo, the amount must be equal to the amount of the bond required and shall be deposited with an insured lending institution pursuant to a noncancellable escrow agreement. The written agreement shall be submitted to the department and shall be approved prior to license issuance. II AUTHORITY: sections 198.009 and 198.090, RSMo 2000.* This rule originally filed as 13 CSR 15-18.020. Original rule filed July 13, 1983, effective Oct. 13, 1983. Amended: Filed Sept. 12, 1984, effective Dec. 13, 1984. Amended: Filed Aug. 1, 1988, effective Nov. 11, 1988. Amended: Filed Jan. 3, 1992, effective Aug. 6, 1992. Amended: Filed July 22, 1994, effective Feb. 26, 1995. Moved to 19 CSR 30-88.020, effective Aug. 28, 2001. Amended: Filed March 15, 2012, effective Oct. 30, 2012. *Original authority: 198.090, RSMo 1979, amended 1982, 1989, 1992, 1993.