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--- version:5155S.01I - Introduced+++ version:Senate Committee Substitute - Committee Version@@ -1,212 +1,50 @@-EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted-and is intended to be omitted in the law.-SECOND REGULAR SESSION+5155S.03C+ 1+SENATE COMMITTEE SUBSTITUTE+FORSENATE BILL NO. 910-103RD GENERAL ASSEMBLY-INTRODUCED BY SENATOR SCHNELTING.-5155S.01I KRISTINA MARTIN, SecretaryAN ACT-To repeal sections 198.036, 198.528, 198.532, and 565.184, RSMo, and to enact in lieu thereof-five new sections relating to the abuse or neglect of certain persons, with penalty-provisions.+To repeal section 565.184, RSMo, and to enact in lieu+thereof one new section relating to the abuse or+neglect of certain persons, with penalty provisions.+Be it enacted by the General Assembly of the State of Missouri, as follows:- Section A. Sections 198.036, 198.528, 198.532, and 1-565.184, RSMo, are repealed and five new sections enacted in 2-lieu thereof, to be known as sections 198.019, 198.036, 198.528, 3-198.532, and 565.184, to read as follows:4- 198.019. 1. As used in this section, the term "long- 1-term care facility" means any facility licensed under this 2-chapter. 3- 2. Except as otherwise provided in subsection 3 of 4-this section, each long-term care facility shall maintain 5-liability insurance coverage in a minimum amount of one 6-million dollars to insure against losses resulting from the 7-negligent or criminal acts of the facility that constitute 8-abuse, neglect, or wrongful death of any resident. 9- 3. A long-term care facility shall be exempt from the 10-requirement to maintain liability insurance coverage under 11-subsection 2 of this section if the long-term care facility 12-maintains a reserve account, segregated from its operational 13-funds, of at least one million dollars to cover losses 14-resulting from the negligent or criminal acts of the 15- SB 910 2-facility that constitute abuse, neglect, or wrongful death 16-of any resident. 17- 198.036. 1. The department may revoke a license in 1-any case in which it finds that: 2- (1) The operator failed or refused to comply with 3-class I or II standards, as established by the department 4-pursuant to section 198.085; or failed or refused to comply 5-with class III standards as established by the department 6-pursuant to section 198.085, where the aggregate effect of 7-such noncompliances presents either an imminent danger to 8-the health, safety or welfare of any resident or a 9-substantial probability that death or serious physical harm 10-would result; 11- (2) The operator refused to allow representatives of 12-the department to inspect the facility for compliance with 13-standards or denied representatives of the department access 14-to residents and employees necessary to carry out the duties 15-set forth in this chapter and rules promulgated thereunder, 16-except where employees of the facility are in the process of 17-rendering immediate care to a resident of such facility; 18- (3) The operator knowingly acted or knowingly omitted 19-any duty in a manner which would materially and adversely 20-affect the health, safety, welfare or property of a resident; 21- (4) The operator demonstrated financial incapacity to 22-operate and conduct the facility in accordance with the 23-provisions of sections 198.003 to 198.096; 24- (5) The operator or any principals in the operation of 25-the facility have ever been convicted of, or pled guilty or 26-nolo contendere to a felony offense concerning the operation 27-of a long-term health care facility or other health care 28-facility, or ever knowingly acted or knowingly failed to 29-perform any duty which materially and adversely affected the 30- SB 910 3-health, safety, welfare, or property of a resident while 31-acting in a management capacity. The operator of the 32-facility or any principal in the operation of the facility 33-shall not be under exclusion from participation in the Title 34-XVIII (Medicare) or Title XIX (Medicaid) program of any 35-state or territory; [or] 36- (6) The operator or any principals involved in the 37-operation of the facility have ever been convicted of or 38-pled guilty or nolo contendere to a felony in any state or 39-federal court arising out of conduct involving either 40-management of a long-term care facility or the provision or 41-receipt of health care; or 42- (7) The operator failed to maintain liability 43-insurance coverage or a reserve account as required under 44-section 198.019. 45- 2. Nothing in subdivision (2) of subsection 1 of this 46-section shall be construed as allowing the department access 47-to information not necessary to carry out the duties set 48-forth in sections 198.006 to 198.186. 49- 3. Upon revocation of a license, the director of the 50-department shall so notify the operator in writing, setting 51-forth the reason and grounds for the revocation. Notice of 52-such revocation shall be sent by a delivery service that 53-provides a dated receipt of delivery to the operator and 54-administrator, or served personally upon the operator and 55-administrator. The department shall provide the operator 56-notice of such revocation at least ten days prior to its 57-effective date. 58- 198.528. 1. The department of health and senior 1-services shall provide through its internet website: 2- (1) The most recent survey of every long-term care 3-facility licensed in this state and any such findings of 4- SB 910 4-deficiencies and the effect the deficiency would have on 5-such facility. If such survey is in dispute, the survey 6-shall not be posted on the website until the facility's 7-informal dispute resolution process resolves the dispute and 8-the department shall, upon request of the facility, post the 9-facility's response; 10- (2) The facility's proposed plan of correction; 11- (3) A link to the federal website that provides a 12-summary of facility surveys conducted over the last three 13-years; and 14- (4) Information on how to obtain a copy of a complete 15-facility survey conducted over the last three years. 16- 2. (1) The department shall display an abuse and 17-neglect icon in form of a visible, standardized graphic 18-symbol next to the informational listing on its website of 19-any facility that has a substantiated finding of abuse or 20-neglect from: 21- (a) The federal Centers for Medicare and Medicaid 22-Services (CMS) Care Compare website, or successor website; 23- (b) A federal or state inspection or complaint 24-investigation conducted by the department or CMS; or 25- (c) An investigation by a law enforcement agency or 26-another authorized investigative body. 27- (2) The abuse icon shall be tied to the facility's 28-physical address and state license number and shall remain 29-in place regardless of any change in the facility's name, 30-ownership, management company, or corporate structure. 31- (3) The abuse icon shall be displayed in close 32-proximity to the facility's name on the facility's profile 33-page or informational listing and in any search results on 34-the department's website where the facility appears. A 35-plain-language summary of the abuse incident or incidents, 36- SB 910 5-including the date or dates of occurrence, the nature of the 37-abuse, and the source of the finding, shall accompany the 38-icon, either on the profile page or informational listing or 39-through an easily accessible link. 40- (4) The abuse icon shall remain displayed for thirty- 41-six months from the date of the most recent substantiated 42-finding, unless the finding is overturned on appeal. 43- 3. Nothing in this section shall be construed as 44-requiring the department to post any information on its 45-internet website that is prohibited from disclosure pursuant 46-to the federal Health Insurance Portability and 47-Accountability Act, as amended. 48- 198.532. 1. Complaints filed with the department of 1-health and senior services against a long-term care facility 2-which allege that harm has occurred or is likely to occur to 3-a resident or residents of the facility due to actions or 4-the lack of actions taken by the facility shall be 5-investigated within thirty days of receipt of such 6-complaints. The purpose of such investigation shall be to 7-ensure the safety, protection and care of all residents of 8-the facility likely to be affected by the alleged action or 9-inaction. Such investigation shall be in addition to the 10-investigation requirements for abuse and neglect reports 11-pursuant to section 198.070. 12- 2. The department shall provide the results of all 13-investigations in accordance with section 192.2500. The 14-department shall provide the results of such investigation 15-in writing to all parties to the complaint, and if 16-requested, to any of the facility's residents, or their 17-family members or guardians. Complaints and written results 18-will be readily available for public access and review at 19-the department of health and senior services and at the long- 20- SB 910 6-term care facility. Personal information identifying the 21-resident will be blanked out, except in regard to immediate 22-family, the attorney-in-fact or the legal guardian of the 23-resident in question. This information will remain readily 24-available for a period of time determined by the department 25-of health and senior services. 26- 3. The department shall provide the results of any 27-substantiated report of a facility resident's abuse or 28-neglect to the general assembly and the lieutenant governor, 29-consistent with the provisions of this section. 30- 565.184. 1. A person commits the offense of abuse of 1-an elderly person, a person with a disability, or a 2-vulnerable person if he or she: 3- (1) Purposely engages in conduct involving more than 4-one incident that causes emotional distress to an elderly 5-person, a person with a disability, or a vulnerable person. 6-The course of conduct shall be such as would cause a 7-reasonable elderly person, person with a disability, or 8-vulnerable person to suffer substantial emotional distress; 9-or 10- (2) Intentionally fails to provide care, goods or 11-services to an elderly person, a person with a disability, 12-or a vulnerable person. The result of the conduct shall be 13-such as would cause a reasonable elderly person, person with 14-a disability, or vulnerable person to suffer physical or 15-emotional distress; or 16- (3) Knowingly acts or knowingly fails to act in a 17-manner which results in a substantial risk to the life, body 18-or health of an elderly person, a person with a disability, 19-or a vulnerable person. 20- 2. The offense of abuse of an elderly person, a person 21-with a disability, or a vulnerable person is a class A 22- SB 910 7-misdemeanor; however, if a person commits the offense of 23-abuse of an elderly person, a person with a disability, or a 24-vulnerable person under subdivision (3) of subsection 1 of 25-this section and such person is a care provider subject to 26-employee disqualification under the provisions of section 27-192.2490, the offense of abuse of an elderly person, a 28-person with a disability, or a vulnerable person is a class 29-E felony. Nothing in this section shall be construed to 30-mean that an elderly person, a person with a disability, or 31-a vulnerable person is abused solely because such person 32-chooses to rely on spiritual means through prayer, in lieu 33-of medical care, for his or her health care, as evidence by 34-such person's explicit consent, advance directive for health 35-care, or practice. 36-✓+ Section A. Section 565.184, RSMo, is repealed and one new+section enacted in lieu thereof, to be known as section 565.184,+to read as follows:+ 565.184. 1. A person commits the offense of abuse of+an elderly person, a person with a disability, or a+vulnerable person if he or she:+ (1) Purposely engages in [conduct involving] more than+one incident in which purposeful and unreasonable conduct+[that] causes emotional distress to an elderly person, a+person with a disability, or a vulnerable person. The+course of conduct shall be such as a reasonable person would+know that such conduct would cause a reasonable elderly+person, person with a disability, or vulnerable person to+suffer substantial emotional distress; or+ (2) Intentionally fails to provide reasonable care,+goods, or services to an elderly person, a person with a+disability, or a vulnerable person. The result of the+conduct shall be such as would cause a reasonable elderly+person, person with a disability, or vulnerable person to+suffer actual physical or emotional distress; or+ (3) Knowingly acts or knowingly fails to act in a+manner which results in a [substantial] grave risk to the+life, body, or health of an elderly person, a person with a+disability, or a vulnerable person. For the purposes of++ 2+this section, "grave risk" shall mean immediate, serious, or+life-threatening situations where an individual faces a high+likelihood of death, severe bodily injury, or profound,+lasting impairment to their physical or mental health.+ 2. The offense of abuse of an elderly person, a person+with a disability, or a vulnerable person is a class [A+misdemeanor] E felony. Nothing in this section shall be+construed to mean that an elderly person, a person with a+disability, or a vulnerable person is abused solely because+such person chooses to rely on spiritual means through+prayer, in lieu of medical care, for his or her health care,+as evidence by such person's explicit consent, advance+directive for health care, or practice.
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