PURPOSE: This rule establishes standards for protecting resident’s personal funds and property in all types of licensed long-term care facilities.

Editor’s Note: All rules relating to long-term care facilities licensed by the Division of Aging are followed by a Roman Numeral notation which refers to the class (either Class I, II or III) of standard as designated in section 198.085.1, RSMo.

1. (1) No operator shall be required to hold 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 and does not apply to other possessions residents have in their rooms or bring into the facility.
2. (2) The administrator, other designated person, or both, 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 or legal guardian. A designee shall not be the administrator or an employee of the facility. II/III
3. (3) When a resident is admitted, s/he and his/her designee or guardian shall be provided with a statement explaining the facility’s policies and resident’s rights regarding personal funds. If the facility handles resident’s 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. III
4. (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 interest accrued shall be credited to each resident’s account at least annually. With written authorization from the resident, the operator may purchase a burial policy for the purpose of burying the resident. III
5. (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. (6) A written account for each resident, showing receipts to and disbursements from the personal funds of each resident, shall be maintained. These may be kept in one (1) ledger or record or they may be kept individually. If the facility policy provides, and if appropriate or required by another governmental agency, two (2) personal funds accounts may be kept for residents—one (1) for clothing allowance and one (1) for spending money. III
7. (7) Receipt of a resident’s funds or personal possessions held in trust shall be acknowledged by a written receipt or cancelled checks. III
8. (8) Receipts for any purchases made by the operator and paid for from the resident’s personal funds shall be kept and be available to the resident, his/her designee or legal guardian. III
9. (9) All written accounts of the resident’s funds shall be brought current monthly and a written statement showing the current balance and all transactions shall be given to the resident, his/her designee or legal guardian on a quarterly basis. II/III
10. (10) The operator shall have a receipt for the funds and possessions returned to the resident, designee or guardian. Within five (5) days of the discharge of a resident, the resident or his/her designee or guardian 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. II/III

11. (11) Upon the death of a resident, the operator of the facility shall submit in writing on form MO 886-3103, a complete account of all the resident’s remaining personal funds and the name and address of the resident’s guardian, 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. The complete account of funds shall be submitted within sixty (60) days from the date of the resident’s death to the Department of Social Services, Division of Medical Services, TPL Unit, PNA Recovery, P.O. Box 6500, Jefferson City, MO 65102-6500. II/III

    1. (A) None of the resident’s personal funds shall be paid to a fiduciary, guardian, conservation 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 the department and documentation of payment shall be attached.
    2. (B) Upon receipt of the accounting of the resident’s remaining personal funds on form MO 886-3103, the Department of Social Services will determine the amount of aid, care, assistance or services paid by the department. The Department of Social Services will notify the operator of the amount determined to have been paid by the department on behalf of the deceased recipient within sixty (60) days of receipt of the facility operator’s accounting or within fifteen (15) working days if special request is made by the operator for expedited handling giving the reason(s) for the request, that is, need to comply with contractual or regulatory obligation of another government agency. The amount specified in the notification shall be considered as a claim upon the funds held by the operator. The operator shall pay to the Department of Social Services any remaining personal funds, in the resident’s personal fund account, up to the amount determined by the department. Payment shall be made by check payable to the Department of Social Services within sixty (60) working days of the receipt of the demand for payment. Payment shall be made as instructed on the department’s claim.
    3. (C) The Department of Social Services will notify in writing the resident’s guardian, 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 the department on behalf of the deceased resident.
    4. (D) If there are any remaining personal funds after payment has been issued to the Department of Social Services, then the deceased resident’s remaining funds shall be handled in accordance with section 98.090.1(8), RSMo and 13 CSR 15- 18.020(12).
    5. (E) Failure of an operator of a facility participating in the Title XIX (Medicaid) program to submit within sixty (60) days of the death of a resident a complete accounting of the remaining personal funds of any resident who has received aid, care, assistance or services from the Department of Social Services Property in Long-Term Care Facilities

shall be a Medicaid program violation under 13 CSR 70-3.030, if the operator had knowledge of such funds, during the sixty (60)-day period. If additional funds are received by the operator after the initial report has been filed, the department shall be immediately informed by the operator.

1. (12) Upon the death of a resident who, to the operator’s knowledge and as confirmed by the department, has not received aid or assistance from the Department of Social Services, if personal funds or possessions are not claimed by a fiduciary within one (1) year of the resident’s death, the operator is required to comply, within sixty (60) days of the one

2. (1) year anniversary of the death of the resident, with section 198.090.1(8), RSMo. II/III

   1. (A) If, after one (1) year from the date of death, no fiduciary makes claim on funds or possessions, the operator shall notify the Division of Aging, Attention: Institutional Accounting Section, that the funds remain unclaimed. This notice shall be sent by the operator within sixty (60) days and 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.

      1. 1. If unclaimed funds in the resident’s

fund accounts or possessions have a value of less than one hundred fifty dollars ($150), and the operator has complied with 42 CFR 483.10(c)(6), if required, the funds or proceeds of the sale of the possessions shall be deposited after one (1) year in a fund for the benefit of all residents of the facility for social and educational activities.

1. 2. If unclaimed funds in the resident’s

fund accounts or possessions have a value of more than one hundred fifty dollars ($150) and the operator has complied with 42 CFR 483.10(c)(6), if required, for deceased residents funds, the operator shall hold the unclaimed funds for two (2) years from the date of death. These funds shall then be considered abandoned property under sections 447.500–447.585, RSMo and shall be returned to the state of Missouri within sixty (60) days after two (2) years from the date of death. If the operator is a 501(c)(3) corporation, then it shall comply with section 447.540, RSMo. The operator shall contact the Office of the Treasurer, Unclaimed Property Administrator, P.O. Box 1272, Jefferson City, MO 65102-1272 for instructions and forms to return the unclaimed funds and possessions to the state of Missouri. There shall be an accounting subject to inspection and audit by the Division of Aging or its authorized agents for these unclaimed funds and possessions returned to the state of Missouri.

1. (B) The operator shall keep an accounting of these funds with documentation and receipts and disbursements to these funds which will be subject to inspection and audit by the Division of Aging.

1. (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 of Social Services or Department of Mental Health as appropriate and to the resident, his/her designee or legal guardian. In one (1) calendar year, no owner, operator, manager, employee or affiliate of an owner or operator shall receive from resident’s personal property or anything of value over one hundred dollars ($100). II/III
2. (14) The bond required by section 198.096, RSMo for operators holding personal funds of residents shall be in a form approved by the Division of Aging 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 resident’s personal funds, including petty cash, or the average total of the monthly balances. The average 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
3. (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 The director may require an operator to file a bond in an amount greater than one and one-half (1 1/2) times the average total of the balances if the division determines the increase is necessary; the operator is given sixty (60)-days’ notice and opportunity for hearing prior to requiring that increase; and the director determines by the evidence presented at any such hearing that the increase is necessary.
4. (15) All records and receipts required to be maintained under this rule and under section 198.090, RSMo shall be maintained for at 19 CSR 30-88

least seven (7) years from the end of the fiscal year during which the records were originally made. II/III

1. (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 Division of Aging or its authorized representative. Records kept for the prior seven (7) years, as required in section
2. (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 entirety, the Division of Aging shall be notified immediately by the new operator. II/III
3. (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 division and shall be approved prior to license issuance. II

AUTHORITY: section 198.090, RSMo Supp. 1993.* 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.

*Original authority: 198.090, RSMo 1979, amended 1982, 1989, 1992, 1993.