{"ref":"MO-HSP-DTH-01","title":"Death in the Home, Pronouncement and Post-Death Care","category":"Hospice care","summary":"Sets out what the Agency does when a patient dies: preparing the family before death, the death visit, how death is determined and recorded under Missouri's legal standard for death (RSMo §194.005), the conditions before an Agency nurse pronounces death, notice to the attending physician, the coroner or medical examiner contact for deaths outside a licensed health care facility and the hospice's written notice within twenty-four hours of the death (RSMo §§58.451 and 58.720), the medical certification within seventy-two hours and the death certificate within five days (RSMo §193.145), unexpected deaths, care of the body, medications after death, and support for the family and staff.","inShort":["Before death, teach the family to call the Agency at any hour, and record the funeral home and their wishes.","Offer a death visit every time and aim to arrive within 90 minutes of the call.","Record your findings and the time. A nurse pronounces death only if the written confirmation is on file; otherwise report the findings to the physician.","For a death outside a licensed facility, call the coroner or medical examiner. The Agency sends written notice within 24 hours of the death.","Tell the attending physician and ask for the medical certification within 72 hours. Never remove medications from the home.","If a death may not be natural, do not move or clean anything. Call 911 or law enforcement and the coroner or medical examiner."],"primaryCitation":"RSMo §193.145","citations":["RSMo §193.145.1, .4-.6","RSMo §194.005","RSMo §58.451.2-.3","RSMo §58.720.2-.3","19 CSR 30-35.010(1)(D)4","19 CSR 30-35.010(2)(H)12-13","19 CSR 30-35.010(2)(J)5.F","19 CSR 30-35.010(2)(K)5.B","19 CSR 30-35.010(2)(M)1.B"],"federalCitations":["42 CFR §418.64(d)(1)","42 CFR §418.106(e)(2)"],"surveyorAsks":["Walk me through what your nurse does when a patient dies at home at night.","Who may pronounce death for your patients, and on what basis?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (RSMo §§193.145, 194.005, 58.451, 58.720)","5. Preparing Before Death","6. When the Family Calls","7. Determining and Recording Death","8. Who Must Be Told","9. Unexpected Deaths","10. Care After Death","11. After the Death","12. Patient Care Volunteers","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"mo-hospice","state":"Missouri","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}