Missouri Nursing Home Camera Laws: RSMo §§ 198.610-198.632 Electronic Monitoring

Missouri gives a resident of a nursing home, assisted living facility, intermediate care facility, or residential care facility the right to install a video or audio monitoring device in the resident's own room, under the Authorized Electronic Monitoring in Long-Term Care Facilities Act, RSMo Sections 198.610 through 198.632. Who may make that request is fixed by statute: under Section 198.618, a resident who still has capacity is the only person who can request monitoring, even if a family member holds a power of attorney, and a guardian or legal representative may act only after a court or a physician has found the resident to lack capacity.

Information last verified on 2026-08-14. This article has not yet been reviewed by a licensed lawyer.

This article covers Missouri's Authorized Electronic Monitoring in Long-Term Care Facilities Act, RSMo Sections 198.610 through 198.632, effective since August 28, 2020. It does not cover Missouri's general one-party consent recording law in full, which has its own dedicated page linked below.

What Missouri's Electronic Monitoring Law Grants

Section 198.622 requires a facility to permit a resident to monitor the resident's own room with an electronic monitoring device, and the request itself is submitted on the department-prescribed form under Section 198.620. Section 198.618 controls who is allowed to make that request, and the hierarchy is strict.

If the resident has capacity, and has not been judicially declared to lack it, Section 198.618 provides that only the resident may request authorized electronic monitoring, "notwithstanding the terms of any durable power of attorney, general power of attorney, or similar instrument." Holding a power of attorney does not let a family member make the request over a resident who is still competent to make it.

If a court has declared the resident to lack the capacity required for taking an action such as requesting electronic monitoring, only the resident's guardian may request it.

If a physician has determined the resident lacks capacity to request monitoring but no court has declared it, only the resident's legal representative may request it.

Monitoring is never compulsory; under Section 198.622 it is conducted only at the request of the resident or the resident's guardian or legal representative. The institution must make reasonable physical accommodations, including a secure mounting place and access to power, and monitoring must be conducted in plain view using a fixed-position device, not hidden.

Does Missouri's Law Cover Assisted Living?

Yes, and broadly. Section 198.610 defines "facility" or "long-term care facility" to mean "any residential care facility, assisted living facility, intermediate care facility, or skilled nursing facility." That single definition covers the full spectrum of Missouri long-term care licensure categories, so an assisted living resident has exactly the same statutory right as a nursing home resident, not a scaled-down version of it.

Roommate Consent and the Request Form

Before a device goes up, Section 198.616 requires each facility to use an electronic monitoring device acknowledgment form developed by the department and adopted by regulation. That form must be completed and signed by or on behalf of the resident prior to the installation of, or any use of, an electronic monitoring device in the facility. Among the things it has to state is that if the facility refuses to permit the electronic monitoring, or fails to make reasonable physical accommodations for it, the person should contact the department. That is the reader's escalation path when a facility stalls.

Under Section 198.620, the resident, guardian, or legal representative must then submit a department-prescribed request form. That form must release the facility from privacy-related civil liability, and it lets the resident choose whether the camera stays unobstructed or is blocked during specified circumstances "to protect the dignity of the resident." Separately, any other resident in the room, or their guardian or legal representative, must consent on a distinct department-prescribed roommate-consent form. A consenting roommate may condition that consent on the camera being pointed away from them, and on limiting or prohibiting audio monitoring.

Monitoring cannot begin until all forms are completed and returned, and devices must be fixed-position only. If a new, non-consenting resident moves into the room, monitoring must cease until the new resident consents. Missouri's statute does not spell out a separate formal withdrawal procedure beyond that new-roommate-triggers-cessation rule.

Notice and Signage

Each facility must post a notice at its entrance stating that the rooms of some residents may be monitored electronically by, or on behalf of, the residents, and that the monitoring is not necessarily open and obvious, per Section 198.628. The department prescribes the exact format and content of that notice by rule.

Who Pays for the Device

The resident, guardian, or legal representative pays all costs except electricity, including installation and maintenance. The facility is not required to provide internet service. Monitoring must be conducted in plain view, and the facility cannot refuse to admit an individual, or remove a resident, because of a request to conduct authorized electronic monitoring.

Tampering and Unauthorized Placement Penalties

Section 198.632 sets out two distinct offenses. First, intentionally hampering, obstructing, tampering with, or destroying a lawfully installed device, or destroying or corrupting the data it recorded, is a class B misdemeanor, with consent from the resident, guardian, or legal representative as an affirmative defense. Second, a person other than a resident who places a device in a resident's room without authorization, or who consents to or acquiesces in such unauthorized placement, commits a class B misdemeanor if the conduct continues after receiving written notice to stop.

Using Recordings as Evidence of Abuse or Neglect

Footage from an authorized monitoring device in a Missouri long-term care facility can support a report to the facility, the Department of Health and Senior Services, or Missouri's Long-Term Care Ombudsman program, and it can support a civil claim if it shows signs of abuse or neglect. Because a resident's consent form allows the resident to keep the camera unobstructed specifically to protect their own dignity, footage that a family reviews is captured on the terms the resident or their representative set going in.

Camera vs. Microphone: Missouri's Consent Law

Missouri is a one-party consent state for recording generally: see Missouri Recording Laws for the full framework. Because only one participant needs to consent, a resident present in their own room who consents to their own device generally satisfies the general consent rule for their own conversations. A device that also picks up a conversation the resident is not part of, such as two staff members talking, is the scenario where the general one-party consent rule still has to be satisfied independently of the Act's roommate-consent process, since staff are not "roommates" the Act's consent mechanics reach.

Installing a Camera in a Missouri Long-Term Care Facility

1. Confirm the facility type is covered. Residential care, assisted living, intermediate care, and skilled nursing facilities are all included.
2. Confirm who is allowed to make the request. Under Section 198.618, a resident who has capacity must make the request personally, even if a relative holds a power of attorney. A guardian may request only after a judicial declaration of incapacity, and a legal representative only after a physician has determined the resident lacks capacity.
3. Complete the acknowledgment form. Section 198.616 requires the department-developed acknowledgment form to be completed and signed by or on behalf of the resident before the device is installed or used at all.
4. Submit the department-prescribed request form under Section 198.620, including the resident's dignity-related camera-blocking election if desired.
5. Obtain roommate consent on the separate prescribed form, with any conditions on camera direction or audio.
6. Wait for all forms to be filed with the facility administrator before installing.
7. Budget for the ongoing cost. The resident or family covers everything except electricity.

If You Suspect Abuse or Neglect

Missouri residents and families can report suspected abuse or neglect to the Department of Health and Senior Services or to Missouri's Long-Term Care Ombudsman program. The federal Long-Term Care Ombudsman program, created under the Older Americans Act and operating in every state, investigates complaints about action or inaction that may adversely affect a resident's health, safety, welfare, or rights, and covers both assisted living and nursing home residents.

Related Resources

• Nursing Home Camera Laws by State covers the national picture across all 18 statute states.
• Missouri Recording Laws covers Missouri's general one-party consent rule for audio recording.
• Nursing Home Abuse & Neglect covers how an abuse or neglect claim works once evidence, including camera footage, is in hand.

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Last updated: 2026-08-14.