When Someone Dies at Home in Missouri: The First Six Hours

When someone dies at home in Missouri, the first call depends on whether the death was expected. If the person was receiving hospice care, call the hospice. If the death was sudden, unexpected, or you are not sure the person has died, call 911. From there, the county coroner or medical examiner decides whether the death has to be looked into, and a funeral home takes the person into its care. You do not need to figure everything out at once.

This guide covers roughly the first six hours: which calls matter, what Missouri law requires of the people who answer them, and what can wait. It is a plain explanation of the rules, not legal advice. The hospice nurse, the coroner's office and the funeral director can answer questions about your own situation.

Who do you call first when someone dies at home in Missouri?

If the person was enrolled in hospice, call the hospice. Under Medicare's hospice benefit, a hospice nurse and doctor are on call 24 hours a day, 7 days a week, so there is someone to reach at three in the morning. Keeping the hospice number written down near the phone saves a search at the worst moment.

If the death was not expected, or you are not certain the person has died, call 911 and do what the dispatcher says. Describe what you found. Working out the cause is not your job, and nothing in the rules below has to be handled by you in the first hour.

When does the coroner or medical examiner get involved in Missouri?

It depends on the county and the circumstances. Missouri counties have either a coroner or a medical examiner, and the statutes for both say that the police, sheriff, law enforcement officer or official, or any person having knowledge of such a death shall immediately notify the office of the medical examiner for the deaths they list. The parallel rule for a coroner county says the same people shall immediately notify the coroner.

The lists include deaths that were not medically attended. In a medical-examiner county, a reportable death includes one that happened when unattended by a physician, chiropractor, or an accredited Christian Science practitioner, during the period of thirty-six hours immediately preceding his death. In a coroner county, the list covers a death from a sudden, unforeseen occurrence where the person had not been attended by a physician during the thirty-six-hour period preceding the death.

In practice this is the question the hospice or the 911 dispatcher will help answer. If the office does take the case, the funeral home waits for its release before moving the person. If it does not, the funeral home can come when you are ready.

Who has the right to decide about burial or cremation in Missouri?

Missouri calls it the right of sepulcher: the right to choose and control the burial, cremation, or other final disposition of a dead human body. The statute sets an order. First in line is an attorney in fact designated in a durable power of attorney wherein the deceased specifically granted the right of sepulcher to that person. After the military designee comes the surviving spouse, unless an action for the dissolution of the marriage has been filed and is pending, then children, parents and other relatives in turn.

This matters in the first hours only if the family disagrees, or if the person who died left written instructions. If that is your situation, tell the funeral director early and bring the paperwork; the order above is what they have to follow.

Who files the death certificate in Missouri, and how fast?

The funeral home handles it. Missouri law says the funeral director or person in charge of final disposition of the dead body shall file the certificate of death, and that a certificate shall be filed with the local registrar, or as otherwise directed by the state registrar, within five days after death.

The medical part is on its own clock. The certifying professional completes the cause of death and it must be returned to the funeral director or person in charge of final disposition within seventy-two hours after death. If the medical examiner or coroner is involved, that office certifies the death instead, which can add time. You will be asked for the personal details that fill the rest of the form.

What changes if the person will be cremated in Missouri?

Cremation needs two authorizations. The state's vital-records rule says a body shall not be cremated until written authorization by the medical examiner/coroner or physician is received by the funeral director. Separately, the funeral establishment must hold a written authorization for cremation executed prior to cremation by the person entitled to custody or control of the body - that is the form the family signs.

Missouri does not set the same fixed waiting period Illinois does, but the authorizations take time to collect, especially over a weekend. If a family wants a service before the cremation, or wants to see the person first, say so at the arrangement conference rather than after.

What do the price rules let you do while you are choosing?

They let you ask questions before you commit. Under the Federal Trade Commission's Funeral Rule, funeral directors must give you price information on the telephone if you ask for it, and you do not have to accept a package that may include items you do not want.

Two more points come up often in the first day. No state law requires routine embalming for every death, and the FTC says in most cases, refrigeration is an acceptable alternative. If the service will be several days away, ask each funeral home how the person will be cared for in the meantime and what that costs.

What about organ and tissue donation, and what can wait?

If the person was registered as a donor, that decision already stands on its own. Missouri's health department describes the state registry as a statewide, voluntary, confidential registry of organ and tissue donors and says it is a first-person consent registry making your decision final unless revoked in a manner provided by law. Mention donation early to the hospice nurse, the coroner's office or the funeral director, because some donation is time-sensitive.

Everything else can wait at least a day: the obituary, the service, notifying banks and insurers, and choosing a casket, urn or burial place. In the first six hours it is enough that the person is cared for, the right office has been called, and someone is looking after whoever else is in the house, including pets. When you are ready for the longer list, PartingPoint's guide to who to notify after a death puts those calls in order, and you can compare Missouri funeral homes and crematories on PartingPoint by county and city.