20-18-601. Registration generally.

20-18-601. Registration generally. (a)(1) A death certificate for each death that occurs in this state shall be filed with the Division of Vital Records or as otherwise directed by the State Registrar of Vital Records within ten (10) days after the death or the finding of a dead body and shall be registered if the death certificate has been completed and filed in accordance with this section. (2) A fact-of-death record for each death that occurs in this state shall be filed with the division within three (3) calendar days after the death or the finding of a dead body. (3)(A) If the place of death is unknown but the dead body is found in this state, the death certificate shall be completed and filed in accordance with this section. (B) The place where the dead body is found shall be shown as the place of death. (C)(i) If the date of death is unknown, it shall be determined by approximation. (ii) If the date cannot be determined by approximation, the date found shall be entered and identified as such. (4)(A) If a death occurs in a moving conveyance in the United States and the dead body is first removed from the conveyance in this state, the death shall be registered in this state, and the place where the dead body is first removed shall be considered the place of death. (B) If a death occurs on a moving conveyance while in international waters or air space or in a foreign country or its air space and the dead body is first removed from the conveyance in this state, the death shall be registered in this state, but the certificate shall show the actual place of death insofar as the place of death can be determined. (C) In all other cases, the place where death is pronounced shall be considered the place where death occurred. (b) The funeral director or the person acting as the funeral director who first assumes custody of the dead body shall: (1) File the death certificate and fact-of-death record; (2) Obtain the personal data from the next of kin or the best qualified person or source available; (3) Obtain the medical certification from the person responsible for the medical certification, as set forth in subsection (c) of this section; and (4) Provide a death certificate that contains sufficient information to identify the decedent to the certifier. (c)(1)(A)(i) The medical certification shall be completed, signed, and returned to the funeral director within three (3) business days after receipt of the death certificate by the physician in charge of the patient's care for the illness or condition that resulted in death, except when inquiry is required by § 12-12-315, § 12-12-318, or § 14-15-301 et seq. (ii) Except as provided in subsection (i) of this section, a medical certification shall be completed using the electronic process or system designated by the division. (B)(i) In the absence of the physician or with his or her approval, the certificate may be completed and signed by his or her associate physician, by the chief medical officer of the institution in which death occurred, by the pathologist who performed an autopsy upon the decedent, or by a registered nurse as provided in this subsection, if the individual has access to the medical history of the case and has reviewed the coroner's report, if required, and if the death is due to natural causes. (ii) The individual completing the cause-of-death section of the certificate shall attest to its accuracy either by a signature as authorized under subsection (i) of this section or by approved electronic process. (2)(A) The Arkansas State Medical Board shall enforce by rule subdivision (c)(1) of this section concerning the time period in which the medical certification shall be executed. (B)(i) If a physician refuses or otherwise fails to complete, sign, and return the medical certification to the funeral director within three (3) business days as required by subdivision (c)(1) of this section, the funeral director may notify the board of the failure to complete, sign, or return the medical certification within three (3) business days as required by subdivision (c)(1) of this section. (ii) The board shall assess against a physician described in subdivision (c)(2)(B)(i) of this section a fine not to exceed two hundred fifty dollars ($250) unless the physician shows good cause for the refusal or failure. (3) A registered nurse employed by the attending hospice may complete and sign the medical certification of death and pronounce death for a patient who is terminally ill, whose death is anticipated, who is receiving services from a hospice program certified under § 20-7-117, and who dies in a hospice inpatient program or as a hospice patient in a nursing home or hospital. (4)(A) If the hospice patient dies in the home, the registered nurse may make pronouncement of death. (B) However, the coroner and the chief law enforcement official of the county or municipality where death occurred shall be immediately notified in accordance with § 12-12-315. (5)(A) The Department of Health shall provide hospitals, nursing homes, and hospices with the appropriate death certificate forms, which will be made available to the certifier of death through an approved electronic process or system or another process designated by the division under subsection (i) of this section. (B) When death occurs outside these health facilities, the funeral home shall provide the death certificate to the certifier of death through an approved electronic process or system or another process designated by the division under subsection (i) of this section. (d)(1) If the cause of death appears to be other than the illness or condition for which the deceased was being treated or if inquiry is required by either of the laws referred to in subsection (c) of this section, the case shall be referred to the office of the State Medical Examiner or coroner in the jurisdiction where the death occurred or the body was found for investigation to determine and certify the cause of death through an approved electronic process or system or another process designated by the division under subsection (i) of this section. (2) If the State Medical Examiner or county coroner determines that the case does not fall within his or her jurisdiction, he or she shall within twenty-four (24) hours refer the case back to the physician for completion of the medical certification. (e)(1) When inquiry is required by either of the laws referred to in subsection (c) of this section, the State Medical Examiner or coroner in the jurisdiction where the death occurred or the body was found shall determine the cause of death and shall complete and sign the medical certification within forty-eight (48) hours after taking charge of the case. (2) A medical certification completed and signed by the State Medical Examiner or coroner shall be completed using an approved electronic process or system or another process designated by the division under subsection (i) of this section. (f)(1) If the cause of death cannot be determined within the time periods under subsection (c) or subsection (e) of this section, the medical certification shall be completed as provided by rule. (2) The attending physician, State Medical Examiner, or county coroner shall give the funeral director or person acting as the funeral director notice of the reason for the delay, and final disposition of the dead body shall not be made until authorized by the attending physician or State Medical Examiner or county coroner. (g) When a death is presumed to have occurred within this state but the dead body cannot be located, a death certificate may be prepared by the state registrar only upon receipt of an order of a court of competent jurisdiction, which shall include the finding of facts required to complete the death certificate. Such a death certificate shall be marked “Presumptive” and shall show on its face the date of death as determined by the court and the date of registration and shall identify the court and the date of the decree. (h) Upon receipt of autopsy results or other information that would change the information in the cause-of-death section of the death certificate from that originally reported, the certifier immediately shall file a supplemental report of cause of death with the division in order to amend the record. (i)(1) Upon request, the department may grant a waiver from the requirement of subdivision (c)(1)(A)(ii) of this section that a medical certification be completed using an electronic process or system if a person requesting the waiver: (A) Lacks reliable internet connectivity sufficient to ensure access and secure submission to the electronic system; (B) Has not received requested training or technical assistance from the division on the use of the system and correct submission procedure; (C) Regularly signs fewer than five (5) medical certifications per month; or (D) Shows other good cause for a waiver as determined by the department in its discretion. (2) A physician who is granted a waiver under subdivision (i)(1) of this section: (A) Shall not be fined under subdivision (c)(2)(B) of this section for failure to submit medical certification using an electronic process or system; and (B) Is liable for failure to submit a medical certification in a timely manner under subdivision (c)(1)(A)(i) of this section.