Memorandum for Home and Community-Base Services Staff and Stakeholders

DATE: May 11, 2026

FROM: Veronica Jameson, Bureau Chief

SUBJECT: General Health Evaluation (GHE) Reminder

This memorandum serves as a reminder for Home and Community Based Services (HCBS) providers of the requirement to complete semi‑annual General Health Evaluation (GHE) nurse visits.

Missouri State Statute 192.2475.14 RSMo requires providers to complete GHEs for participants receiving Agency Model Personal Care Services. Participants who only receive Consumer-Directed Services (CDS) are not required to have GHEs.

GHEs shall be completed by a registered nurse (RN) or a licensed practical nurse (LPN) employed by the provider agency, with the RN providing oversight of the LPN. These evaluations must occur in the 4th and 10th months of the participant’s care plan authorization period. They ensure the care plan continues to meet the participant’s needs and provide the required oversight of the personal care aide. After a GHE is completed, the form shall be uploaded into the participant’s electronic case record. If a participant refuses a GHE, this must be reported to DSDS and services will be closed.

Providers must check authorization periods and complete GHEs in the designated months authorized on the participant’s care plan. If a GHE is missed, it must be completed the following month; however, the visit will not be reimbursable. Reauthorizing the GHE for another month will only occur when the delay is outside the provider’s control (e.g., a participant's hospitalization).

GHEs will not appear as separate tasks on the care plan when another nursing task is required. In those cases, the designated GHE months will be reflected in the nursing task authorization.

Questions may be directed to the Bureau of Policy and Quality Enhancements at LTSS@health.mo.gov.