The Three Types of Care in the Home

A company may have one or all of these types of programs.

#1 Commonly Called: Home Health

Major Payer: Medicare

Services Offered:

  • Skilled Nursing
  • Physical Therapy
  • Occupational Therapy
  • Speech Therapy
  • Medical Social Services (social worker)
  • Home Health Aide- personal care (bathing, dressing, hair & nail care)
    Not homemaker/companion care

Consumer Needs:

  • Short-term (usually several weeks to months)
  • Acute needs (exacerbation of illness) (care after surgery)
  • Medicare Patient is homebound (for duration of care )
  • Services ordered by Physician
  • Part-time or Intermittent basis (visits may last 1-2 hours) (could be several times a week)

Agency Criteria:

  • Provides two or more of the 6 services listed above
  • One service must be skilled nursing
  • Visits must be on intermittent basis (several times a week 1-2 hours)
  • Follows federal & state regulations
  • Requires a state home health license
  • Most likely also Medicare Certified

Oversight:

MO Department of Health and Senior Services/Bureau of Home Care and Rehabilitative Standards is responsible for licensure and oversight.

Telephone for questions 573-751-6336

Home Health Website

For Abuse & Neglect 800-392-0210

#2 Commonly Called: In-Home Care

Major Payer: Medicaid

Services Offered:

  • Homemaker Chore Services (cleaning, cooking, laundry)
  • Personal Care Assistance (bathing & grooming)
  • Respite Care (caregiver relief)
  • Advance Personal Care (assist with activities of daily living when assistance requires devices and procedures related to altered body functions)
  • Authorized Nurse Visits (i.e., RN fill medicine box)
  • Adult Day Care
  • Consumer Directed (Independent Living Waiver- specialized medical equipment, supplies, environmental accessibility adaptations)

Consumer Needs:

  • Long-term (usually months to years)
  • Chronic needs (assistance needed to stay in the home) (help with activities of daily living)
  • Services ordered by Physician

Agency Criteria:

  • Provides home & community-based services to elderly & disabled who meet Nursing Home Level of Care & are eligible for Medicaid
  • Follows state regulations
  • Requires a contract with the state

To request services - DSDS Call Center at 866- 835-3505

To Report Abuse/Neglect call 800-392-0210

To request a care plan or provider change, click here.

Oversight:
Missouri Medicaid Audit and Compliance (MMAC) - 573/751-3399
Questions on opening an in-home /CDS agency or regarding in-home/CDS contract) mmac.ihscontracts@dss.mo.gov

IHS/CDS Proposal/Provider Enrollment Information

#3 Commonly Called: Private Duty/Private Pay

Major Payer: Private Fund/Insurance

Services Offered:

  • Provides only 1 Service (could be nursing or aide services for personal care)
  • Provides care in Shifts (4 plus hours at a time, may offer both nursing & personal care in shifts)
  • Provides Staffing (supplies nurses to hospitals, etc.)

Consumer Needs:

  • No limit on amount or duration of time in the home (determined by the patient and/or family)
  • No criteria needed to obtain care (determined by patient and/or family needs)
  • No Physician order needed for aide giving personal care , respite or companion care

Agency Criteria:

  • NO license issued in MO for this type of company
  • Examples of care that does not meet the Missouri requirement for licensure:
    • Company only provides 1 service
    • Company does supply nurse and aide (2 services), but they do shift work of 4 plus hours
    • Company provides 2 or more services, (personal care, chore services & respite care) but only one service (aide) from the “Home Health” list

Oversight:

No government oversight.

If company provides nursing, register complaint with Missouri State Board of Nursing.

For Abuse & Neglect 800-392-0210

Issues with fraud, contact the MO Attorney General's Office through the Consumer Hotline at 800-392-8222