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
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