Starting a Missouri Home Health or Personal Care Agency?

• Missouri-licensed Home Health Agency — offers at least two intermittent skilled services, including skilled nursing, under Missouri HHA law and 19 CSR 30-26.010.
• Medicare-certified Home Health Agency — also completes CMS enrollment, certification, and a state-agency or approved-accreditor survey.
• Private-duty/private-pay Personal Care Agency — remains outside the HHA definition and is not issued a Missouri license.
• IHS or CDS provider — separately completes MMAC contracting, MO HealthNet enrollment, EVV, and DSDS authorization requirements.

Yes. Missouri DHSS licenses HHAs under sections 197.400–197.478 RSMo and 19 CSR 30-26.010. The Bureau of Home Care and Rehabilitative Standards conducts licensure and federal-certification oversight.

A company providing two or more listed home health services in a patient's residence on a part-time or intermittent basis under a written plan of treatment may meet the HHA definition. A licensed agency must offer at least two skilled services, including skilled nursing.

The initial process includes an application, ownership information, Secretary of State registration, policies and procedures, fee, and on-site survey. Licenses renew annually. A license is not transferable; ownership, management, or substantial organizational changes require a new license.

The agency submits CMS-855A through PECOS or to the Medicare Administrative Contractor, completes applicable federal agreement and civil-rights materials, and completes an initial certification survey through Missouri DHSS or a CMS-approved accrediting organization.

Leadership, staffing, patient rights, assessments and plans of care, clinical records, QAPI, infection control, emergency preparedness, complaints, and service-delivery systems should satisfy 19 CSR 30-26.010 and, for Medicare applicants, 42 CFR Part 484.

DHSS's Bureau of Home Care and Rehabilitative Standards conducts state oversight and federal certification work under agreement with CMS. A CMS-approved accrediting organization may provide an optional deemed-status Medicare survey pathway.

No. MO HealthNet and MMAC provider enrollment, agreements, billing setup, EVV when applicable, and program compliance remain separate.

Missouri DHSS states that no license is issued for a private-duty/private-pay company remaining outside the HHA definition. Examples include providing only one service or providing nursing and aide services in shifts of four or more hours. Verify the exact service model with DHSS.

Typical non-medical services include assistance with bathing, dressing, grooming, toileting, transfers, mobility, meals, light housekeeping, laundry, companionship, transportation, errands, and medication reminders within each worker's lawful scope and competency.

In-Home Services and Consumer-Directed Services are separate Missouri HCBS programs. MMAC evaluates providers and contracts, MO HealthNet administers Medicaid, and DSDS assesses participants and authorizes services.

The applicant uses the current MMAC packet and submits a separate proposal for IHS, CDS, or both. MMAC states that the process is approximately nine months after submission and may take longer; approval is required before serving DSDS-authorized participants.

Yes. Effective August 1, 2026, Missouri imposed a six-month statewide moratorium on new CDS/Personal Care provider enrollments. Existing enrolled providers are not affected. Verify the current status and affected provider types with MMAC before filing.

Program providers must satisfy current employee-disqualification, criminal-background, Family Care Safety Registry, qualification, competency, supervision, and training requirements.

Yes for Medicaid-funded personal care and home health services subject to EVV. Missouri permits a provider-selected system that integrates with the state EVV Aggregator Solution.

Yes. If the company provides two or more listed home health services intermittently under written plans of treatment, it may meet the HHA definition. Obtain a DHSS scope determination before offering skilled or mixed-service programs.

• Logo creation, customized WordPress website, one year of hosting, and domain registration.
• 500 business cards and 500 tri-fold brochures.
• Missouri-specific policies, human-resources documents, admission or client-service documents, and operational forms.
• Missouri DHSS licensure and CMS certification preparation for the HHA package, or private-pay and optional IHS/CDS contracting preparation for the Personal Care package.
• Members' area access, customization, ongoing guidance, and applicable updates.

No. Government filings, Medicare or Medicaid enrollment, accreditation, background checks, insurance, office, personnel, EVV, survey expenses, software, mailing, and other third-party costs are separate unless expressly included in writing.

Home Health Forms provides customized documents, guidance, and preparation assistance. DHSS, MMAC, MO HealthNet, DSDS, CMS, survey organizations, accreditors, and payers make their own decisions. Home Health Foms provides guidance and documents that meet regulatory requirements to ensure your success.

Customized policy manuals, forms, and related digital documents are generally emailed within five business days after all information needed for customization is received. Website development, printing, shipping, and other components may have separate timelines.

Eligibility depends on work completed, customized materials produced, digital products delivered, third-party expenses paid, printing ordered, and other services already performed.