Types of In Home Care as Definitioned by MO Department of Health & Seniors Services

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)
  • 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 inter- mitten 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 Dept. of Health & Senior Services/Bureau of Home Care and rehabilitative standards is responsible for licensure and oversight.

Telephone for Questions:

Call 573/751-6336
or visit http:/www.health.mo.gov.

To Voice a Complaint:

Call 800/392-0210

In-Home Care

Major Payer:

  • Medicaid

Services Offered:

  • Homemaker Chore Services (cleaning, cooking, laundry).
  • Personal Care Assistance (bathing & grooming)
  • Respite Care (caregiver relief)
  • Advanced 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 Services (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

Call 573/52-8527

Oversight:

MO Medicaid Audit & Compliance 573/751-3399

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 MO requirement for licensure: 1) Company only provides 1 service; 2) Company does supply nurse & aide (2 services), but they do shift work of 4 plus hours; 3) Company provides 2 or more services (personal care, chore services & respite care, but only one service (aide) from the “Home Health” list).

To Request services

DSDS Call Center at 866/835-3505

To Report Abuse/Neglect

Call 800/392-0210

To Report Fraud contact MO Attorney General Office Hotline

Call 800/392-8222

Oversight:

No government oversight. If company provides nusing, register complaint with MO State Board of Nursing at http://pr.mo.gov/.

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