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 https:/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
573/ 526-8557
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 https://pr.mo.gov/.