Records desk / which file to open

Home health versus non-medical home care: which record to check

Two different services are sold in the same conversation in this metro. Only one of them has a federal star, a CMS certification number, and a Missouri licence number. The other has none of those, and on the Missouri side that is the legally correct state of the file. If you open the wrong record, you will either panic at a missing licence or trust a star that does not apply to the hours you are buying. This page tells you which record to open for which quote.

The underlying legal line is set out, with the statutes, in the two-categories file. Read that file if you need the definitions. This file is the practical sequel: given the quote in your hand, which public document is the matching one.

If the quote is for home health

Home health, in Missouri's statute, is skilled clinical care at the residence under a written plan of treatment signed by a physician, nurse practitioner, clinical nurse specialist, or physician assistant. Section 197.400 RSMo lists the services: nursing, physical therapy, speech therapy, occupational therapy, home health aid, or medical social service. Section 197.405 RSMo is the licensure requirement. DHSS states the operational threshold on its home health state licensure page: a licensed agency must offer two skilled services on an intermittent basis, one of which must be skilled nursing.

Open these records, in this order:

Medicare Care Compare and the CMS provider file. A certified agency holds a CMS certification number and appears in Care Compare and in dataset 6jpm-sxkc. This desk copies the 47 metro-addressed agencies that carry a quality star onto the star ratings file. If the company claims certification and is not in that file under any spelling, the claim is the thing to question.

The survey file, as a second column, not a substitute. HHCAHPS joins on the certification number. 38 of those 47 agencies carry a survey star in the July 2026 release. The other 9 have none. See the survey stars file.

The zip service-area file, for the house itself. Dataset m5eg-upu5 records which zip codes each certified agency reports serving. 81 distinct certification numbers appear for at least one metro zip, which is more than the 50 agencies with a metro street address, because agencies based elsewhere still name territory here. Confirm the zip of the house on the zip file.

The Missouri certified directory, for the state licence. Search the DHSS directory and the downloadable Home Health In-State Certified Providers file. 39 agencies list at least one St. Louis metro Missouri county as a service area in the current extract. This desk publishes those county counts and does not republish the rows, because the portal licence field is null.

If the quote is for non-medical care at home in Missouri

Personal care, bathing and dressing assistance, companionship, homemaking, meal preparation, transportation, supervision, respite, and dementia support, with no clinician and no plan of treatment, fall outside Chapter 197. Missouri does not license that category. DHSS publishes a directory of providers it licenses or certifies, and because the category is not licensed or certified, its providers are not in that directory. There is no other state directory they are in.

Do not open the star table and treat absence as a low score. Do not demand a Chapter 197 licence number and treat a truthful "we do not have one" as a warning. Open these records instead:

The Missouri Secretary of State business registry at bsd.sos.mo.gov, to confirm the legal entity exists, is in good standing, and matches the name on the contract.

NPPES, the NPI Registry, only as an identity check. Organisations that enumerated under taxonomy 253Z00000X (In Home Supportive Care) are counted on this desk by city: 1,162 organisational registrations in 65 cities, published as counts only, with no names, because an NPI carries no quality, licensure, or accreditation meaning. Finding a number there proves a registration exists. It verifies nothing else.

The one place Missouri touches this work is narrower than it first appears. When the hours are paid by Missouri Medicaid through home and community based services, the provider must hold a contract administered through MMAC provider enrolment. That is a contract to bill public money. It is not a general licence, and a private-pay company has no reason to hold one.

For the questions no Missouri file will answer, the hiring walkthrough at Hire Caregiver STL is the matching guide: what to ask, who to check, and what the first days look like after you say yes.

If the quote is for non-medical care at home in Illinois

Cross the river and the answer changes. Illinois licenses both categories under 210 ILCS 55, implemented through 77 Illinois Administrative Code 245. IDPH describes a home services agency as non-medical, in four of its own words: home services are not medical. It licenses that category anyway, separately from home health agencies. The department publishes a home services agency directory of 1,029 rows. This desk links that directory as a search tool and does not republish it at row level, because the portal licence field is null. On the Illinois side, a missing licence for this category is a real finding rather than an expected one. Search the directory yourself.

If you need both, which is common after a hospital stay

Medicare covers home health services when a beneficiary meets its conditions, and it does not pay for long-term personal care or homemaking on their own. Many households end up with a certified agency visiting under a plan of treatment and a separate non-medical provider covering the daily hours. These are two arrangements, two contracts, two invoices, and two different records. A quote that blurs them is a quote worth separating before you compare price or stars. The first week home is a different problem from the record check, and it is covered at After the Hospital STL.

Some companies run both a licensed home health agency and a non-medical operation, sometimes as separate legal entities. If you are quoted for personal care and handed a Chapter 197 licence number or a CMS star, ask which entity holds the licence, which entity is on your contract, and whether the licensed one is providing any of the hours you are buying. Often it is not.

Sources

1. Section 197.400 RSMo and 197.405 RSMo. Read 2026-09-10.
2. Missouri DHSS, Home Health State Licensure and provider directory.
3. CMS 6jpm-sxkc, ccn4-8vby, m5eg-upu5. Pulled 2026-09-10.
4. Missouri DHSS, Home Health In-State Certified Providers. Portal record updated 2026-09-04.
5. Illinois DPH, Home Services Agencies, and directory 9miz-pbzm.
6. NPPES, NPI Registry, taxonomy 253Z00000X.
7. Medicare, Home health services coverage.

This file tells you which public record matches which kind of quote. It is not medical advice and not legal advice, and it does not tell you which kind of help a particular person needs.