Records desk / category distinction
Home health and home care in Missouri are two different categories
One is licensed by the state and scored by the federal government. The other is not licensed by Missouri at all. They are sold in the same conversation, quoted on the same call, and confused constantly, and the confusion costs families money and time. This file sets out what each category legally is, on both sides of the river, with the statute and the agency's own words.
What Missouri licenses
Missouri's licensing statute is Chapter 197 of the Revised Statutes. Section 197.400 RSMo defines a home health agency as an organisation that provides two or more home health services at the patient's residence according to a written plan of treatment signed by a physician, nurse practitioner, clinical nurse specialist, or physician assistant. The same section defines home health services as a closed list: nursing, physical therapy, speech therapy, occupational therapy, home health aid, or medical social service. Section 197.405 RSMo is the licensure requirement itself, and the Department of Health and Senior Services administers it.
The department states the operational threshold in its own words on its home health state licensure page: a licensed home health agency must offer two skilled services on an intermittent basis, one of which must be skilled nursing.
Two things in that definition do the work. The services are clinical. And there is a physician signed plan of treatment behind them. An arrangement with no clinician, no plan of treatment and no skilled nursing is not the thing Chapter 197 licenses, whoever is paying for it.
A Missouri home health licence number proves the holder met the state's requirements for an agency delivering skilled clinical services under a physician signed plan of treatment, and that it is in the department's directory of licensed and certified providers.
It does not prove anything about a provider of personal care, companionship or homemaking, because that provider was never eligible for this licence in the first place. Asking a non-medical provider for a Chapter 197 licence number is asking for a document its category does not have.
What Missouri does not license
Personal care, bathing and dressing assistance, companionship, homemaking, meal preparation, transportation, supervision, respite and dementia support delivered at home, with no clinician and no plan of treatment, fall outside the Chapter 197 definition. Missouri has no separate licensing act for them. The Department of Health and Senior Services 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 and there is no other state directory they are in.
There is one place the state does touch this work, and it is narrower than it first appears. When non-medical care at home is paid for by Missouri Medicaid through the home and community based services programme, the provider must hold a contract with the state to bill for it, administered through MMAC provider enrolment. That is a contract to be paid with public money, with the programme conditions that come with it. It is not a general licence to operate, it does not apply to a private-pay arrangement, and a provider that only serves private-pay clients has no reason to hold one.
None of this is a statement about quality, in either direction. An unlicensed category is not a lawless one: a provider of non-medical care at home is still a registered business subject to employment law, tax law, contract law and its own insurance. It is a statement about which records exist. On the Missouri side, for this category, the answer is that the state publishes none.
What Illinois does, which is not the same
Cross the river and the answer changes, which matters for any family in the metro east or anyone comparing a provider on each side. Illinois licenses both categories under one act, the Home Health, Home Services, and Home Nursing Agency Licensing Act, 210 ILCS 55, implemented through 77 Illinois Administrative Code 245.
The Illinois Department of Public Health describes a home services agency as one that provides services through workers in a consumer's residence, including assistance with activities of daily living, housekeeping, personal laundry and companionship, intended to enable that person to remain safely and comfortably at home. The department then says it in four words of its own: home services are not medical. Illinois licenses that category anyway, separately from home health agencies, which are the clinical ones.
So the same company, doing the same work, has a state licence number in Illinois and no state licence number in Missouri, and both facts are correct at the same time. A licence is evidence about a jurisdiction as much as about a provider.
An Illinois home services agency licence proves the holder is licensed by IDPH for non-medical care at home in Illinois, and that its workers fall under the state's health care worker background check requirements.
It does not carry over the state line. It says nothing about work performed in Missouri, and a Missouri family should not read an Illinois licence number as state oversight of the care being delivered in their own home.
What this means when you are holding two quotes
Four practical consequences follow, and they are the reason this file exists.
A missing licence number is not automatically a red flag. If you ask a Missouri provider of non-medical care at home for its state licence and it says it does not have one because the state does not license this category, that answer is correct and you should not penalise it. If the same provider invents a number, or shows you a licence belonging to a different entity, that is a serious problem.
A licence number that does exist may belong to a different service. 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, 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.
Star ratings do not span the line. Every star rating on this site comes from Medicare's home health quality programme, which only measures certified home health agencies. A provider of non-medical care at home has no star rating, and that is not a low score. It is the absence of a scoring system. The ratings file says so at the top of the page for exactly this reason.
The two services are often both needed, and are billed separately. Medicare covers home health services when a beneficiary meets its conditions, and it does not pay for long-term personal care or homemaking on its own. Many households end up with a certified agency visiting under a physician's plan of treatment and a separate non-medical provider covering the daily hours. These are two arrangements, two contracts and two invoices, and a quote that blurs them is a quote worth questioning.
Whatever the category, the checks are the same and you can run them in an afternoon: how to check a provider yourself, in five lookups.
What the distinction looks like in practice
New Plan Care sits on the unlicensed side of the line this file describes, and says so. It provides non-medical care at home in the St. Louis metro: personal care, companionship, homemaking, transportation, and dementia support. It holds no Missouri home health licence, has no CMS certification number, and is in no state directory of certified agencies, because Missouri publishes no directory for the category it is in.
That is what a family should expect a truthful provider on this side of the line to say. It is also a paid placement: New Plan Care is a client of OwnersFirm, which publishes this site.
Call New Plan Care at (314) 405-0887.
Sources
- Section 197.400 RSMo, definitions. Missouri Revisor of Statutes. Read 2026-09-10.
- Section 197.405 RSMo, licensure required. Read 2026-09-10.
- Missouri DHSS, Home Health State Licensure, and Laws, Regulations and Manuals. Read 2026-09-10.
- Missouri DHSS, provider directory. Read 2026-09-10.
- Missouri MMAC, In-Home Services general information. Read 2026-09-10.
- Illinois DPH, Home Services Agencies, and Home Health Agencies. Read 2026-09-10.
- 77 Ill. Adm. Code 245, implementing 210 ILCS 55. Read 2026-09-10.
- Medicare, Home health services coverage. Read 2026-09-10.
This file describes how two categories of service are regulated. It is not medical advice, it is not legal advice, and it does not tell you which kind of help a particular person needs. That is a conversation for that person's clinician and family.