Home Health State Licensure Forms and Resources

Home Care

An entity operating as a licensed home health agency must offer two skilled services on an intermittent basis, one of which must be skilled nursing.

 Guidelines for Development - Licensed Home Health

 Letter of Intent for State Licensure and/orMedicare Certification

 Application for Home Health Agency License

 State Disclosure of Ownership and Control Interest Statement

 197.400 - 197.475 RSMo Home Health Agencies

 19 CSR 30-26.010 Home Health Licensure Rule

Alzheimer's and Dementia Specific Training - 660.050

 Interpretive Guidelines - Home Health Agencies (State Operations Manual-Appendix B)

 Patient Rights (42 CFR 484.10)

Criminal Background - 660.317

Family Care Safety Registry

 Advance Directive Information - 42 CFR 489.100-489.104

 MO Law Regarding a Patient's Right to Make Health Care Treatment Decisions

 Possession of Drugs by a HHA or Hospice - 4 CSR 220-2.010(8)

Hepatitis B - 29 CFR 1910.1030(f)(1), (i)(ii),(ii)(A),(2)(iv)

Home Health Aide Competency Evaluation - Please call our office at 573/751-6336 to obtain a copy.