the checklist
What to ask before you hire anyone
The questions already exist on this desk. This page is how to walk them in order so you do not spend the first conversation asking for a licence Missouri does not issue, or treating a billing number as a credential. You are not ranking companies. You are finding out what a public record can prove about the one you are about to let into the house, and what you still have to ask in the room.
The full checklist, cited to the statute and the state agency pages it quotes, is Ask these before you hire anyone to come into the house. Do not skip that page. Use this one as the reading order.
know this first
Missouri does not license this category
An unlicensed category is not a lawless one. It means the state publishes no record you can look up, so the burden of asking moves to you. Anybody who tells you to verify a non-medical licence number is sending you to look for a document that does not exist.
the order
Ask identity, then category, then the person, then the paper
Walk the four blocks in that order. Skipping to price is how a family hires a trading name that is not the legal entity on the contract.
- Legal name, twice. Get the exact legal name that will be on the contract.
Search it at the
Missouri Secretary of State business filings search
and in the
federal NPI registry.
The NPI taxonomy code for in-home supportive care is
253Z00000X. An NPI is a billing identifier. It is not vetted, not inspected, and not a qualification. A company that presents one as a credential has told you something. A name that does not match, character for character, is a stopping point. - Which kind of company. "Are you a licensed Missouri home health agency, or a non-medical company?" Either answer is fine. A mixed answer needs untangling. Licensed home health is checkable in the DHSS directory of licensed and certified providers and on data.mo.gov. Medicare-certified is checkable on Care Compare. Absence from those lists is not a finding against a non-medical company. It is the expected result.
- Who is coming, and what they were checked against. Get a name, not a category, and the backup plan when that person is sick. Ask, in writing, whether caregivers are registered with the Family Care Safety Registry and whether the company runs the screening. You cannot run the Employee Disqualification List yourself: DHSS states that information "is confidential and not accessible to the general public." The honest answer is a written yes or no from the company, not a reassurance.
- Terms on paper before the first visit. Hourly rate, minimum visit length, minimum hours a week, notice to cancel, notice to end, what the caregiver will and will not do (meals, laundry, rides, stairs, tub), who you call at nine at night. This desk publishes no rates and will not tell you what is normal, because no public dataset says. Ask whether anything in the arrangement is medical. If the answer is yes, go back to the category questions.
The NIA's advice for hiring any in-home service is to "get as much information as you can about a service before you sign an agreement" and to "check references before hiring a particular person or company." Ask for two references and call them. Source: NIA, Services for Older Adults Living at Home, content reviewed October 12, 2023.
two conversations
Keep home health and help at home on separate lines
Medicare's booklet says its home health benefit does not pay for "custodial or personal care like bathing, dressing, and using the bathroom (when this is the only care you need)," nor for meals delivered to the home, shopping, cleaning, or laundry. Source: Medicare, Medicare & Home Health Care, CMS product 10969, July 2025. A star rating on Care Compare covers clinical visits, not the non-medical hours the same agency may also sell. Ask which entity and which service each line of the quote belongs to.
If you are hiring because someone is coming home from hospital, sort the first week before you sign anything. Medicare's discharge checklist is the document, and this desk's first week home page walks the logistics. The companion guide for that moment is After the Hospital STL. Walk the house first so you are hiring against stairs and a bathroom, not against a brochure: the room by room checklist.
The lookups verify a name, a category and a status. They do not tell you whether the person who arrives on Monday will be kind, on time, or the same person on Wednesday. The state does not measure that. This site does not measure that. Any page that claims to rank companies on it in Missouri is ranking on something it invented. Compare written answers in the same notebook, not brochures.
If you are hiring because the unpaid week has taken over, say that in the family conversation before you say it to a company. In 2021, 33.6 percent of Missouri's older caregivers averaged 20 or more hours a week. Illinois: 39.9 percent. Paid hours are how some families move tasks off that week. They are not a verdict on whether you cared enough. When the hours themselves are the problem, Burned Out Daughter is the page written for that.
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