the checklist

Ask these before you hire anyone to come into the house

Missouri does not license non-medical help at home. That is the first thing to know, because it changes which questions are worth asking. There is no licence number to check for this kind of company, so anybody who tells you to verify one is sending you to look for a document that does not exist. What you can check is narrower, and it is all free and public.

This is a checklist, not a ranking, and it will not tell you which company to pick. It tells you what to ask, which public record can answer it, and, more usefully, which records cannot. Every claim below about what Missouri does and does not regulate is cited to the statute or the state agency's own page.

know this first

Understand what Missouri licenses, and what it does not

The statute, in its own words

Missouri's home health licensing law defines a home health agency as one "that provides two or more home health services at the residence of a patient according to a written plan of treatment signed by a physician, nurse practitioner, clinical nurse specialist, or physician assistant," and defines home health services as "nursing, physical therapy, speech therapy, occupational therapy, home health aid, or medical social service." Source: Section 197.400 RSMo. The Department of Health and Senior Services states the threshold on its own page: a licensed agency "must offer two skilled services on an intermittent basis, one of which must be skilled nursing." Source: DHSS, Home Health State Licensure.

A company that sends someone to make meals, do laundry, drive to appointments and keep your parent company, with no clinician and no plan of treatment, is outside that definition. Missouri has no separate licence for it. The one place the state touches this work is when Missouri Medicaid pays for it, which requires a provider contract administered through MMAC provider enrolment. That is a contract to be paid with public money, not a general licence, and a private-pay company has no reason to hold one. The sister records desk sets the two categories out in full on its two categories page. All sources opened September 10, 2026.

None of that is a judgement, in either direction, about any company. 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.

identity

Ask for the legal name, then look it up twice

"What is the exact legal name of the company that will be on my contract?" Trading names, website names and old franchise names are often not the entity you will be paying. If you cannot get the legal name, stop; you have your answer.
Search that name at the Missouri Secretary of State. The business filings search shows whether the entity exists, its status and its registered agent. You are checking that the name on the registry and the name on the contract are the same name, character for character. A recently formed company is not by itself a concern; a name that does not match is.
Search it in the federal NPI registry, and know what you are looking at. The NPI registry lists organisations by name and state with the taxonomy they chose for themselves; the code for in-home supportive care is 253Z00000X. An NPI is a billing identifier. It is not vetted, not inspected and not a qualification of any kind, and a company that presents one as a credential has told you something.

Both lookups, with what each proves and does not prove, are walked through step by step on the sister desk's how to check a provider yourself.

Ask which kind of company you are talking to

"Are you a licensed Missouri home health agency, or a non-medical company?" Either answer is fine. A mixed answer needs untangling.
If the answer is "licensed home health," that is checkable. The DHSS publishes its directory of licensed and certified providers, and the same records sit on the state open data portal as Home Health In-State Certified Providers. A listed agency shows a licence number and an expiry date.
If the answer is "Medicare-certified," that is checkable too. Medicare Care Compare lists certified home health agencies with their star ratings. Medicare's own 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)," so a certified agency's rating covers its clinical visits, not the non-medical hours it may also sell. Ask which entity and which service each line of the quote belongs to.
If the answer is "non-medical," there is no directory, and its absence from the two above is not a finding. This is the single most common mistake families make with these records. Move on to the questions below, which are the ones that matter for this category.

Source: Medicare, Medicare & Home Health Care, CMS product 10969, July 2025, "What isn't covered."

the people

Ask who is coming, and what they were checked against

This is where the public record runs out, and it is worth knowing exactly where.

"Who exactly will come to the house, and what happens when that person is sick or leaves?" Get a name, not a category, and get the backup plan in writing.
"Are your caregivers registered with the Family Care Safety Registry, and do you run the screening?" Missouri's registry page says that "people who will care for children, seniors, or disabled persons must register with the FCSR" and that "an employer who will hire one of these care workers can request a background check through the FCSR." The screening draws on seven state record systems, including criminal records, the sex offender registry and the Employee Disqualification List. Ask the company, in writing, whether it does this.
Know that you cannot run that check yourself. The DHSS states that information in the Employee Disqualification List "is confidential and not accessible to the general public." So the answer to the question above has to come from the company, and the honest form of it is a written yes or no, not a reassurance.
"How are caregivers trained and supervised, and who do I call at nine at night?" No registry answers this. 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.

Sources: DHSS, Family Care Safety Registry; DHSS, Employee Disqualification List (EDL); NIA, Services for Older Adults Living at Home, content reviewed October 12, 2023. All opened September 10, 2026.

the arrangement

Ask for the terms on paper before the first visit

"What is the hourly rate, the minimum visit length, and the minimum hours a week?" Get all three. A low rate with a four-hour minimum is a different price from a higher rate with a two-hour minimum. This desk publishes no rates and will not tell you what is normal, because no public dataset says.
"What is the notice period to cancel a visit, and to end the arrangement?"
"What is written down about what the caregiver will and will not do?" Meals, laundry, rides, errands, companionship, help on the stairs: get the list. Ask specifically what is off the list.
"Who is my one point of contact, and how do schedule changes reach me?"
"Is anything here medical?" If the answer is yes, go back to the category questions, because that changes which company you are dealing with and which records apply.

The NIA's page on services at home links a worksheet of questions to ask before hiring a care provider; it is a good second list to hold beside this one. Source: NIA, Services for Older Adults Living at Home.

what no record answers

Accept that the important part is a conversation

The lookups above verify a name, a category and a status. They do not tell you whether the person who arrives on Monday will be kind to your parent, on time, or the same person on Wednesday. Nothing public does. The state does not measure it, this site does not measure it, and any page that claims to rank companies on it in Missouri is ranking on something it invented. That is why this desk has a checklist here and not a leaderboard.

What you can do is ask every question above of every company you talk to, write the answers down in the same notebook, and compare the answers, not the brochures.

Keep going

Sort the first week home before they leave the hospitalSix logistics stops, cited to Medicare and the National Institute on Aging. Call the agency that covers your addressFind out what already exists before you pay for anything. Fix the house one room at a timeThe checklist with no ranking in it, cited to the National Institute on Aging. Check every number against its sourceHow the survey pages on this site are built, and what they cannot tell you.