These guidelines are for use in development of a licensed home health agency. (If you desire Medicare certification in addition to state licensure, please refer to the Home Health Medicare Certification and State Licensure Forms and Resources website link.) Home health agencies must meet the licensure requirements specified in Chapter 25, Section 197.400197.475 and 19 CSR 30-26.010. Please review these statutes and regulations before proceeding with this process. If you wish to participate as a state licensed home health agency, submit the following information to: Missouri Department of Health and Senior Services Bureau of Home Care and Rehabilitative Standards P.O. Box 570 Jefferson City, MO 65102 The application will not be processed until all of these items are received: 1. 2. 3. 4. 5. 6. Letter of Intent for State Licensure and/or Medicare Certification Application for Home Health Agency License $600 licensure fee made payable to the Missouri Department of Health and Senior Services (non-refundable) State Disclosure of Ownership and Control Interest Statement Agency policy and procedure manual Proof of current registration with the Missouri Secretary of State. If the agency is using a "doing business as" (d/b/a) name, you will need to provide proof of the fictitious filing. For any questions regarding the registration process or fictitious filing, contact the Secretary of State office at 573- 751-4153. All forms received by the Bureau must list the legal entity name and the d/b/a, if applicable.

Missouri statute at 197.445 requires all licensed home health agencies to meet the standards for Medicare certification. In developing your policy and procedure manual refer to the website link for Interpretive Guidelines – Home Health Agencies (State Operations Manual – Appendix B.) Policies and procedures must address all of the standards listed in the Interpretive Guidelines except for those related to the...