From Application to Approval: How to Get Your In-Home Services License in Missouri

Starting an in-home services agency is one of the most rewarding ways to serve your community, helping seniors and individuals with disabilities maintain independence in their own homes. But before you can begin offering care, you must be licensed by the Missouri Department of Health and Senior Services (DHSS).

If you’re wondering how to get your In-Home Services (IHS) license in Missouri, this step-by-step guide will walk you through the process and share insider tips to help you avoid common mistakes that can delay approval.

1. Know What Type of Services You’ll Offer

Missouri recognizes two main types of in-home care services: Basic Personal Care Services (IHS) provide assistance with daily living activities such as bathing, dressing, grooming, meal preparation, and light housekeeping. Advanced Personal Care (APC) includes higher-level services such as catheter care, ostomy care, and range-of-motion exercises, which require RN oversight and competency verification.

Clearly defining your service scope from the start ensures your application includes the correct documentation and training plans.

2. Complete the In-Home Services Application Packet

The application for licensure can be downloaded directly from the Missouri DHSS website. Your completed packet must include:

• A business plan that describes your company, services, and structure

• Policies and procedures that comply with 13 CSR 70-91.010

• A staffing plan and personnel qualifications

• Proof of office location and accessibility

• Background screening documentation for owners and key staff

Pro Tip: Double-check every form before submitting. Even small omissions such as missing signatures or incomplete training outlines can delay processing for weeks.

3. Prepare Your Policies and Procedures

Your policies and procedures are the backbone of your application. They show DHSS how your agency will operate safely and within state guidelines. Required policies include:

• Participant rights and grievance procedures

• Telephone and after-hours contact protocols

• Emergency and incident reporting

• Training and supervision plans for aides

• Electronic Visit Verification (EVV) compliance

Make sure your documents reference the correct state regulations and clearly outline how your agency will meet each requirement.

4. Schedule the Pre-Licensure Survey

Once your paperwork is reviewed and accepted, DHSS will schedule a pre-licensure survey (on-site visit). During this visit, inspectors verify:

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  Your office setup and record-keeping systems

• Staff files, RN credentials, and training documentation

• Policy compliance and readiness to serve clients

Insider Tip: Have your RN present for the visit and keep all binders, manuals, and staff files neatly organized. Presentation matters. A professional setup shows your agency is prepared and compliant.

5. Receive Your License and Start Providing Services

After a successful inspection, DHSS will issue your In-Home Services license. This approval allows your agency to begin accepting clients and billing under MO HealthNet (Medicaid) once enrolled. must maintain ongoing compliance, including:

• Staff training renewals

• Updated EVV records

• Proper participant documentation

• RN supervision for APC services

Regular self-audits help ensure your agency remains in good standing with the state.

6. Common Reasons for Application Delays

Avoid these frequent mistakes that slow down approvals:

• Incomplete or missing forms in the application packet

• Policies that do not match current 13 CSR 70-91.010 requirements

• Unclear business or staffing structure

• Missing proof of liability insurance or RN oversight

• Not responding promptly to DHSS follow-up questions

Getting your In-Home Services license in Missouri takes preparation and attention to detail, but with the right documents, organization, and guidance, you can move smoothly from application to approval.

A well-structured agency not only earns licensure faster but also sets the foundation for long-term success and compliance.

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