Maryland Medical Residential Service Agency Complete Startup Package

This package is designed for a Maryland Residential Service Agency offering skilled medical services under COMAR 10.07.05. It covers agency structure, application preparation, policies, personnel materials, and operational documents for the selected medical services.

It does not include a Maryland Home Health Agency license, federal Medicare certification, Maryland Medicaid enrollment, accreditation, hospice licensure, or services not selected in the written agreement.

An RSA is a nongovernmental business that employs or contracts with individuals to provide at least one home health care service for compensation to an unrelated sick or disabled person in that person's residence. OHCQ recognizes RSAs that provide skilled nursing, therapy, home health aide, personal care, or medical equipment services.

The Maryland Department of Health, Office of Health Care Quality (OHCQ), licenses and oversees RSAs. The principal regulations are COMAR 10.07.05, together with applicable Maryland professional-practice requirements.

The current OHCQ application permits an RSA to request nursing, home health aide, physical therapy, occupational therapy, speech therapy, audiology, respiratory therapy, medical social services, dietary and nutritional services, and durable medical equipment services. The agency must be properly staffed, governed, and equipped for every service selected.

The June 26, 2026 OHCQ application says there is no fee to apply.

No. Department of Health fees, background checks, insurance, office expenses, personnel costs, Medicare or Medicaid enrollment, accreditation, and other government or third-party expenses are separate unless expressly included in writing.

OHCQ's current application requires the typed application, a one-year operating budget, marketing plan, detailed service description, organizational chart, COMAR 10.07.05.08B policies and procedures, an official SDAT letter of good standing, Workers' Compensation documentation or applicable exemption, ownership and disclosure information, and the online RSA worker-classification certification.

Home Health Forms prepares the application for review, but the applicant must provide complete and accurate company, ownership, personnel, and service information.

The agency must maintain an operating location where required administrative and clinical records are available and where the current license can be posted conspicuously. The location is subject to Department inspection. Applicants should verify zoning, lease, accessibility, record-security, business-license, and local requirements before committing to a location.

The RSA must have a governing authority responsible for policy determination, management, operation, and financial liability. The governing authority must meet with management staff at least annually to review policies and retain minutes documenting participants, agenda items, and actions taken.

Skilled services are provided by or under the supervision of an RN and under a plan of treatment. An RN must assess each new client who requires skilled services and ADL assistance, help develop the care plan and assign personnel, determine whether a certified caregiver is required, and participate in caregiver training when indicated.

Nursing must be furnished by personnel licensed or certified for the assigned functions. Delegated nursing tasks must comply with Maryland Board of Nursing requirements, the client assessment and care plan, and RN oversight. Certified care must be performed by an appropriately Maryland-certified individual.

Medical RSA services may include nursing, physical therapy, occupational therapy, speech therapy, audiology, respiratory therapy, medical social services, dietary and nutritional services, and approved medical equipment services. Each service must be within the agency's OHCQ-approved scope and furnished by qualified personnel.

Screening includes the applicable criminal-history or private background check, verification of licenses or certifications, health and tuberculosis screening, references, employment history, identity and work authorization, an in-person interview, and a skills assessment and demonstration. Training must address the care provided, RN referral situations, records, confidentiality, CPR, infection-control precautions, and abuse and neglect prevention.

The care plan must be based on assessment of the client's health, function, and psychosocial condition and identify the services, frequency, method, responsible personnel, goals, and safety measures. It must be reviewed by an RN or another authorized practitioner when appropriate.

Yes. COMAR requires a quality-assurance program and clinical-management policies addressing assessment, care plans, delegation, and supervision. Quality-assurance records must be maintained on site and made available to OHCQ. Home Health Forms includes the documents necessary to meet these requirements.

OHCQ may conduct an announced or unannounced on-site inspection before approving or denying an application. After licensure, the agency remains subject to announced or unannounced inspections and complaint investigations.

An RSA license is generally valid for three years unless surrendered, suspended, revoked, or issued provisionally for a shorter term. Licenses are not transferable.

No. An RSA license is not a Medicare-certified Home Health Agency license. Medicare HHA billing requires the separate Maryland Home Health Agency and federal CMS certification and enrollment pathway.

No. State facility licensure and Medicaid provider enrollment are separate processes. An agency seeking Medicaid reimbursement must satisfy the applicable program, enrollment, contracting, screening, and billing requirements.

OHCQ does not guarantee one processing time. Completeness, policy review, ownership and disclosure review, service scope, personnel readiness, inspection scheduling, and corrections can affect the timeline. An incomplete application may be administratively closed after 180 days.

• Logo creation and a customized WordPress website.
• One year of website hosting and domain registration.
• 500 business cards and 500 tri-fold brochures.
• Maryland COMAR 10.07.05 policy, human-resources, admission, clinical, and operational documents for the selected medical services.
• Preparation assistance for the Maryland RSA application.
• Members' area access, document customization, ongoing guidance, and applicable updates.

Unless stated otherwise in writing, the price does not include Department fees, Medicare certification, Medicaid enrollment, accreditation fees, insurance, rent, utilities, personnel or payroll costs, background checks, fingerprinting, software, or other expenses not specifically identified as included.

Home Health Forms provides documents, guidance, and application-preparation assistance. OHCQ makes licensing decisions, and federal authorities determine Medicare enrollment and certification. The applicant remains responsible for qualified personnel, accurate information, financial readiness, insurance, fees, regulator responses, inspections, and ongoing compliance. Home Health Foms provides guidance and documents that meet regulatory requirements to ensure your success.

Customized policy manuals, forms, and related digital documents are generally emailed within five business days after all information needed for customization is received. Website development, printing, shipping, and other package components may have separate timelines.

Eligibility depends on work completed, customized materials produced, digital products delivered, third-party expenses paid, printing ordered, and other services already performed.