Maryland home care license requirements
Bottom line: Yes — MDH/OHCQ Residential Service Agency (RSA) license.
WATCH Watch item: OHCQ released draft COMAR 10.07.05 amendments (incl. training) for informal comment on Sept 9, 2026; not adopted.
- License required?
- Yes
- License / pathway
- MDH/OHCQ Residential Service Agency (RSA) license
- Fees (initial / renewal)
- $1,000 per 3-yr term (COMAR); application form says no fee to apply (sources conflict)
From the 50-state summary. Fees shown as stated in the state entry; see each entry for conditions, conflicts, and sources.
Maryland requirements, item by item
Bracketed numbers link to the official sources at the bottom of this page.
Not confirmed in official sources — check with the state agency We could not confirm this item on an official state source during our review, so we did not estimate it.
| Item | What the guide found |
|---|---|
| License required? | A Maryland license is required to operate a Residential Service Agency (RSA). The definition covers entities employing or contracting with individuals to provide at least one home health care service for compensation to an unrelated sick or disabled individual; an agency providing only household or family support services is stated not to require licensure. [1][2][3] |
| License type / name | Residential Service Agency (RSA) license under COMAR 10.07.05. MHCC describes the RSA as a home care business offering no more than two types of home care services and states that a Certificate of Need is not required before seeking this license. [1][4] |
| Licensing agency | Maryland Department of Health, Office of Health Care Quality (OHCQ) is responsible for RSA licensure and oversight. The Secretary of Health issues the license. [5][1][2] |
| Agency website | Maryland Department of Health OHCQ Residential Service Agencies page: https://health.maryland.gov/ohcq/Pages/Residential-Service-Agencies.aspx [5] |
| Initial application / license fee | Conflicting fee information: the June 26, 2026 application says there is no fee to apply; COMAR 10.07.05.04 states a $1,000 nonrefundable license fee for a 3-year term. The sources reviewed do not reconcile whether the application fee is distinct from a fee collected later for licensure. [1][6] |
| Renewal fee | $1,000 nonrefundable license renewal fee for a 3-year licensing term under COMAR 10.07.05.04. [6] |
| Renewal cycle | The license is valid for 3 years from issuance; renewal is for a 3-year licensing term. [6][3] |
| Typical approval timeline | OHCQ holds an application for 180 days from initial receipt while awaiting required materials; afterward it is deemed inactive and administratively closed. This is not an estimate of processing time. [1] |
| Administrator qualifications | The applicant or corporate representative must be at least 21 years old. The applicant must demonstrate financial or administrative ability to operate the agency. [6] |
| Caregiver background checks | Prospective employees, independent contractors, and contractual employees who will serve clients must have a State criminal history records check or a private agency background check. [3] |
| Caregiver training hours | The supplied adopted-rule text states no total training-hour requirement; it lists required training topics including personal-care instruction and supervised practice, CPR, infection control, and abuse and neglect prevention. A September 9, 2026 working draft proposes training within 45 days of hire, before referral/direct care, and annually; it also describes 3 hours of initial dementia training, 2 hours of dementia continuing education each calendar year, and biennial hands-on CPR training with in-person skills assessment. Draft provisions are not established as adopted requirements by the sources reviewed. [3][7] |
| Registry checks | Not confirmed in official sources — check with the state agency |
| General liability insurance | Not confirmed in official sources — check with the state agency |
| Workers' compensation | Applicants must attach proof of workers’ compensation coverage. The application also specifies a Certificate of Compliance or Letter of Exemption when coverage is not required; COMAR requires proof for employees as required by the Maryland Workers’ Compensation Commission. [1][6] |
| Bonding (surety / dishonesty) | Not confirmed in official sources — check with the state agency |
| Rule changes 2025–2026 | September 9, 2026: OHCQ released a working draft proposing amendments to COMAR 10.07.05 for informal public comment. The draft includes a $1,000 nonrefundable 3-year license fee and proposed training requirements; the sources reviewed do not show that the draft was adopted or took effect. [7] |
Source notes and conflicts
Initial-fee sources differ: the June 26, 2026 application states there is no fee to apply, while COMAR 10.07.05.04 states a $1,000 nonrefundable license fee for a 3-year term. The sources reviewed do not explain whether these refer to separate charges or how the application statement relates to the regulation.
Sources
- RSA - Application for License
https://health.maryland.gov/ohcq/docs/Applications/APPLICATION_RSA-License-06.26.2026-A.pdf - Pages - 10.07.05.02.aspx - Maryland Division of State Documents
https://regs.maryland.gov/us/md/exec/comar/10.07.05.02 - Chapter 05 Residential Service Agencies | Library of Maryland ...
https://regs.maryland.gov/us/md/exec/comar/10.07.05/index.full.html - Home Health | Maryland Health Care Commission
https://www.mhcc.maryland.gov/home-health - Residential-Service-Agencies - Maryland Department of Health
https://health.maryland.gov/ohcq/Pages/Residential-Service-Agencies.aspx - .04 Licensing Procedures. | Library of Maryland Regulations
https://regs.maryland.gov/us/md/exec/comar/10.07.05.04 - health.maryland.gov
https://health.maryland.gov/ohcq/docs/Regulations%20Pages/10.07.05%20Residential%20Service%20Agencies/RSA-Targeted-Reg-Change-10.07.05-Working-Draft-Sept-9-2026-A.pdf
Limits: fees and forms change often. Agencies sometimes post conflicting figures (a statute vs. an older form); those conflicts are shown, not resolved by guessing. Confirm the current fee with the agency before filing. This guide is a research reference, not legal advice.
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