From application to approval, we handle your OHCQ licensing — then hand you the platform to run your agency from day one. Most consultancies disappear when your license arrives. We keep going.
Want to open a non-medical home care agency in Maryland? You need a Residential Service Agency (RSA) License from the Maryland Department of Health, Office of Health Care Quality. Our estimate: 180 days for provisional approval plus an on-site survey. State filing fees total $1,000 and are paid directly to OHCQ.
Maryland Department of Health, Office of Health Care Quality
License Types
1 Categories
Residential Service Agency
Certificate of Need
Not Required
Non-medical home care agencies do not require a CON in Maryland.
Medicaid Program
Maryland Medicaid Community First Choice (CFC)
Program details available during your strategy call.
Home Care License Type in Maryland
Maryland regulates home-based care under several license categories. Most new founders start with a RSA License for non-medical care, then add skilled services later if they choose.
NON-MEDICAL
Residential Service Agency (RSA) License
Maryland calls a home care agency a Residential Service Agency (RSA).
Personal care and daily living assistance
Companionship and homemaker services
Medication reminders (not administration)
Transportation and errand assistance
Respite care for family caregivers
State fee:
$1,000 3-Year License Fee (No Fee to Apply)
Timeline:
Up to 6 Months for provisional approval
Regulator:
Maryland Department of Health, Office of Health Care Quality
How to Get Licensed in Maryland
Maryland licensing follows a structured 6-step process through OHCQ. Our specialists handle all 6 steps in the Launch and Signature packages; in the Licensing Kit, you handle the submission yourself with our expert guidance.
180 days from start to provisional approval
1
FOUNDATION
2
POLICIES
3
INSURANCE
4
APPLICATION
5
SURVEY
1
Register your business
FOUNDATION
Set up your LLC or corporation with the Maryland Department of Assessments and Taxation (SDAT). Use Maryland Business Express. Get an EIN from the IRS. Open a business bank account. Order a letter of good standing from SDAT. OHCQ asks for it.
2
Write policies and line up your RN
POLICIES
Write the policies COMAR 10.07.05.08B lists. They cover administration, personnel, patient care, informed consent, and environment and safety. Set up a governing authority that meets at least once a year. Line up an RN to assess and supervise personal care clients. Set up a 24/7 on-call line. Clients must get a call back within 1 hour (COMAR 10.07.05.12G).
3
Get insurance & plan your hiring checks
INSURANCE
Get workers' compensation. OHCQ needs your declaration page. General and professional liability insurance are smart to have, too. Set up how you will screen workers. That means a CJIS or private 7-year background check, TB screening, references, and a skills check.
4
Submit RSA license application to OHCQ
APPLICATION
Type the RSA License Application. OHCQ returns handwritten forms. Send it through the "Submit a License Application" link on the OHCQ website. Attach a business plan with a 1-year budget and marketing plan. Add your org chart, policies, SDAT good standing letter, and workers' comp declaration page. Also fill out the online RSA Certification about how you classify aides. There is no fee to apply.
5
OHCQ review period
SURVEY
OHCQ reviews your file. It does not publish a set review time. Answer every OHCQ request fast. If your file is still incomplete after 180 days, OHCQ closes it. Then you must apply again.
6
Inspection & license
SURVEY
OHCQ may inspect your agency before it decides. Extra visits caused by problems can cost $250 each. When you pass, OHCQ issues your license. It may add conditions. Your $1,000 license lasts 3 years.
Why Maryland Founders Choose HomeCareAtlas
The biggest difference between us and traditional consultancies isn't the license — it's what happens after the license arrives.
Traditional Consultant
HomeCareAtlas
Pricing
A mystery sales process and hard upsells
Clear packages built for your goals
Policies & Procedures
Generic templates
Built around your state and your service model
Application Filing
You assemble the packet
Done-for-you in Launch and Signature
Survey Day
You're on your own
On-call phone support during your state visit
After License Arrives
Relationship ends
Platform, dashboard, and directory listing go live
Caregiver Onboarding
Not included
Digital onboarding ready for hire #1
Compliance Tracking
You build a spreadsheet
Live compliance dashboard included
Directory Presence
None
Listed on Carezano the day you open
Three Ways to Get Your Maryland Agency Licensed
Pick the level of support that matches how hands-on you want to be. Maryland state fees ($1,000 to OHCQ) are passed through at cost.
Maryland charges a state application fee, paid directly to the state licensing body. We don't mark it up.
Want to see pricing? We share it on your free 15-minute call. Pick a time →
The Platform That Comes With Your License
Every tier includes free time on Home Care Atlas — the operating system for your new agency. This is the part other Maryland consultancies don't offer.
Maryland Licensing Workspace
Track your application, documents, and deadlines in one dashboard. Your Atlas specialist works in the same view you do.
Custom Maryland P&P Manual
Written around your state's rules, your service model, and your agency — not a generic national template. Survey-ready before you file.
Business Formation
LLC, EIN, NPI, surety bond, and insurance — all tracked and handled in Launch and Signature packages.
Compliance Dashboard
From caregiver #1 onward, every certification, background check, and required document is tracked with automatic expiration alerts.
Caregiver Onboarding
I-9, W-4, direct deposit, and required background-check verifications — all collected digitally.
Carezano Directory Listing
Listed on our public directory the day you open. Local families find you, referral partners find you, you're visible from day one.
Common Questions Before You Book
How much does an RSA license cost in Maryland?
There is no fee to apply. The license fee is $1,000 for each 3-year term (COMAR 10.07.05.04). We estimate total startup costs at $50,000 - $95,000. That includes insurance, background checks, an RN, policies, office space, and working capital.
How long does licensing take in Maryland?
OHCQ does not publish a set time. We suggest planning for up to 6 months. OHCQ may inspect you before it decides. Start early and answer every OHCQ request fast. An incomplete file is closed after 180 days.
Are there different RSA license levels?
No. COMAR 10.07.05 has one RSA license. You list the services you will give on the application. Your services decide what rules apply. For example, hands-on personal care needs RN oversight.
Do I need a Certificate of Need in Maryland?
No. Under Health-General §19-4A-05, RSAs do not need a CON. Home health agencies do. So you skip any need-based approval to enter the market.
Does OHCQ inspect before I get my license?
It can. COMAR 10.07.05.04 lets OHCQ inspect your agency before it approves or denies your license. The visit can be announced or not. If problems force extra visits, OHCQ can charge $250 per visit or deny you. Be ready from day one.
Do I need a nurse?
For personal care, yes. Under COMAR 10.07.05.12, an RN assesses clients who need help with daily tasks. The RN also oversees the aides. If you only help with chores, meals, and errands, you do not need a license at all (COMAR 10.07.05.03B).
Is Maryland a good market for home care?
Maryland has about 1.15 million adults 65 and older. That is 18.4% of people (Census 2025 estimate). The Baltimore area and DC suburbs have strong private-pay demand. There is no fee to apply and no CON. Medicaid Community First Choice can add more work.
Can I work from home?
COMAR 10.07.05 talks about an agency office. You must post your license near its entrance. Check with OHCQ and your county zoning office before you use a home address.
Maryland Home Care Licensing: What You Need to Know
Maryland calls a home care agency a Residential Service Agency (RSA). You need an RSA license from OHCQ. The rules are in COMAR 10.07.05. There is no fee to apply. The license costs $1,000 and lasts 3 years. RSAs do not need a Certificate of Need (CON). OHCQ may inspect your agency before it says yes. If your file sits incomplete for 180 days, OHCQ closes it.
The Residential Service Agency (RSA) License
Maryland has one RSA license. COMAR 10.07.05 does not split it into levels. On the OHCQ form, you list the services you will give. Want to add a service later? You file the same form again. OHCQ does not charge to apply. The license fee is $1,000 for each 3-year term (COMAR 10.07.05.04). If OHCQ has to visit more than once before licensing because you are not ready, it can charge $250 per extra visit. OHCQ may visit your agency before it approves or denies your license. The visit can be announced or not. OHCQ can approve you, approve you with conditions, or deny you. Under Health-General §19-1902, you must check each uncertified aide before they start work. Use a state criminal history check (CJIS) or a licensed private agency. A private check must cover every state the worker lived or worked in for the last 7 years. Your agency pays. Do your clients need help with bathing, dressing, or other daily tasks? Then a registered nurse (RN) must assess them and oversee their care (COMAR 10.07.05.12). The RN visits in person at least every 4 months. Visits are more often if staff help with medicine. Do you only help with chores, meals, and errands? Then you do not need an RSA license (COMAR 10.07.05.03B). Once you help with bathing, dressing, or other hands-on care, you need one.
Certificate of Need (CON) in Maryland
No Certificate of Need (CON). RSAs do not need a CON (Health-General §19-4A-05). That means no need-based approval to get into the market. Home health agencies are different. They do need a CON.
Medicaid Participation — Maryland Medicaid Community First Choice (CFC)
Community First Choice is a Maryland Medicaid program. It pays for personal care at home for people who would otherwise need a nursing home level of care.
The OHCQ On-Site Survey
Pre-License Inspection (COMAR 10.07.05.04). OHCQ may inspect your agency before it approves or denies your license. Visits can be announced or unannounced. Extra visits caused by problems can cost $250 each. A provisional license is only for special cases. One example is small problems with a plan of correction OHCQ accepts.
Common Reasons Maryland Applications Are Rejected or Delayed
Generic P&P manuals that don't reflect state-specific regulations
Incomplete administrator documentation
Insurance or surety bond policies that don't meet state minimums
Missing or inadequate quality assurance program documentation
Physical office that doesn't meet site-review standards
Caregiver background checks that miss required state databases
Every one of these is preventable with proper preparation. It's the biggest reason founders choose done-for-you packages over DIY — the cost of a rejection in lost time is almost always higher than the cost of doing it right the first time.
Book a Free Maryland Strategy Call
15 minutes with a home care specialist. We'll map out Maryland licensing for you, your timeline, and your best next step — even if you don't hire us.
Which Maryland license type fits your business model (Residential Service Agency)
Your realistic timeline and budget
Whether Maryland Medicaid Community First Choice (CFC) enrollment makes sense for your plan
No pressure. No obligation. Maryland-specific guidance either way.
Your Future Maryland Clients Are Already Looking for Care.
Every week you spend piecing this together alone is a week you're not serving your first Maryland client. Let's get your agency licensed, launched, and visible — with people on your side who know OHCQ.
Built exclusively for non-medical home care|Maryland-specific guidance under COMAR 10.07.05 (Residential Service Agencies)|Platform & HomeCareAtlas directory on day one
Maryland licensing details verified by HomeCareAtlas on November 1, 2026.
Maryland Home Care License — Done-for-You Licensing
