HOME HEALTH CARE SERVICES PROVIDER IN MARYLAND

Fatumata Kaba
Sep 2
4 min read

DELIVERING MEDICAL, PERSONAL, AND THERAPEUTIC SUPPORT TO INDIVIDUALS IN THEIR HOMES TO PROMOTE SAFETY, INDEPENDENCE, AND QUALITY OF LIFE

Home Health Care in Maryland involves the provision of skilled nursing, personal care, therapy, and social services to individuals in their own homes. These services are authorized through Maryland Medicaid, including programs like the Community First Choice (CFC), Community Options Waiver, and Model Waiver, and are licensed by the Office of Health Care Quality (OHCQ) as Residential Service Agencies (RSAs).

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)

Role: Administers Medicaid-funded home health care under CFC and waiver programs

Agency: Office of Health Care Quality (OHCQ)

Role: Licenses and inspects Residential Service Agencies (RSAs) that provide home health services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Regulates federal HCBS standards and supports person-centered home care delivery

Agency: Maryland Board of Nursing / Board of Physical Therapy / Other Boards

Role: Licenses clinical professionals delivering services in the home

2. HOME HEALTH CARE SERVICE OVERVIEW

Services may include any combination of the following, as authorized by a physician and documented in a Plan of Care:

Skilled nursing care (RN/LPN)
Home health aide services (personal care, grooming, toileting, feeding)
Physical, occupational, or speech therapy
Medical social work
Medication administration and monitoring
Caregiver education and coordination
Wound care, catheter care, and chronic condition management

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

To operate as a home health provider in Maryland, agencies must:

Register the business with the Maryland Department of Assessments and Taxation (SDAT)
Obtain an EIN and Type 2 NPI
Apply to become a licensed Residential Service Agency (RSA) with OHCQ
Meet staffing requirements, including hiring a Nursing Administrator (RN)
Develop and submit a policy and procedure manual, sample care plans, and staffing plans
Maintain liability and malpractice insurance
Enroll with Maryland Medicaid via ePREP for reimbursement

4. OHCQ LICENSING PROCESS

Step 1: Business Formation and Pre-Application

Step 2: Submit RSA Application to OHCQ

Include the nurse administrator resume, operating procedures, sample forms, and clinical protocols
Select levels of care: Skilled, Unskilled, or Both

Step 3: Pass OHCQ Inspection

Includes review of clinical documentation, patient rights policies, and staff files

Step 4: Medicaid Enrollment via ePREP

5. REQUIRED DOCUMENTATION

Articles of Incorporation / LLC registration
IRS EIN and Type 2 NPI documentation
OHCQ RSA application and license
Medicaid provider number and ePREP approval
Policy & procedure manual including:
- Admission and discharge criteria
- Physician order and care plan templates
- RN supervision, home visit logs, and aide documentation forms
- Infection control and emergency preparedness protocols
- Medication administration record (MAR) and incident reporting
- HIPAA compliance and client confidentiality standards
- Staff training records and credentialing files

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: Valid MD license, CPR, experience with in-home care, supervises clinical team

Role: Licensed Practical Nurse (LPN)

Requirements: Works under RN supervision, provides delegated care

Role: Home Health Aide / Certified Nursing Assistant (CNA)

Requirements: Active Maryland certification, trained in personal care, transfers, and hygiene

Role: Therapists (PT, OT, ST) – if offering rehab services

Requirements: Licensed by the respective MD Boards

Role: Medical Social Worker (if applicable)

Training Requirements:

HIPAA, infection control, and emergency response
Delegation and supervision protocols
Documentation standards and incident reporting
CPR/First Aid
Annual continuing education and skills checks

7. MEDICAID WAIVER SERVICES

Home Health Care services are reimbursed under:

Community First Choice (CFC) – For individuals needing assistance with ADLs and nursing
Community Options Waiver – For adults with physical disabilities or the elderly
Model Waiver – For medically fragile children under age 22
Increased Community Services (ICS) – For those transitioning from nursing facilities

Covered services may include:

Skilled nursing (intermittent or continuous)
Home health aide support (e.g., bathing, grooming, meals)
Medication administration and IV therapy
Therapy (PT/OT/ST) services as ordered
Caregiver training and supervision

8. TIMELINE TO LAUNCH

Phase: Business Registration and Office Setup

Timeline: 1–2 weeks

Phase: RSA Application Development and Policy Manual

Timeline: 2–4 weeks

Phase: OHCQ Review and Inspection

Timeline: 6–8 weeks

Phase: Medicaid Enrollment and Participant Referrals

Timeline: 4–6 weeks

9. CONTACT INFORMATION

Maryland Office of Health Care Quality (OHCQ)

Website: https://health.maryland.gov/ohcq

Phone: (410) 402-8217

Regulations: COMAR 10.07.05

Maryland Medicaid Provider Enrollment (ePREP)

Website: https://eprep.health.maryland.gov

Maryland Board of Nursing

Website: https://mbon.maryland.gov

Maryland Department of Assessments and Taxation (SDAT)Website: https://egov.maryland.gov/BusinessExpress

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND HOME HEALTH CARE PROVIDER

We assist RNs, health professionals, and mission-driven entrepreneurs in launching fully licensed and Medicaid-approved Home Health Agencies across Maryland.

Scope of Work: