Maryland · Made to order · Founding price
Maryland home care policies & procedures, built to COMAR 10.07.05 (Health-General Title 19, Subtitle 4A)
Maryland requires a written policy and procedure manual to license a non-medical home care agency. We build yours to COMAR 10.07.05 (Health-General Title 19, Subtitle 4A), delivered in 3 business days, fully refundable.
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- Built from your state's own .gov citations
A business document, not legal advice.
$149 one-time. Consultants charge $1,000 to $4,000 for the same document.
How home care licensing works in Maryland
Maryland licenses private-pay non-medical home care as a Residential Service Agency under COMAR 10.07.05, administered by the Office of Health Care Quality. There is no fee to apply and no Certificate of Need; the license is $1,000 per 3-year term. What makes Maryland unusual is the application’s structure: COMAR 10.07.05.08B enumerates the required policy set, and the application form makes you index each required policy to the page number in your own manual. A manual pre-organized to the COMAR citations drops straight into that table. Maryland also draws a bright staffing line: hands-on ADL care runs through certified nursing assistants under RN delegation, while purely household/IADL support businesses are exempt from licensure entirely.
Your written policy & procedure manual sits inside a larger licensing process. Here is the path the Maryland Department of Health, Office of Health Care Quality (OHCQ) expects, and where your manual fits.
- 1Form the entity and obtain the SDAT Letter of Good Standing plus proof of workers’ compensation coverage (or exemption), both required application attachments.
- 2Complete the mandatory online RSA Certification on personal-care-aide worker classification (Health-General §19-4A-11), required for all applicants even if you do not plan to hire personal care aides, and renewed every 3 years.
- 3Prepare the written policy and procedure set enumerated at COMAR 10.07.05.08B, plus the screening (.10), complaint (.09), client-rights (.16), records (.14/.15) and training (.11) policies. The typed application (handwritten forms are rejected) makes you cite each policy by document name and page number, and you may request written waivers for genuinely inapplicable items like biomedical waste (.08B(2)).
- 4Attach the business plan the application requires: a one-year operating budget, marketing plan and service description (COMAR 10.07.05.04A(2)(h)), along with the organizational chart and ownership disclosures.
- 5Submit through OHCQ’s online license-application portal. Incomplete applications are administratively closed after 180 days, so assemble the full packet before filing.
- 6Cooperate with OHCQ review and any announced or unannounced inspection (.04D, .07); a failed prelicensure compliance visit costs $250 per additional visit (.04K). The license runs 3 years (.04H) and renewal requires updated policies, employee credentials and the annual data survey (.04I).
Timeline: No statutory processing deadline; OHCQ holds incomplete applications for 180 days and then closes them. Practical reports run roughly 4 to 6 months from filing to license, driven by application completeness and the prelicensure review.
The policies Maryland requires in your manual
These are the specific written policies the Maryland Department of Health, Office of Health Care Quality (OHCQ) reviews, each tied to the rule that requires it. Your manual is organized to cover every one in Maryland-specific language, not a generic national template.
Administrative policy set: scope of services, care-coordination delineation and client notification, admission criteria, pre-acceptance assessment, billing and service records, and the quality assurance program
COMAR 10.07.05.08B(1)(a)
Clinical management: assessment, plans of care, delegation and supervision, the RN-oversight policy that anchors the staffing model
COMAR 10.07.05.08B(1)(a)(viii)
Personnel policies: job descriptions with educational qualifications, skill assessments, and health requirements for every employee and contractor
COMAR 10.07.05.08B(1)(b)
Patient-care policies: service provision with criteria for identifying the need for skilled services, drug administration, client-monitoring frequency, and client/family training
COMAR 10.07.05.08B(1)(c)
Informed-consent policies with signed forms: plan-of-care changes, and nonlicensed assistance with routine treatments or medication self-administration
COMAR 10.07.05.08B(1)(d)
Environment and safety: supply preparation and storage, infection control, biomedical-waste disposal (waivable if inapplicable), equipment maintenance, and emergency procedures
COMAR 10.07.05.08B(1)(e)
Employee and contractor screening: criminal history check, licensure/certification verification, TB and health screening, references, employment history, I-9 and identity verification, an in-person interview and a skills assessment before referral
COMAR 10.07.05.10A-B
Internal client complaint process with investigation protocols, non-disruption of services, and the state complaint-hotline notice
COMAR 10.07.05.09
Client rights and cost disclosures: itemized cost estimate, caregiver names and supervisor contact, 24/7 phone number, subcontract disclosure, plus the dignity, participation, refusal, privacy and complaint rights statement
COMAR 10.07.05.16C-D
Client representative recognition and documentation (guardians, powers of attorney, surrogates)
COMAR 10.07.05.13
Clinical records, with the simplified non-skilled record set (nursing assessment, plan of care, services provided, significant changes) and care notes at admission, weekly, and on significant change
COMAR 10.07.05.14
Record retention and confidentiality: 5 years after discharge (longer for minors), complete record within 30 days of discharge
COMAR 10.07.05.15
The 7-topic training program: personal-care instruction with supervised practice, RN-referral triggers, recordkeeping, ethics and confidentiality, CPR, standard precautions, and abuse/neglect prevention; outside trainers need OHCQ written approval
COMAR 10.07.05.11B-C
Governing authority that convenes at least annually to review policies, with minutes recording participants, agenda and actions
COMAR 10.07.05.08A
Advertising compliance: every ad carries the license number and the exact statement “Licensed as a residential service agency by the Maryland Department of Health, Office of Health Care Quality”
COMAR 10.07.05.06
Informational summary of what Maryland regulations require, not legal advice. Citations are provided so you can verify each against the source; confirm current requirements with the Maryland Department of Health, Office of Health Care Quality (OHCQ).
See what you actually get
A finished, formatted manual organized to the rule, not a checklist or a generic template. A page from your Maryland manual:
Contents: required policies
COMAR 10.07.05.08B(1)(a) Administrative policy set: scope of services, care-coordination delineation and client notification, admission criteria, pre-acceptance assessment, billing and service records, and the quality assurance program
COMAR 10.07.05.08B(1)(a)(viii) Clinical management: assessment, plans of care, delegation and supervision, the RN-oversight policy that anchors the staffing model
COMAR 10.07.05.08B(1)(b) Personnel policies: job descriptions with educational qualifications, skill assessments, and health requirements for every employee and contractor
COMAR 10.07.05.08B(1)(c) Patient-care policies: service provision with criteria for identifying the need for skilled services, drug administration, client-monitoring frequency, and client/family training
Key Maryland facts to know before you apply
The application indexes your manual
Maryland’s RSA application makes you map each required policy in COMAR 10.07.05.08B to the document name and page number in your own manual, roughly 23 line items. Surveyors then check the manual against the rules. A manual pre-organized to those citations fills the table in minutes.
$0 to apply, $1,000 per 3 years, no CON
There is no application fee; the license fee is $1,000 per 3-year term under COMAR 10.07.05.04A(2)(k) (verify current, since older guides still quote $500). Certificate of Need applies to home health agencies under COMAR 10.07.10, not to RSAs.
The nursing line is real
Clients needing ADL assistance get certified nursing assistants performing RN-delegated tasks (.10E), an RN assesses clients requiring skilled services plus ADL assistance (.12B), and RN supervisory visits recur at 45-day to 4-month intervals depending on medication involvement (.12E). Most personal-care RSAs retain a part-time or contract delegating RN, a cost most out-of-state guides never mention.
Companion-only businesses are exempt
Agencies providing only household or family support services (IADLs, errands, housekeeping-type tasks, no hands-on ADL care) are exempt from RSA licensure under COMAR 10.07.05.03B. The moment staff bathe, dress, transfer or feed clients, the license is required.
180-day completeness clock
OHCQ administratively closes applications still incomplete after 180 days, and a failed prelicensure compliance visit costs $250 per re-visit. Filing a complete packet with the finished policy manual is the difference between one visit and several.
Uses independent contractors? Same screening
The chapter expressly permits contractor caregivers (.03E), but every contractor goes through the identical .10B screening, and every applicant completes the state’s worker-classification RSA Certification (Health-General §19-4A-11), renewed every 3 years. Maryland actively polices aide misclassification.
A Maryland manual, not a national template
Free templates and national sample manuals miss the Maryland-specific language and citations reviewers look for. Every manual we build is organized to COMAR 10.07.05 (Health-General Title 19, Subtitle 4A) and the Maryland Department of Health, Office of Health Care Quality (OHCQ) application, and delivered as editable Word + PDF you can brand with your agency name.
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A fraction of the start-up consultant’s price.
Start-up consultants charge $1,000–$4,000 to assemble these documents by hand, and instant template shops are instant because they sell everyone the same generic document. Every manual is made to order: built from your agency details, organized to your state's rules, and delivered within 3 business days, with a full refund anytime before delivery. Founding pricing is limited to the first 25 agencies; after that the State P&P Manual is $199.
Delivered within 3 business days, with a full refund anytime before delivery. This is a self-prepared operational document you adopt for your own agency, not legal advice, and not a guarantee of license approval.
Maryland home care licensing FAQ
Sources
- health.maryland.gov/ohcq/Pages/Residential-Service-Agencies.aspx
- regs.maryland.gov/us/md/exec/comar/10.07.05.08
- health.maryland.gov/ohcq/docs/Applications/APPLICATION_RSA-License-06.26.2026-A.pdf
- mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=19-4A-11
Maryland requirements last reviewed 2026-06-30. Regulations change, so verify current requirements with the Maryland Department of Health, Office of Health Care Quality (OHCQ) before relying on them.
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