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Services / Starting a Residential Service Agency (RSA)

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Starting a Residential Service Agency (RSA)

Policies and procedures for starting a home care agency licensed by the Maryland Office of Health Care Quality.

A Residential Service Agency (RSA) is a business that employs or contracts with individuals to provide at least one home health care service for pay to an unrelated sick or disabled person. Examples include private duty nursing, personal care and daily living help, therapy, and home medical equipment. In Maryland, RSAs are licensed and overseen by the Office of Health Care Quality (OHCQ).

Who it is for

  • Nurses and caregivers who want to open a home care or private duty agency
  • Entrepreneurs planning to hire or contract nurses, certified nursing assistants, or medication technicians
  • Owners who must prepare a complete policies and procedures manual for licensure

What you will learn

  • What counts as an RSA and which services require a license
  • License application contents: application form, proof the owner is 21 or older, ownership disclosures (25 percent or more), history of any prior license denial or revocation, and disclosure of criminal charges or convictions
  • Writing your business plan: a 1 year operating budget, a marketing plan naming the populations you will serve, and a detailed description of services
  • Preparing the agency policies and procedures required under COMAR 10.07.05.08, including handling complaints and evaluating and assessing clients
  • Workers' compensation proof for all employees
  • Staff training rules, including OHCQ approval before using an outside trainer
  • Employee versus independent contractor classification under Maryland labor law
  • Posting the OHCQ RSA complaint hotline, (800) 492-6005, for clients

Class format

  • Step by step walk through of the application and policy manual
  • Review of the OHCQ and COMAR requirements in plain language
  • Templates and checklists are discussed in class

After the class

  • The license fee is $1,000 for a 3 year license
  • OHCQ may inspect the agency before approving or denying the application, announced or unannounced
  • The Secretary can approve, approve with conditions, or deny. Licenses last 3 years and renew with updated policies, employee credentials, and an annual data survey
  • Recent proposed changes would require applicants to attend an OHCQ orientation class, so check OHCQ for current rules

Sources

Information is summarized from the sources above. Requirements can change, so we confirm current details at registration.