Maryland RSA license application: OHCQ’s form, section by section

Sample files. OHCQ’s 2018 instructions and 2020 slides also asked for a sample personnel file and sample client files for adults and, if served, children. The 2026 application does not list them. (instructions, 2018, archived) Our suggestion: have a blank personnel file and a blank client file ready in case the RSA Team asks.

Ownership and history: what the rule adds

• Two thresholds. The rule asks for the "Identification of any individual or corporate owner of a 25 percent or more interest in the agency" (COMAR 10.07.05.04A(2)(d)). The form uses 25% for LLCs and partnerships, but asks a corporation for every owner and investor with 2% or more (application, Section D).
• A past revocation. An applicant or 25% owner whose license was suspended or revoked by the Department may not own, operate or manage another agency for 10 years without good cause shown. (COMAR 10.07.05.04B(1))
• An agency under sanctions. Someone who runs an agency that had sanctions in the last 2 years and is not in compliance when applying may not apply to open more agencies. (COMAR 10.07.05.04B(2))
• Other history. The Department may deny a license based on the applicant’s, an owner’s or a 25% owner’s prior history of RSA rule violations, or criminal history it decides may be potentially harmful to clients. (COMAR 10.07.05.04B(3)) By our reading, a yes in Section E is not an automatic refusal, since the form asks you to explain it in Section F. Answer fully: the attestation warns that knowingly failing to disclose fully and accurately may lead to denial (application, Section G).

The statute makes it a condition of the license: "As a condition of obtaining an initial license from the Department to operate as a residential service agency and every 3 years thereafter", the agency certifies to the Department on its form, signed by someone with authority over its pay or employment practices (Health-General §19-4A-11(b)).

• Who and how. To get and keep an RSA license, someone with authority over pay or employment practices must read the Attorney General’s guidance and complete OHCQ’s online RSA Certification form. (OHCQ, RSA page)
• Every applicant. "This is a requirement for all RSA applicants, including those that do not plan to hire personal care aides." (application, Instructions)
• Why it exists. The Attorney General’s guidance says RSAs sometimes wrongly classify personal care aides as independent contractors, which is illegal. (Attorney General’s guidance) Since January 1, 2026, the Department may pay an RSA for personal assistance services only when an employee provides them (Health-General §19-4A-10(b)).
• One step of several. "This RSA certification mandate is only one step in the application process to obtain a license to operate an RSA." (OHCQ, RSA page) We could not see the online form itself, so we do not describe its questions.

• Download, then type. OHCQ says to download the RSA License Application to your device and complete it in Adobe Acrobat, Adobe Reader or another PDF application, saving your progress as you go. (OHCQ, RSA page) "The application must be typed. Handwritten applications are not accepted and will be returned to the applicant." (application)
• Upload. "Submit the licensure application and all supporting documents to OHCQ through the Submit a License Application." (OHCQ, RSA page)
• All at once. "An application is not complete until the Department has received all the materials required in this application." (application, Determination) Our suggestion: send a complete set at once, and keep a copy of everything you upload with the date.
• By email. OHCQ’s 2018 instructions said application notices and process updates come by email, and an approved agency gets its operating license with an effective date. (instructions, 2018, archived) Our suggestion: use an email address you check daily for the primary and secondary contacts in Section A.
• Questions. The Maryland Department of Health’s Office of Health Care Quality (OHCQ) licenses and oversees RSAs (RSA Team, 410-402-8040). (OHCQ, RSA page)

• What the Department looks for. The Department reviews every application to decide whether the applicant can provide appropriate services in clients’ homes and meets COMAR 10.07.05. (COMAR 10.07.05.04C) The statute puts it this way: an applicant "shall show that the residential service agency will provide appropriate home health care providers to sick or disabled individuals who may be provided care in the individual’s residence, instead of in a hospital" (Health-General §19-4A-05(1)).
• A visit before the decision. "Before approving or denying an application for licensure, the Department may conduct an announced or unannounced on-site inspection of the agency." (COMAR 10.07.05.04D) If the agency is not compliant and more than one prelicensure visit is needed, the rule text lets the Department charge $250 for each extra visit or deny the license (.04K). We could not confirm the $250 is still charged since 2018.
• Approval. OHCQ issues the license once it decides the applicant complies with all licensure requirements, with or without conditions. (application, Determination) Conditions may include an approved management firm or a license term under 1 year (COMAR 10.07.05.04E), and "The Secretary may not require the use of a management firm for a period in excess of 24 months." (.04F)
• Denial and appeal. An applicant that cannot comply with all licensure requirements is denied and gets a detailed letter with the reasons and appeal rights. (application, Determination) An applicant denied a license may ask for a hearing: the request goes to the Office of Administrative Hearings, with a copy to OHCQ, within 30 days of receiving notice of the decision, with a copy of the decision. (COMAR 10.07.05.04G, .28A)
• An incomplete application. "OHCQ will hold an application for 180 days from the date of initial receipt, after which the application will be deemed inactive and administratively closed." An applicant whose application was administratively closed may reapply with a new application. (application, Determination)
• Withdrawing. An applicant may withdraw at any time by telling OHCQ in writing, and may reapply with a new application. (application, Determination)
• How long. OHCQ’s 2018 application instructions said processing should take 2 to 3 months after all documents arrive. No current figure is published for RSAs. (OHCQ says NRSA licenses generally take 1-2 months.) (instructions, 2018, archived; OHCQ, NRSA page) We cannot give you a date.

Why we read it as no fee. Chapter 661 of 2018 struck the statutory requirement that the Secretary charge RSA licensing fees (struck text shown in brackets in the chapter law). (Chapter 661 of 2018) The bill’s fiscal note says it "effectively authorizes OHCQ to issue nonexpiring licenses to specified provider types and eliminate all related licensing fees" (fiscal and policy note, SB 108 (2018)). COMAR 10.07.05 was last amended effective March 13, 2017, before that law (COMAR 10.07.05, history), and OHCQ’s current application says there is no fee.

New services. For a new service, the rule asks for an application fee "as required by" Health-General §19-4A-03(c). By our reading that points to the fee language Chapter 661 of 2018 struck; the current §19-4A-03(c) sets no fee, and OHCQ’s application, used for new services too, says there is no fee. (COMAR 10.07.05.05A(2)(c))

Renewal. COMAR 10.07.05.04H-I still describe a 3-year license with a renewal application. After Chapter 661 of 2018 the statute no longer provides for renewal, and OHCQ’s RSA page has no renewal process. By our reading licenses no longer expire, but the 3-yearly worker classification certification still applies. Confirm with OHCQ. (COMAR 10.07.05.04H; Chapter 661 of 2018) The full cost and timeline →

• Post it. "The licensee shall display the agency’s current license in a conspicuous place, at or near the entrance of the agency’s office." (COMAR 10.07.05.03D)
• Advertising. All advertising and marketing shows your license number and the statement “Licensed as a residential service agency by the Maryland Department of Health, Office of Health Care Quality” (COMAR 10.07.05.06A). An RSA may not advertise that it is licensed as a hospice, home health agency or nursing referral service agency unless it holds that license too. (.06B(3))
• Open in your hours. The agency must be open for inspection during all the hours its application gives as routine business hours. OHCQ "may conduct announced or unannounced licensure inspections or complaint investigations to ensure compliance with the requirements of this chapter" (COMAR 10.07.05.07A).
• The certification again. The RSA Certification is due for the initial license and every 3 years after (Health-General §19-4A-11(b)). By October 1 each year, an RSA paid by Medicaid for personal care aide services reports how many aides it classifies as employees and as independent contractors. (§19-4A-11(c))
• Every worker, before work. Before an eligible employee starts work, the agency applies for a State criminal history records check (or asks a licensed private agency for a background check) and requests a reference from the most recent employer. (Health-General §19-1902(a)) Background checks and screening.

• No transfer. "The license is valid in the name of the licensee to whom it is issued, and is not subject to sale, assignment, or other transfer." (COMAR 10.07.05.05D) A sale or transfer that changes who controls or operates the agency makes it a new agency: the licensee applies for a new license and meets the rules in force at the transfer. (.05A(4)(a)) A transfer of stock that changes who controls the agency, or of more than 25% of the stock, is a sale needing a new license. (.05A(4)(b))
• 45 days’ notice. Give the Department written notice at least 45 days before voluntarily closing, changing ownership or selling, with how clients will be told and helped; tell clients in writing 45 days before. A new owner applies for a new license at least 45 days before the transfer. (.05B(1)-(4)) OHCQ’s page repeats the 45-day written notice, takes the notice through an online link, and says the future owner applies at least 45 days ahead on the RSA License Application. (OHCQ, RSA page) The buyer ticks Change of Ownership on the application (application, Section A).
• Who is responsible meanwhile. The original licensee runs the agency, and corrects outstanding deficiencies and sanctions, until the new owner’s license is issued; then the former licensee returns its license by certified mail. (.05B(5)-(6))

Our suggestion: plan the sale with the RSA Team before it closes, so the buyer’s license is in place before the buyer provides services.

• Before. Written notice to the Department at least 45 days ahead, saying how clients will be told and helped to find comparable services, and written notice to clients 45 days ahead (COMAR 10.07.05.05B(1)-(3)).
• After. After closing, the licensee tells the Department the closure date and returns all licenses, past and present, by certified mail. (.05B(7)) "A license is void if the agency ceases to operate." (.05F)
• Records. Client records are kept 5 years after discharge, and a minor’s until age 21 or 5 years, whichever is later (COMAR 10.07.05.15A). "If an agency ceases operation, the agency shall make arrangements to return the records to the client or client representative with legal authority to make health care decisions, or retain the records as required by §A of this regulation." (.15B) Our suggestion: say in your notice to OHCQ which you will do, and where any records you keep will be held.
• If OHCQ acts on the license. Notify each competent client and client representative within at least 30 days of a significant change of licensure status, a voluntary surrender, or a denial, revocation or suspension. (.26)