A Residential Service Agency (RSA) is a business that employs or contracts with individuals to provide at least one home health care service for compensation to an unrelated sick or disabled individual.  There are several types of RSAs that may provide a variety of services.  Some agencies have nurses that provide skilled nursing care and certified caregivers that provide assistance with activities of daily living, such as bathing, grooming, and dressing.  Individuals can contract with private duty agencies for as many hours as needed, including overnight care of 24 hours, 7 days a week.  Other RSAs provide physical therapy, occupational therapy, or speech therapy.  Some RSAs provide durable medical equipment (DME), including hospital beds, CPAP machines, and oxygen.  OHCQ is responsible for the licensure and oversight of residential service agencies. 

Regulations related to Residential Service Agencies are found in COMAR 10.07.05​.  To order copies of COMAR regulations, contact Tarshia Neal at the Maryland Division of State Documents at 410-260-3874 or [email protected].  Regulations are also available at public libraries - Find your nearest public library​.

Request an Initial License:  To apply for a license for a residential service agency, complete the RSA License Application​.  In order to complete the application, please download a copy to your device.  Adobe Acrobat, Adobe Reader or another *.PDF application are required to complete the application.  It is recommended that you save your progress throughout the process. Submit the licensure application and all supporting documents to OHCQ through the Submit a License Application.  After a completed application and all requested information is received by OHCQ, it generally takes 3 to 4 months to receive a license.

Request an Additional Service for a Licensed RSA:  To request additional services, complete the RSA License Application​.  Submit the application and all supporting documents to OHCQ through the Submit a License Application system​.

Change of Ownership:  A licensee shall notify OHCQ in writing at least 45 days in advance of the intention to sell the agency or to have a change of ownership/transfer of stock in excess of 25% or transfer of any stock which results in a change in a person(s) who control the agency. The licensee shall include the following information in the notice to the Department: (a) The method for informing clients or client representatives, if applicable, of its intent to close, change ownership, or sell its agency; and (b) The actions the licensee will take to assist clients in securing comparable services and assistance, if necessary. The notice can be submitted at the following link.  A licensee shall notify clients or client representatives, if applicable, of any proposed in writing, at least 45 days before the effective date of the proposed change.

The future owner shall apply for a new license at least 45 days in advance of the proposed change by completing the RSA License Application.  Submit the application and all supporting documents to OHCQ through the Submit a License Application system.

Residential service agencies (RSA) may train their staff who provide care in clients' homes or may use an outside trainer. If an outside trainer is used, that individual must have OHCQ's approval prior to training. See COMAR 10.07.05.11C for more information.

An outside trainer uses this form​ to submit their training materials to OHCQ for review and approval.

Pursuant to Health General §19–4A–11, as a condition of obtaining an initial RSA license and to remain licensed, an RSA shall complete a certification related to the employment of personal care aides (PCA).  To comply with this requirement, an individual with authority over the RSA’s pay or employment practices must:

This RSA certification mandate is only one step in the application process to obtain a license to operate an RSA. Please submit any questions to Questions about RSA Certification​​.

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All RSAs must provide notice to clients of OHCQ's hotline number for complaints about services provided by the agency or services that the agency failed to provide.  The RSA Hotline number is 800-492-6005.​