How to Get an RSA License in Maryland (2025 Guide)

How to Get an RSA License in Maryland (2025 Guide)

Anton Fonseka

Want to open a Residential Service Agency (RSA) in Maryland? This step-by-step guide explains how to apply, what documents you need, how much it costs, and how to prepare the required Maryland RSA policies and procedures to pass inspection and get licensed fast.

What Is an RSA in Maryland?

A Residential Service Agency (RSA) is a licensed provider that delivers non-medical and limited medical home care services-such as assistance with Activities of Daily Living (ADLs), medication reminders, and skilled nursing-in a client’s residence. Unlike Home Health Agencies (HHAs), RSAs in Maryland do not require a Certificate of Need (CON) and are regulated solely by the Maryland Department of Health’s Office of Health Care Quality (OHCQ). Learn more about RSA regulations on the Maryland OHCQ official website.

RSA License Maryland: Who Needs It?

You need an RSA license in Maryland if your agency will:

  • Hire aides or nurses to provide home-based care
  • Offer help with bathing, dressing, grooming, mobility, or medication
  • Deliver skilled nursing care under RN/LPN supervision
  • Supply Durable Medical Equipment (DME) for home use

RSA Application Maryland: Step-by-Step Process

To get your RSA license, follow these four key steps:

  1. Prepare Your Documents
    You’ll need:
  2. Complete the Application
    Complete the official RSA application form (check below)
    No application fees for RSA in Maryland
  3. Submit and Await Approval
    (Step placeholder as per original content)
  4. Receive Your Full RSA License
    You’ll be granted a approx. 6-month full RSA license in Maryland

🔗 Track RSA licensing progress using the Smartsheet project management tool.

Maryland RSA Policies and Procedures: Required Content

To get licensed, your agency must submit a full set of state-compliant operational policies that include:

  • Client intake and care planning
  • RN delegation and supervision protocols
  • Staff onboarding and training
  • Medication administration (Level 2/3)
  • HIPAA, incident reporting, infection control
  • Emergency preparedness
  • Abuse prevention and corrective action plans

👉 Get all required policies prewritten and customized for Maryland RSA compliance:
Get the Complete Policy and Procedure Manual for RSA Maryland →

Types of RSA Licenses in Maryland

There are two main license types depending on the services you offer:

  • 🔹 RSA – Other
    Skilled services only (no aides)
    Includes Physical/Occupational/Speech Therapy, Medical Social Work, DME
    Only DME providers may qualify for Medicare Part B
  • 🔹 RSA – Skilled Nursing and Aides
    Requires RN supervision
    Includes personal care, ADLs, and skilled nursing
    3 License Levels:
    • Level 1: ADLs + med reminders (no administration)
    • Level 2: ADLs + med administration (CMT/LPN under RN)
    • Level 3: Complex care (e.g., IV, trach, ventilator) by RN/LPN
    ✅ Levels 2 & 3 are eligible for Maryland Medicaid Waiver Program

RSA Maryland vs. Home Health Agency (HHA)

Feature RSA Maryland Home Health Agency (HHA)
Certificate of Need (CON) ❌ Not Required ✅ Required
RN Supervision ✅ Yes (for aides) ✅ Yes
Skilled Nursing ✅ Optional ✅ Required
Medicare Billing ❌ Only DME (RSA-Other) ✅ Full billing
Medicaid Waiver ✅ Levels 2–3 ✅ Yes
Service Duration ✅ Ongoing/24-7 ⚠️ Limited to 30-day episodes

FAQs

  • Is the RSA license application fee in Maryland really FREE?
    ✅ Yes, as per OHCQ guidelines, the RSA application fee is free. You will not be required to pay application fees at the point of submission.
  • Do RSAs in Maryland need to meet federal CMS rules?
    ❌ No. RSAs are only regulated at the state level.
  • Can I start an RSA and get Medicaid approval?
    ✅ Yes - if you are licensed for Level 2 or Level 3 services.
  • Where can I get help preparing the RSA application?
    👉 CarePolicy.US offers full support, forms, and policies for Maryland RSA providers.

Downloadable Resources

📥 ✅ Official RSA Fact Sheet from Maryland Health Care Commission
📥 📊 RSA Application Tracker (Smartsheet)
📥 📘 Maryland-Compliant RSA Policies & Procedures

Final Thoughts

Getting your RSA license in Maryland is one of the fastest ways to enter the home care industry without federal red tape. By submitting a complete RSA application Maryland packet, investing in professional Maryland RSA policies and procedures, and ensuring your agency structure is compliant, you’ll be well on your way to building a successful, licensed care agency. For licensing help, forms, and done-for-you policy documents, visit CarePolicy.US.

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