How to Start a Home Health Care Business

About Home Health Care Services

Q. What is a Home Health Agency?
A. A home health agency is a provider of home health services which include skilled nursing services, home health aides, and at least one other home care service such as medical social services, and therapies such as physical, occupational or speech therapy. A certificate of need must be obtained from the Maryland Health Care Commission (410-764-3558) before a license is issued.
Q. What is the difference between a home health agency and a residential service agency?
A. The most important differences in these two agencies are:

  • Home health agencies must provide at a minimum-skilled nursing services, home health aides, and one or more other services such as physical therapy, occupational therapy, medical social services, and home medical equipment.
  • Residential services agencies cannot provide skilled nursing, home health aides & one other service. (if these services are provided, you are defined as a home health agency). Services such as aides only, or skilled nursing and aides, or home medical equipment only may be provided.
  • Home health agencies can participate in the Medicare program. Residential service agencies cannot be Medicare providers.
  • Home health agencies require a certificate of need (CON) prior to licensure. Residential service agencies do not require CON approval. They must have an RSA license from the Maryland Department of Mental Hygiene, Office of Healthcare Quality (OHCQ). (Source, MD Department of Health and Mental Hygeine)


First, join MNCHA! While MNCHA does not provide consulting support on how to start a home care business, you will gain contacts and information that can help you learn the ropes and enhance your chance for success when you participate in MNCHA events or join the Association as an individual or provider member.    


Perhaps the best part of becoming a MNCHA member is the chance to network with experienced business leaders who can provide guidance to you as you build or expand your business. 


Members benefit from training, events, and teleconferences provided by experts in Maryland and at the National level which address all the issues relevant to starting, growing, or making a homecare or home medical equipment  business more effective and successful. MNCHA's lobbies at the state and federal level to address legislation, regulation, or policies that could benefit or negatively impact its members.    

MNCHA offers 2 conferences each year and numerous training and technical assistance events which are open to both members and non-members including a Advocacy Day in Annapolis, an Annual Meeting, as well as seminars such as OASIS, Coding, Private Duty Conferences, Marketing Seminars, training with surveyors, and much more. 


A state official is in the best position to help you figure out how to set up your business in Maryland.  The primary state agency is the Maryland Department of Health and Mental Hygiene which issues licenses for home health agencies, private duty agencies, and home medical equipment providers. The Maryland Health Care Commission also provides oversight on the Certificate of Need program for Medicare Certified Home Health Agencies. Please contact these agencies directly for assistance. 


You may also wish to contact the National Association for Hospice and Homecare or the American Association for Homecare for information on national issues.  Please see their web addresses below. 


Department of Health and Mental Hygiene

Office of Health Care Quality

Bland Bryant Building - Spring Grove Hospital Center

55 Wade Avenue, Catonsville, Maryland 21228


Maryland Health Care Commission

Center for Long-term and Community-based Services

4160 Patterson Avenue, Baltimore, Maryland 21215 



National Association for Home Care and Hospice, Inc.

American Association for Home Care