Home Health
The Maryland Health Care Commission (MHCC) regulates Home Health Agencies (HHAs) in Maryland to support quality care, demonstrated need, and appropriate distribution of services across the state. This page provides an overview of how home health services are regulated, along with access to facility data, reports, and information on Certificate of Need and related regulatory processes.
About Home Health in Maryland
A Home Health Agency (HHA) is a licensed health care provider that delivers skilled medical services to clients in their homes, including nursing care, physical therapy, occupational therapy, and other therapeutic services. HHAs serve clients who require intermittent skilled care but do not need to be hospitalized or reside in a facility.
The Maryland Health Care Commission (MHCC) regulates the establishment of HHAs through the Certificate of Need (CON) program. MHCC reviews and approves applications to ensure that new HHAs meet State Health Plan standards, demonstrate sufficient need in the proposed service area, and maintain quality of care. MHCC also establishes application review schedules, which are posted on its website at mhcc.maryland.gov, and may evaluate changes in ownership or control through its review processes, as applicable.
Quick Facts: Home Health Agencies
Home Health Agencies (HHAs) deliver skilled medical care to clients in their homes, including nursing, physical therapy, and occupational therapy.
Establishing a new HHA
- Requires Certificate of Need (CON) review
Change of ownership
- Notice of Acquisition required
- CON review not required
- Submit at least 60 days in advance
Residential Services Agency (RSA) License
Another type of home care business, offering no more than two types of home care services, is the Residential Services Agency (RSA) license, with state licensing requirements found under COMAR 10.07.05. MHCC has no regulatory authority for the RSA license, meaning that a CON is not required prior to seeking an RSA license.
Facility Data and Reports
Quality & Performance
Access information on the quality and performance of home health facilities in Maryland.
Facility Data
Request public use files containing inventory and utilization information on licensed home health facilities in Maryland.
Reports
Browse staff reports and recommendations on home health services in Maryland, prepared by the Commission in accordance with the State Health Plan.
Regulatory Process
The CON process begins with the submission of a Letter of Intent (LOI), followed by a pre-application conference with MHCC staff. The applicant then files a formal CON application, which is reviewed by MHCC for completeness. Once deemed complete, the application enters a formal review period that includes opportunities for public comment and, if applicable, comparative review with competing applications. The CON review schedules are posted on the MHCC website at mhcc.maryland.gov.
MHCC staff evaluate the application in accordance with the State Health Plan and applicable review criteria, including project need, cost-effectiveness, impact on existing providers, financial feasibility and health equity. A staff report and recommendation are prepared and presented to the Commission. The Commission then issues a final decision to approve, approve with conditions, or deny the application.
Following approval, the applicant must meet applicable conditions and will be required to obtain first use approval from MHCC prior to initiating services.
The Commission administers an annual survey application, conducted by the Health Facility Planning division around the fourth quarter of every year.
A change of ownership for a Home Health Agency (HHA) in Maryland does not require a Certificate of Need (CON); however, the Maryland Health Care Commission (MHCC) must be notified of the transaction. The applicant is required to submit a Notice of Acquisition, including details of the proposed ownership structure, such as pre- and post-transaction organizational charts, ownership tables, and a description of the transaction.
MHCC reviews the submission to determine whether the proposed change constitutes a change in control and to confirm that no additional services or changes in scope are being proposed that would otherwise require CON review. In cases involving indirect or upstream ownership changes, MHCC notification is still required.
Applicants are generally advised to submit Notice of Acquisition materials at least 60 days in advance of the anticipated transaction to allow sufficient time for review.