Health Care Facility Services   Home Health    Establishing a home health agency


Interested in establishing a home health agency in Maryland? The following addresses some of the most frequently asked questions

In order to be eligible to seek licensure and subsequently to be eligible to apply for Medicare certification, an applicant must first obtain a Certificate of Need (CON) from the Maryland Health Care Commission (MHCC). A CON is required to establish a new home health agency or to expand the services of an existing home health agency into a jurisdiction that the agency does not currently serve. To obtain a CON, an application must be filed with the MHCC in accordance with an established schedule. The MHCC will only grant a CON to an applicant if it finds that the project proposed is needed and that it is consistent with the applicable State Health Plan standards and CON review criteria.

The standards which a prospective applicant must meet are set forth in the State Health Plan (COMAR 10.24.08) and may be found at:*

Within this regulation, review rules may be found at COMAR and; the methodology for projecting need may be found at Additional background information and data on home health agencies may be found under Supplement 1 and need projections to 2010 may be found under Supplement 2 at: State Health Plan

The CON review criteria and the rules regarding review of the application may be found in COMAR 10.24.01., which is available on the Certificate of Need page on the MHCC website. The current schedule for accepting CON applications for review can also be found on the CON page of the MHCC website. The schedule will identify, on the basis of each jurisdiction you propose to serve, the deadline for filing a letter of intent and a CON application. The CON procedural rules, the process, the schedule for reviews, and the CON application form may be found at: on the Certificate of Need home page

PLEASE NOTE:  that a valid letter of intent must include the following information:
A. The identity of each person on whose behalf the letter of intent is filed, including: 
1). The name and address of each such person; and
2). In the case of a letter of intent filed on behalf of a person that is not a natural person, the date the entity was formed, the business address of the entity, and the identity and percentage of ownership of all persons having an ownership interest of 5 percent in the entity;

B. A description of the proposed project;

C. The quantity and types of beds or health services involved [in this case, home health agency services]; and  

D. The specific location and each jurisdiction in which sevices will be provided, according to the relevant planning region in the State Health Plan for that facility or service [For home health agency services, the relevant planning region is the county or the independent city of Baltimore]. 


Information regarding licensure * as a Maryland Home Health Agency is provided under the Department of Health and Mental Hygiene’s Office of Health Care Quality

For more information on the federal requirements governing Medicare-Certified home health agencies (42 CFR 484) and on the Conditions of Participation as a Medicare agency, information is provided at



*As defined in licensing statute at §19-404, Annotated Code of Maryland, and in regulation at COMAR 10.07.10


Last Updated: 2/5/2020