Maryland-National Capital Homecare Association

About Homecare

Generally, home care is appropriate whenever a person prefers to stay at home but needs ongoing care that cannot easily or effectively be provided solely by family and friends.

More and more older people are electing to live independent, non-institutionalized lives, and are receiving home care services as their physical capabilities diminish. Younger adults who are disabled or recuperating from acute illness are choosing home care whenever possible.  Chronically ill infants and children are receiving sophisticated medical treatment in their loving and secure home environments. Adults and children diagnosed with terminal illness also are being cared for at home, receiving compassionate care and maintaining dignity at the end of life. As hospital stays decrease, increasing numbers of patients need highly skilled services when they return home. Other patients are able to avoid institutionalization altogether, receiving safe and effective care in the comfort of their own homes.


Listed below is a brief description of the different kinds of homecare agencies.  Some providers may offer two or more kinds of program.  


Medicare Certified Home Health Agencies: Medicare Certified Home Health Agencies in Maryland and DC must meet federal and state standards.  A doctor’s orders are required for care.  Medicare-certified agencies deliver "skilled" nursing care and therapeutic services such as occupational therapy, physical therapy, and speech therapy.  Medicare-certified agencies deliver "brief and intermittent care" meaning that they work off of a doctor's order that only runs for an episode of 60 days.  Episodes can be renewed by doctors when necessary. 

Private Duty Agencies/ Residential Service Agencies: All private duty agencies in Maryland and DC are regulated by the state.  (In Maryland private duty agencies are called Residential Service Agencies.) This process is in place to ensure that agencies are adhering to strict health and safety requirements. These agencies typically hire a variety of staff and provide a wide range of services.  Many agencies have both nurses and companion care workers that provide assistance with everything from skilled nursing care through assistance with the instrumental activates of daily living such as cooking, cleaning, driving customers to appointments, and paying bills. Private duty agencies can be contracted to provide as many hours as needed – including overnight care or 24 hour- 7 day a week care. 


Registry: All registries in Maryland and DC are regulated by the state to ensure that the agency is adhering to strict health and safety requirements. Registries can deliver skilled services such as nursing care or companion style services to assist the customer with their activities of daily living.  Staffing is the primary difference between a private duty agency and registry. While private duty agencies employ the workers that are sent to customers’ homes, registries do not. Once you call a registry looking for services, they will refer an independent contractor. This means that the caregiver in the customer’s home does not work for an agency.


Home Medical Equipment: All Home Medical Equipment Providers in Maryland and DC are regulated by the state.  Any Home Medical Equipment business that received Medicare or Medicaid reimbursement must also meet federal standards. Home medical equipment providers deliver healthcare products and supplies directly to the homes of consumers.  The products can vary from complex rehabilitation equipment through oxygen and diabetic supplies.  HME providers typically hire a variety of staff to ensure that customers not only receive their products and supplies but that trained professionals ensure that more complex equipment is customized to meet the needs of the customer.  


FAQs - Frequently Asked Questions

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)

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