A hospital social worker mentions “home health.” A neighbor talks about aides who stay overnight. The two are not the same.
In Maryland, help with bathing, meals, and companionship is licensed differently from the skilled nursing visits Medicare sometimes covers after a hospital stay. Mixing them up can leave a parent without overnight coverage, or with a plan that ends when therapy goals are met.
This guide is for families in Howard, Montgomery, Anne Arundel, and Prince George’s counties. It explains the two state license types, how to look a name up on the official Maryland directory, when to call Maryland Access Point for public programs, and how a non-medical, private-pay consultation works.
The National Institute on Aging describes aging in place as staying in your own home with the right mix of help: personal care, household chores, meals, transportation, safety, and, when needed, health care. Those are different jobs. See Aging in Place: Growing Older at Home.
Non-medical in-home care (often called private-duty or personal care) is help with everyday life:
Caregivers may offer medication reminders. They do not provide skilled nursing, wound care, IV therapy, or physical therapy. Free State Home Care is this kind of support: non-medical, private-pay, and built around the hours your family actually needs. There is no long-term contract. See all in-home care services.
Home health, in the medical sense, is skilled care. The NIA’s services for older adults living at home notes that home health can include nursing, wound care, medical equipment, and physical therapy, often for a limited period after surgery, an accident, or an illness. Medicare coverage, when it applies, is limited, short-term, and tied to Medicare-certified agencies. Most private health insurance does not cover ongoing companion or personal-care hours.
A parent can need both. A nurse from a home health agency might visit a few times a week after a hospital discharge. That visit does not replace someone who can stay through the night, help with a shower, or keep a person with dementia from wandering. If the need is daily living, not a skilled-nursing order, you are looking for non-medical care.
Maryland’s Office of Health Care Quality (OHCQ) licenses both. The names are easy to confuse. The rules are not.
OHCQ defines a Residential Service Agency as a business that employs or contracts with individuals to provide at least one home health care service, for compensation, to an unrelated sick or disabled person. RSA types vary. Some agencies have nurses and certified caregivers who help with activities of daily living such as bathing, grooming, and dressing. Families can contract for as many hours as they need, including overnight care, 24 hours a day, seven days a week. Other RSAs focus on therapy or durable medical equipment. RSA regulations are in COMAR 10.07.05. OHCQ licenses and oversees RSAs.
That “as many hours as needed” language is the practical difference. Private-duty RSA care is typically scheduled and paid privately, or through long-term care insurance if a policy covers it. It is not a Medicare home-health episode.
A home health agency provides skilled nursing and other therapeutic services under the supervision of a physician or registered professional nurse. OHCQ handles initial licensure, recertification surveys, and complaint investigation. Home health agencies are regulated under COMAR 10.07.10. To become eligible for a Maryland HHA license, an organization must first obtain a Certificate of Need from the Maryland Health Care Commission.
OHCQ points families who want Medicare-certified home health to Medicare.gov Care Compare. That tool compares Medicare providers. It is not how you verify private-duty personal care.
Free State Home Care does not provide skilled nursing and does not bill Medicare. If a physician has ordered home health, keep that discharge plan. If the need is help getting through the day and night at home, you are in a different lane.
Anyone can check whether an agency is currently licensed. OHCQ publishes downloadable Excel lists, by provider type, on its Licensee Directories page. As of the August 27, 2026 update on that page, the lists include separate files for Residential Service Agencies and Home Health Agencies.
A practical way to use it:
OHCQ’s directory contact line, listed on that page, is (410) 402-8018, or toll-free (877) 402-8218 / (866) 810-0099, TTY (800) 735-2258.
Private-pay care is one path. Medicaid waivers, veterans benefits, nutrition, transportation, and caregiver supports are another. Maryland Access Point (MAP) is the state’s No Wrong Door Aging and Disability Resource Center — the single entry point for older adults and people with disabilities who need help planning long-term care and living independently. Trained specialists help families identify private- and public-sector supports. See the Maryland Department of Aging MAP page and the MAP consumer site.
Call the MAP Help Line at 1-844-MAP-LINK (1-844-627-5465). MAP will not replace a private-duty schedule, but it will tell you which public doors are actually open.
Write these down. A good agency will answer them in plain language.
License and employment. Are you looking at an RSA or an HHA? Who employs the caregiver — the licensed agency, or is this a registry that refers independent contractors? Ask for the legal name you should search on the OHCQ directory.
What the caregiver can and cannot do. Will they help with bathing and transfers? Medication reminders only, or skilled nursing? If memory loss is involved, what dementia-specific training do they have, and how do they handle wandering, sundowning, and refusal of care?
Hours and backup. Can you start with a few mornings a week and add nights later? What happens if the regular caregiver is sick? Overnight and live-in care are different from a 45-minute skilled visit.
Pay source. Is this private-pay, long-term care insurance, or a Medicare home-health episode with a defined end date? Free State Home Care is private-pay. We do not claim Medicare coverage for personal care, companionship, or live-in hours. The NIA notes that Medicare, Medicaid, and private health insurance generally do not cover companion visits; some long-term care policies do.
Plan and cost. Ask for a written description of services and how hours are billed. In-home care in Maryland is typically billed by the hour and varies with the level of care and the number of hours. We do not publish a price list here; we go over clear pricing at a free in-home consultation.
Complaints. Licensed RSAs must tell clients how to reach OHCQ. The RSA complaint hotline on OHCQ’s Residential Service Agencies page is (800) 492-6005. The same number is listed as the Home Health Hotline on the HHA page. Keep it.
Families in our four counties — Howard, Montgomery, Anne Arundel, and Prince George’s — can see coverage on the areas we serve page. The process is the same whether you need a few hours of company or around-the-clock support.
Call (301) 686-3016, or request a consultation. We respond the same day.
A free in-home visit is how we learn who your loved one is, which rooms are hard to navigate, what the nights look like, and whether memory loss is part of the picture. The plan is tailored to those needs, not a package you have to buy.
Care is delivered by vetted, background-checked caregivers, matched for fit as well as skill, and coordinated by a local Maryland care team through a licensed Maryland home care agency.
Support starts when the plan is agreed. There is no long-term contract. You can adjust hours as needs change.
Non-medical care does not replace a physician’s home-health order. If MAP or a hospital discharge planner has already opened a skilled-nursing case, keep it. If the missing piece is a person in the house for daily living, that is the conversation we are built for.
Choosing in-home care in Maryland is about matching the license, the hours, and the pay source to the actual problem. Look the legal name up on OHCQ’s directory. Call MAP if public programs might apply. Ask who employs the caregiver and what happens at 2 a.m.
If you are in Howard, Montgomery, Anne Arundel, or Prince George’s County and you want non-medical care at home, start from the homepage or call Free State Home Care at (301) 686-3016.
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