Title 19. Health Care Facilities — Subtitle 4B. Nursing Referral Service Agencies
Statutes in effect as of October 1, 2026.
Md. Code Ann., Health-Gen. § 19-4B-01 (2026)
Title 19. Health Care Facilities
Subtitle 4B. Nursing Referral Service Agencies
§ 19–4B-01LinkCopy Citation
(a)
In this subtitle the following words have the meanings indicated.
(b)
“Background check” has the meaning stated in § 19-1901 of this title.
(c)
“Care provider” means an individual who provides health care services and assistance to a client in the activities of daily living, including:
(1)
Bathing, toileting, and personal hygiene;
(2)
Dressing;
(3)
Meal preparation and eating;
(4)
Companionship; and
(5)
Assistance in physical transfer and ambulation.
(d)
“Central Repository” means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services.
(e)
“Home health aid services” means personal and health care services delivered to a client by a care provider.
(f)
“License” means a nursing referral service agency license.
(g)
“Licensed health professional” means an individual who is licensed or certified under the Health Occupations Article to provide health care services.
(h)
“Nursing referral service agency” means one or more individuals engaged in the business of screening and referring, directly or in accordance with contractual arrangements that may include independent contractors, licensed health professionals or care providers to clients for the provision of nursing services, home health aid services, or other home health care services at the request of the client.
(i)
“Private agency” has the meaning stated in § 19-1901 of this title.
Md. Code Ann., Health-Gen. § 19-4B-02 (2026)
Title 19. Health Care Facilities
Subtitle 4B. Nursing Referral Service Agencies
§ 19–4B-02LinkCopy Citation
This subtitle does not limit the right of any person who holds a license under this article to act as authorized by that license.
Md. Code Ann., Health-Gen. § 19-4B-03 (2026)
Title 19. Health Care Facilities
Subtitle 4B. Nursing Referral Service Agencies
§ 19–4B-03LinkCopy Citation
(a)
(1)
A nursing referral service agency may receive a fee or other compensation for providing its services.
(2)
A contractual arrangement may provide that a nursing referral service agency is not responsible for paying any part of the compensation to the licensed health care professionals or care providers that the nursing referral service agency screens or refers to clients.
(3)
A nursing referral service agency may provide administrative assistance.
(b)
A nursing referral service agency shall:
(1)
Obtain a license from the Department prior to operating as a nursing referral service agency;
(2)
Develop and implement a procedure to screen licensed health professionals and care providers that includes the following:
(i)
In accordance with subsection (c) of this section:
(1)
A State criminal history records check; or
(2)
A private agency background check;
(ii)
Verification of current licensure or certification under the Health Occupations Article;
(iii)
A basic health screening, including a tuberculosis screening;
(iv)
Verification of references;
(v)
Verification of employment history;
(vi)
Completion of I-9 forms; and
(vii)
An in-person interview of a licensed health professional and care provider before any referral of the individual is made to a client;
(3)
Institute an internal client complaint investigation process that includes:
(i)
Notice to the client or client’s representative of the complaint process; and
(ii)
Protocols to investigate complaints;
(4)
Provide notice to clients of the Department’s complaint hotline number for complaints about the services provided by an individual referred by the nursing referral service agency; and
(5)
Allow clients to accept or reject, at their discretion, any licensed health professional or care provider referred by the nursing referral service agency.
(c)
(1)
For each licensed health professional and care provider, a nursing referral service agency shall:
(i)
Apply to the Central Repository for a State criminal history records check; or
(ii)
Request a private agency to conduct a background check.
(2)
(i)
As part of the application for a criminal history records check, the nursing referral service agency shall submit to the Central Repository:
(1)
Two complete sets of legible fingerprints of the licensed health professional or care provider taken on forms approved by the Director of the Central Repository; and
(2)
The fee authorized under § 10-221(b)(7) of the Criminal Procedure Article for access to Maryland criminal history records.
(ii)
In accordance with §§ 10-201 through 10-228 of the Criminal Procedure Article, the Central Repository shall forward to the licensed health professional or care provider and the nursing referral service agency a printed statement listing the criminal convictions of the licensed health professional or care provider.
(iii)
Information obtained from the Central Repository under this subsection:
(1)
Is confidential and may not be redisseminated; and
(2)
May be used only for the screening purpose authorized by this subsection.
(iv)
The subject of a criminal history records check under this subsection may contest the contents of the printed statement issued by the Central Repository as provided in § 10-223 of the Criminal Procedure Article.
(3)
If a nursing referral service agency requests a private agency to conduct a background check:
(i)
The private agency shall:
(1)
Conduct a background check in each state in which the nursing referral service agency knows or has reason to know the licensed health professional or care provider worked or resided during the past 7 years; and
(2)
Issue a statement of its findings to:
(A)
On request, the licensed health professional or care provider; and
(B)
The nursing referral service agency; and
(ii)
The licensed health professional or care provider shall have an opportunity to contest the findings.
Md. Code Ann., Health-Gen. § 19-4B-04 (2026)
Title 19. Health Care Facilities
Subtitle 4B. Nursing Referral Service Agencies
§ 19–4B-04LinkCopy Citation
(a)
(1)
The Department shall adopt regulations to implement the requirements of this subtitle.
(2)
The regulations may not preclude a nursing referral service agency from operating with independent contractors.
(b)
The Department shall issue a license to a nursing referral service agency after the nursing referral service agency completes an application for licensure.
(c)
The Department may suspend or revoke a license issued under this section if the nursing referral service agency is operating in violation of the requirements of this subtitle.
Md. Code Ann., Health-Gen. § 19-4B-05 (2026)
Title 19. Health Care Facilities
Subtitle 4B. Nursing Referral Service Agencies
§ 19–4B-05LinkCopy Citation
(a)
An individual may not operate or engage in, or attempt to operate or engage in, or hold one’s self out as operating or engaging in the business of a nursing referral service agency unless the individual is licensed under this subtitle.
(b)
(1)
An individual who violates this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 for the first offense and not exceeding $10,000 for any subsequent offense.
(2)
Each day a violation is continued after the first conviction is a separate offense.
Md. Code Ann., Health-Gen. § 19-4B-06 (2026)
Title 19. Health Care Facilities
Subtitle 4B. Nursing Referral Service Agencies
§ 19–4B-06LinkCopy Citation
For the purposes of any other provision of law, the granting of a license under this subtitle does not constitute a finding of any fact on which the granting of the license was based and may not give rise to any presumption regarding the existence of any fact on which the granting of the license was based.