About Assisted Living in Maryland

While Maryland may be one of the smallest states in use it is geographically diverse - the weather is mild and there is an abundance of cultural opportunities. It is, however, expensive, with a cost of living significantly higher than the national average. Sales and property taxes are also higher than average, but then the median income is one of the highest in the nation. You can find more affordable options in pockets across the state.

What Options are Available for Assisted Living?

In the state of Maryland assisted living programs provide residential or facility-based housing for individuals who are unable to perform or require assistance with activities of daily living (ADLs) or instrumental activities of daily living (IADLs) to promote optimum dignity and independence.

Facilities are required to follow National Fire Protection Association Life Safety Codes, utilizing smoke detectors and fire extinguishers, and must have a plan in place for safe evacuation, transportation, and shelter. Drills must be conducted and written up annually.

Assisted living programs providing service to 50 or more residents are required to have an emergency back-up generator capable of running up to 48 hours.

What are the Alzheimer’s Requirements for Assisted Living Programs in Maryland?

An assisted living program that wishes to provide Alzheimer’s care must send a written description of the special care unit program at the time of initial licensure and upon renewal to the Department. Specific information must also be disclosed to the resident and family prior to admission, including the mission statement, staff training, and job titles, any services or other procedures that are above the scope of care of the existing assisted living program, and any other information that the department may require.

Senior Assisted Living Details and Costs for Cities in Maryland

Listed below are some of the larger cities in Maryland. Each city details page provides details on senior assisted living options, independent living, senior apartments and homes, as well as Alzheimer's care facilities. City pages may include details on costs, amenities and services offered, medical care, as well as other useful information.

What Training is Required for Assisted Living Program Staff?

Staff providing personal care to residents must complete a 5 hour state-approved training course on cognitive impairment and mental illness within the first 90 days of employment and must demonstrate competence to the delegating nurse before performing personal care services without supervision.

Additional training is required for staff working in special care units to meet the specific needs of Alzheimer’s and dementia residents, and 2 hours of ongoing training must be completed each year.

Is an Assessment Required Before Move-In?

Using the Resident Assessment Tool a full assessment must be completed within 48 hours of admission to create an individual service plan based on the applicant’s health, function, and psychosocial status. An assessment is also required if there is a significant change in the resident's condition and upon each non-routine hospitalization.

What Care is Available in an Assisted Living Program?

  • Assistance with functioning.
  • Assistance with medication and treatment.
  • Management of behavioral issues.
  • Management of psychological or psychiatric conditions.
  • Social and recreational activities.

If a resident requires a higher level of care than the facility is licensed, the facility must request authority from the department to change its authority and approve additional care.

Home health agencies may be contracted by the resident to provide additional healthcare services not provided by the assisted living facility.

How is Medication Managed?

All staff must complete the medication administration course to administer medication.

What are the Bathroom Requirements for an Assisted Living Program?

For residents’ privacy latching hardware is required for all resident toilets. The facilities must have a minimum of 1 toilet for every 4 residents and 1 bathtub or shower for every 8.

What are the Move-In or Move-Out Requirements?

Assisted living programs can only admit residents whose needs can be met by the facility, and they may not admit or retain residents who:

  • Require more than intermittent nursing care.
  • Require treatment for stage III and IV skin ulcers.
  • Need ventilator services or skilled monitoring, testing, and aggressive medications or treatments.
  • Require treatment for an active, reportable communicable disease,
  • Require treatment for a disease or condition that requires more than contact isolation.
  • Are dangerous to themselves or others.
  • Are high risk for health and safety complications that can’t be adequately managed.

A buddy exception may be granted if two individuals who are in a long-term relationship are admitted together and one requires one of the above services a waiver may be granted, allowing the resident to remain in the facility’s care.

Is an Assisted Living Program Covered by Medicaid in the State of Maryland?

Yes. Assisted living services are covered by a Medicaid home and community-based services waiver and a state-funded program.

Who can I contact for more information?

Department of Health and Mental Hygiene, Office of Health Care Quality
Cheryl Reddick
(410) 402-8201