Assisted Living in Maryland

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Families looking for assisted living in Maryland (MD) have a wide array of communities to choose from, since estimated that there are more than 30,000 assisted living communities serving seniors across the U.S., and over 597 statewide. The state is also home to a rapidly growing number of senior citizens, with adults over 65 making up an estimated 15 percent of the population. A resident in an assisted living community in Maryland will pay $4,673 per month on average.

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597 Communities

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Average Monthly Cost

States near Maryland

$6,065.00 New Jersey
$5,350.00 Delaware
$4,673.00 Maryland
$4,451.00 Virginia
$4,000.00 US
$3,750.00 Pennsylvania
ALP facilities and homes in Maryland have a median monthly cost of $4,673 according to Genworth's 2018 Cost of Care Survey, which is slightly higher than the national average of $4,000. Assisted living expenses in Maryland compare favorably to other mid-Atlantic states; however, programs in neighboring Pennsylvania are more affordable on average.

Compare Monthly Care Costs

When it comes to care options, assisted living is just one of several choices available to seniors. Some care options, like part-time in-home care or independent living, may cost less, while others like memory care or skilled nursing are likely to cost significantly more. Seniors can speak with their medical practitioners to receive guidance on what level of care will best suit their needs and abilities.
$9,231.00

Nursing Home Care

$4,673.00

Assisted Living

$4,097.00

In-Home Care

Average Monthly Cost

Cities in Maryland

$5,315.00 Salisbury
$4,250.00 Baltimore
$3,650.00 Cumberland
As with any state, the pricing can vary greatly by geographic location within Maryland. Those looking for assisted living options in Baltimore pay, on average, $4,250 per month. Smaller towns aren’t necessarily less expensive; Salisbury ALPs cost about 25 percent more than Baltimore, while Cumberland community costs $600 less compared to the big city.

What You Should Know About Assisted Living in Maryland

Maryland’s Department of Health and Mental Hygiene oversees the licensing of the state’s assisted living programs (ALPs) and adult foster care (AFC) homes.

Assisted living programs are residential or community-based homes that help residents who cannot perform or need assistance with the activities of daily living (ADLs) like bathing and mobility and instrumental activities of daily living (iADLs) such as laundry and meal preparation.

ALPs provide services that include:

  • Supervision
  • Supportive services
  • Personal assistance
  • Health-related services

ALPs are licensed based on the level of care they provide:

  • Level 1: Low level of care
  • Level 2: Moderate level of care
  • Level 3: High level of care

See the services section below for more information regarding licensing levels.

There are also two types of adult foster care in Maryland:

  • Social services manage communities for aged adults (65 years or older) or adults with disabilities requiring protective oversight, ADL assistance and room and board.
  • Certified Adult Residential Environment (CARE or Project Home) programs oversee and license individuals who provide assistance, supervision and room and board to adults with disabilities who can function in a community but aren’t able to live on their own. Visit Maryland’s CARE program page for more information.

Financial Assistance for Assisted Living in Maryland

Maryland offers assistance for low- and moderate-income seniors through its Medicaid Home and Community-Based Services (HCBS) and state-funded Senior Assisted Living Group Home Subsidy programs.

Medicaid HCBS Program

The HCBS waiver program in Maryland provides a number of home and community-based services. Using the Medicaid 1915(c) HCBS Waiver, Maryland covers Level 2 and Level 3 ALP services for Medicaid beneficiaries.

Who Is Eligible?

To enroll in Medicaid and receive HCBS waiver benefits, applicants must:

  • Be 65 years of age or older
  • Be a resident of Maryland
  • Have no more than $2,024 in monthly income
  • Own no more than $2,500 in personal assets
  • Be a U.S. citizen or meet immigration status requirements
  • Have a valid social security number
  • Meet medical eligibility requirements

How to Apply

Maryland residents wishing to apply for Medicaid so they can be eligible for the HCBS waiver can visit myDHR or mail a completed application to, or visit, their local social services office.


More Ways to Finance Assisted Living

While many families use their own funds or personal assets to pay for assisted living, there are plenty of additional options to cover these costs. Visit our 9 Ways to Pay for Assisted Living page for more information.


Free Assisted Living Resources in Maryland

Maryland residents have several options to turn to when looking for information and programs for long-term senior care. Most agencies and nonprofit organizations offer services online, in person or through the mail.

Maryland Area Agencies on Aging

States can designate a public agency or private nonprofit organization as an Area Agency on Aging (AAA); they’re typically spread throughout a state with each agency representing a geographic location. AAAs are intended to address the concerns and needs of local seniors, with a focus on maintaining their independent living.

Maryland is home to 19 Area Agencies on Aging, each with individual offices and websites.

Allegany County Human Resources Development Commission

125 Virginia Avenue, Cumberland, MD 21502
301-777-5970

Anne Arundel County Department of Aging and Disabilities

2666 Riva Road, Annapolis, MD 21401
410-222-4464

Baltimore City Division of Aging and Care Services

417 E. Fayette St., 6th Floor, Baltimore, MD 21202
410-396-4932

Baltimore County Department of Aging

611 Central Avenue, Towson, MD 21204
410-887-2594

Calvert County Office on Aging

450 West Dares Beach Road, Prince Frederick, MD 20678
410-535-4606

Caroline, Kent, Talbot Upper Shore Aging, Inc.

100 Schauber Road, Chestertown, MD 21620
410-778-6000

Carroll County Bureau of Aging and Disabilities

125 Stoner Avenue, Westminster, MD 21157
410-386-3800

Cecil County Department of Community Services

200 Chesapeake Boulevard, Suite 2550, Elkton, MD 21921
410-996-5295

Charles County Aging and Human Services

8190 Port Tobacco Road, Port Tobacco, MD 20677
301-934-9305

Dorchester, Somerset,Wicomico, Worcester MAC, Inc.

909 Progress Circle, Salisbury, MD 21804
410-742-0505

Frederick County Department of Aging

1440 Taney Avenue, Frederick, MD 21702
301-600-1605

Garrett County Area Agency on Aging

104 East Center Street, Oakland, MD 21550
301-334-9431

Harford County Office on Aging

145 North Hickory Avenue, Bel Air, MD 21014
410-638-3025

Howard County Office on Aging and Independence

6751 Columbia Gateway Drive,2nd Floor, Columbia, MD 21046
410-313-6410

Montgomery County Department of Health and Human Services

401 Hungerford Drive, 3rd Floor, Rockville, MD 20850
240-777-3000

Prince George's Department of Family Services

6420 Allentown Road, Camp Springs, MD 20748
301-265-8450

Queen Anne's County Area Agency on Aging

104 Powell Street, Centerville, MD 21617
410-758-0848

St. Mary's County Department of Aging Human Services

41780 Baldridge Street, Leonardtown, MD 20650
301-475-4200

Washington County Commission on Aging

535 E. Franklin Street, Hagerstown, MD 21740
301-790-0275


Assisted Living Laws and Regulations in Maryland

Maryland provides laws and regulations to ensure that the needs of residents in long-term care facilities and homes are met effectively. Some key information is highlighted below.

Assisted Living Service Plan Requirements

A service plan is a document that outlines the specific details of care a resident receives, including the costs of those services. ALP facility staff members create a service plan after performing an assessment to evaluate a resident’s ability to perform ADL and iADL activities.

Assessments also include evaluations of a resident’s social and recreational needs, habits and cognitive abilities. They account for risk factors, problematic behaviors and the ability to self-administer medications.

Maryland requires ALP communities and homes to perform a review of the assessment at a minimum of once every six months, but certain events can trigger the need for a full reassessment, such as:

  • A significant change in a resident’s condition
  • Nonroutine hospitalization

A licensed health care practitioner must evaluate residents, and ALP staff must adjust a service plan if an assessment results in a score change in any of these areas:

  • Cognitive and behavioral needs
  • Ability to self-administer medications

Assisted Living Admission Requirements

Without a waiver, assisted living communities and residential homes may not admit or retain applicants requiring:

  • Treatment of Stage III or IV skin ulcers
  • Ventilator services
  • More than intermittent nursing care
  • Skilled monitoring, testing or adjustment of medications or treatment
  • Monitoring of chronic conditions that can’t be controlled through common medications or treatment
  • Treatment for a reportable communicable disease
  • More than contact isolation for a disease or condition
  • Monitoring for behaviors that present a danger to themselves or others

Assisted Living Scope of Care

There are three progressive levels of licensure for Maryland ALPs that detail the services a home or community provides.

Level 1 ALPs

Level 1 ALPs are not eligible for the Medicaid waiver program. Assisted living communities with a Level 1 license must provide:

  • Medication self-administration assistance
  • Assistance with accessibility and coordination of health services
  • Social and recreation service assistance
  • Supervision or occasional assistance with at least two ADLs
  • Simple interventions to address infrequent disruptive or harmful behavior
  • Simple interventions and monitoring to address infrequent psychological issues

Level 2 ALPs

Any facility or home with a Level 2 license must provide the services detailed in Level 1 as well as:

  • Significant support with at least two ADLs
  • Medication administration
  • Monitoring and intervention for disruptive or harmful behaviors
  • Monitoring and prompt intervention for frequent psychological episodes
  • Ongoing social and recreational service assistance

Level 3 ALPs

Level 2 and Level 3 ALPs are eligible providers under the Medicaid waiver program. Level 3 ALPs must provide the services detailed for Level 1 and Level 2 ALPs as well as:

  • Coordination of comprehensive health services
  • Full and frequent assistance with ADLs
  • Provision and monitoring of ongoing therapeutic intervention or intensive supervision for chronic disruptive or harmful behaviors
  • Monitoring and management of different psychological or MD-4 psychiatric episodes

Assisted Living Medicaid Policy

Maryland residents may be eligible for financial assistance and subsidies available through Maryland’s Medicaid program by using the HCBS waiver program. Not all facilities accept Medicaid as payment for services, so it's important to confirm with any prospective property regarding their Medicaid policy and the terms of your benefits.

Maryland residents receiving supplemental security income (SSI) automatically qualify for Medicaid; however, they must still meet the eligibility requirements noted above to receive ALP assistance.

Assisted Living Facility Requirements

Maryland sets standards for all ALPs concerning toilets, showers and room occupancy.

  • All programs must have at least one toilet for every four residents.
  • Multilevel buildings with at least nine residents must maintain that ratio on each level that residents occupy.
  • Resident units may contain a maximum of two people.
  • ALPs with eight or fewer residents must provide at least one bathtub or shower for every four.
  • Communities with more than eight residents must maintain a ratio of one shower or bathtub for every eight.

Medication Management Regulations

All licensed ALPs in Maryland must provide self-administered medication assistance, which includes reminders, help with packaging and removal of medication from a package. A licensed health professional must review a resident’s ability to self-administer medication quarterly.

To administer medications, ALP staff members must complete a Board of Nursing program.

For residents taking nine or more medications, ALPs must arrange for an on-site review by a licensed pharmacist of prescriptions, orders and resident records every six months. Medications include as-needed and OTC drugs.

In addition, all new residents’ medication must be reviewed by a licensed health professional within 14 days of admission.

Staffing Requirements

Maryland does not require minimum staffing ratios; however, communities are required to employ or contract specific staff types and provide sufficient coverage to meet the planned and unplanned needs of all residents.

  • Management: ALPs must employ a manager for daily operations. For times when the manager is not available, ALPs must also have an identified alternate manager.
  • Nursing: All residential homes and communities must have a contracted or employed registered nurse to provide nursing services.
  • Overnight staff: Awake, overnight staff is required unless a qualified nurse or doctor determines that residents don't need it. In these cases, the ALP must obtain a waiver to use an electronic monitoring system instead.
  • Medication technicians: ALPs that offer medication administration must have staff who have completed the required Board of Nursing program.

Direct care: ALPs must employ staff members to provide personal care to residents.

Staff Training Requirements

Maryland helps ensure staffing competence by requiring specific knowledge and ongoing training for management and staff. ALP managers at locations with five or more residents must complete 20 hours of approved continuing education every two years.

All staff, in addition to their job training, must receive onboarding and continuing training in:

  • Infection control
  • Basic food safety
  • Basic first aid
  • Fire and life safety
  • Emergency disaster plans
  • Resident assessment process
  • Service plan usage
  • Resident rights

Any staff member providing personal care must complete a state-approved course on cognitive impairment and mental illness within 90 days of employment. Further, a delegating nurse must first determine competence before a direct care staff member provides personal-care services.

Background Checks for ALP Staff in Maryland

To receive a license to operate an assisted living program in Maryland, an ALP applicant must provide the state with current criminal background checks or criminal records for:

  • Owner
  • Applicant
  • Manager
  • Alternate manager
  • Other staff
  • Other household members (for owner-occupied homes)

After licensure, the ALP manager must continue to conduct background checks for all prospective employees.

Requirements for Reporting Abuse

Health practitioners and human service workers are mandated reporters of suspected abuse, neglect or exploitation of a vulnerable adult.

Maryland Adult Protective Services has a hotline for telephone reports at 800-91-PREVENT or 800-917-7383 and a website for online reporting.


Assisted Living Facilities in Maryland

Cities

Counties

Top-Rated Caring Stars Winners in Maryland

Caring.com’s Caring Stars award program recognizes the best assisted living facilities across the U.S. based on reviews from family caregivers and older adults. This award is meant to help older adults and their loved ones find the best assisted living or in-home care option in their area. The list below shows up to 10 listings that have won the most Caring Stars annual awards in their state, sorted by their current overall average rating. For a complete list of Caring Stars winners for each year, please visit our Caring Stars info center.

730x450%23

Arbor Terrace of Lanham

Lanham, MD Cost Levels

23 reviews

730x450%23

Sunrise of Frederick

Frederick, MD $$$

19 reviews

730x450%23

The Atrium Village

Owings Mills, MD $$

36 reviews

730x450%23

Roland Park Place

Baltimore, MD Cost Levels

14 reviews

730x450%23

Sunrise of Annapolis

Annapolis, MD $$$$

13 reviews

730x450%23

Heartlands at Ellicott City

Ellicott City, MD Cost Levels

17 reviews

730x450%23

Sunrise of Severna Park

Severna Park, MD $$$$

14 reviews

Kensington Park Senior Living

Kensington, MD Cost Levels

11 reviews

730x450%23

Country Meadows of Frederick

Frederick, MD Cost Levels

20 reviews

730x450%23

Charlestown

Catonsville, MD Cost Levels

12 reviews