In Maryland, the license families see for assisted living is "Assisted Living Program (ALP)", issued by the Maryland Department of Health, Office of Health Care Quality. Within 30 days before admission, the prospective resident's health must be documented on the state's Resident Assessment Tool, based on an exam by a primary physician, nurse practitioner, nurse midwife, registered nurse or physician assistant. The program must give at least 30 calendar days' written notice before an involuntary discharge, except in a health emergency or when other residents face substantial risk.
Key facts
- The median monthly cost of assisted living in Maryland was $7,172 in CareScout's 2025 Cost of Care Survey, or $86,070 a year, $972 above the national median of $6,200 a month. (CareScout, 2026)
- Maryland's Home and Community-Based Options Waiver (Community Options Waiver) can pay for assisted living services in licensed programs, but it has a waitlist and does not pay room and board. (Maryland Department of Health, 2026)
- The Resident Assessment Tool, completed within 30 days before admission, must include medical confirmation that the person is free from communicable tuberculosis and other active reportable airborne communicable diseases. (COMAR 10.07.14.22, 2025)
- Unlicensed staff may give medications only after completing the Board of Nursing medication technician course and certification, with an on-site delegating nurse review at least every 45 days. (COMAR 10.07.14.31, 2025)
- An assisted living program needs the Department's written approval before it operates or advertises an Alzheimer's special care unit, and must give families a written description of the unit before admission. (COMAR 10.07.14.32, 2025)
Maryland calls assisted living an assisted living program (ALP), meaning a residential or facility-based program for two or more residents. The Maryland Department of Health's Office of Health Care Quality licenses ALPs under COMAR 10.07.14, which was rewritten effective April 28, 2025, and each license sets one of three levels of care: Level 1 (low), Level 2 (moderate) or Level 3 (high). An Alzheimer's special care unit needs separate written approval, and the facts below cover the main ALP license.
Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the Maryland Department of Health, Office of Health Care Quality. This page is general information, not legal advice.
The rules at a glance
| Medical assessment before move-in | Within 30 days before admission, the prospective resident's health must be documented on the state's Resident Assessment Tool, based on an exam by a primary physician, nurse practitioner, nurse midwife, registered nurse or physician assistant. The tool is reviewed at least every 6 months and redone at least yearly and within 48 hours after a significant change. [3] More on this |
|---|---|
| TB test | The Resident Assessment Tool, completed within 30 days before admission, must include medical confirmation that the person is free from communicable tuberculosis and other active reportable airborne communicable diseases. The rule does not name a specific TB test. [3] More on this |
| Notice before a move-out | The program must give at least 30 calendar days' written notice before an involuntary discharge, except in a health emergency or when other residents face substantial risk. The rule lists no discharge reasons; the resident agreement must state them, including that a resident whose needs exceed the program's licensed care level, without a waiver, will be discharged. [4][5] More on this |
| Who may give medications | Unlicensed staff may give medications only after completing the Board of Nursing medication technician course and certification, with an on-site delegating nurse review at least every 45 days. Technicians may not give injections except subcutaneous ones after a nurse has calculated the dose, and these rules do not name insulin. [6][7] More on this |
| Memory care and dementia | An assisted living program needs the Department's written approval before it operates or advertises an Alzheimer's special care unit, and must give families a written description of the unit before admission. Staff giving personal care on the unit need at least 6 hours of advanced cognitive impairment training. [8] |
| Long-term care ombudsman | Maryland's Long-Term Care Ombudsman Program, part of the Department of Aging, gives free and confidential help to residents of assisted living and nursing homes through local offices listed by county, and the Department's main line is 410-767-1100. [9] Official page More on this |
| Medicaid help | Maryland's Home and Community-Based Options Waiver (Community Options Waiver) can pay for assisted living services in licensed programs, but it has a waitlist and does not pay room and board. To get on the waitlist, call Maryland Access Point at 844-627-5465. [10][11] Official page More on this |
What assisted living costs in Maryland
The median monthly cost of assisted living in Maryland was $7,172 in CareScout's 2025 Cost of Care Survey, or $86,070 a year, $972 above the national median of $6,200 a month. [14]
A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.
How to check a community in Maryland
The Office of Health Care Quality's Licensee Directory lists every licensed assisted living program in Maryland, and its Notice of Final Action page discloses sanctions against licensed and unlicensed programs. The Maryland Health Care Commission's guide covers programs with 10 or more beds and includes OHCQ survey reports. OHCQ takes complaints through an online form, and its assisted living team can be reached at 1-800-492-6005. Search Maryland's records. [2][13]
The licensing agency: Maryland Department of Health, Office of Health Care Quality. [1] Our guide on how to read an inspection report explains what to look for.
Put Maryland's paperwork on a date
Parent Move Plan counts every task back from the move-in day, including the medical assessment and TB screening the community will ask for, so nothing lands in the last week.
Get your first 3 days freeFrequently asked questions
How much does assisted living cost in Maryland?
The median monthly cost of assisted living in Maryland was $7,172 in CareScout's 2025 Cost of Care Survey, or $86,070 a year, $972 above the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.
What medical assessment does Maryland require before moving into assisted living?
Within 30 days before admission, the prospective resident's health must be documented on the state's Resident Assessment Tool, based on an exam by a primary physician, nurse practitioner, nurse midwife, registered nurse or physician assistant. The tool is reviewed at least every 6 months and redone at least yearly and within 48 hours after a significant change.
Does Maryland require a TB test for assisted living?
The Resident Assessment Tool, completed within 30 days before admission, must include medical confirmation that the person is free from communicable tuberculosis and other active reportable airborne communicable diseases. The rule does not name a specific TB test.
How much notice must an assisted living community in Maryland give before a move-out?
The program must give at least 30 calendar days' written notice before an involuntary discharge, except in a health emergency or when other residents face substantial risk. The rule lists no discharge reasons; the resident agreement must state them, including that a resident whose needs exceed the program's licensed care level, without a waiver, will be discharged.
Who can give medications in assisted living in Maryland?
Unlicensed staff may give medications only after completing the Board of Nursing medication technician course and certification, with an on-site delegating nurse review at least every 45 days. Technicians may not give injections except subcutaneous ones after a nurse has calculated the dose, and these rules do not name insulin.
Who can help with a complaint about assisted living in Maryland?
Maryland's Long-Term Care Ombudsman Program, part of the Department of Aging, gives free and confidential help to residents of assisted living and nursing homes through local offices listed by county, and the Department's main line is 410-767-1100.
Does Medicaid pay for assisted living in Maryland?
Maryland's Home and Community-Based Options Waiver (Community Options Waiver) can pay for assisted living services in licensed programs, but it has a waitlist and does not pay room and board. To get on the waitlist, call Maryland Access Point at 844-627-5465.
Sources
- Maryland Department of Health, Office of Health Care Quality: Assisted Living Programs (2026) (checked October 22, 2026)
- Maryland Department of Health, Office of Health Care Quality: Assisted Living Programs, Consumer Resources (2026) (checked October 22, 2026)
- COMAR 10.07.14.22, Preadmission Requirements (via Maryland Division of State Documents, regs.maryland.gov), effective April 28, 2025 (checked October 22, 2026)
- COMAR 10.07.14.26, Resident Agreement, General Requirements and Nonfinancial Content (via Maryland Division of State Documents, regs.maryland.gov), effective April 28, 2025 (checked October 22, 2026)
- COMAR 10.07.14.34, Relocation and Discharge (via Maryland Division of State Documents, regs.maryland.gov), effective April 28, 2025 (checked October 22, 2026)
- COMAR 10.07.14.31, Medication Management and Administration (via Maryland Division of State Documents, regs.maryland.gov), effective April 28, 2025 (checked October 22, 2026)
- COMAR 10.39.04.09 and .10, Medication Technicians, Nursing Functions and Prohibited Acts (via Maryland Division of State Documents, regs.maryland.gov), 2007 (checked October 22, 2026)
- COMAR 10.07.14.32, Alzheimer's Special Care Unit (via Maryland Division of State Documents, regs.maryland.gov), effective April 28, 2025 (checked October 22, 2026)
- Maryland Department of Aging: Long-Term Care Ombudsman (2026) (checked October 22, 2026)
- Maryland Department of Health, Medicaid Administration: Home and Community Based Options Waiver overview (February 2026) (checked October 22, 2026)
- COMAR 10.09.54.05 and .13, Home and Community-Based Options Waiver, assisted living provider conditions and covered services (via Maryland Division of State Documents, regs.maryland.gov), 2017 (checked October 22, 2026)
- COMAR 10.07.14.02 and .05, Definitions and Levels of Care (via Maryland Division of State Documents, regs.maryland.gov), effective April 28, 2025 (checked October 22, 2026)
- Maryland Department of Health, Office of Health Care Quality: File a Complaint (2026) (checked October 22, 2026)
- CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)