Last verified: October 2026
Should a Baltimore parent move to assisted living or a nursing home?
Assisted living fits people who need help with daily activities and medications but not round-the-clock nursing; a nursing home fits people who need skilled nursing daily, have unstable medical conditions, or need more than intermittent nursing that Maryland assisted living may not provide at admission.
Maryland's admission limits for assisted living spell it out: COMAR 10.07.14.23: at initial admission a program may not serve someone who would need more than intermittent nursing care, treatment of stage 3 or 4 skin ulcers, ventilator services, skilled monitoring of a fluctuating acute condition, or monitoring of a chronic condition not controllable with readily available medications -- unless a licensed hospice is involved.
| Assisted living program | Nursing home |
|---|---|
| OHCQ license, COMAR 10.07.14 | Licensed long-term care facility, CMS-certified |
| Delegating RN on site every 45 days, on call | Licensed nurses on duty around the clock |
| $7,173/month CareScout MD median | $12,927/month semi-private median |
| Medicaid via Community Options Waiver (registry) | Medicaid long-term care entitlement |
| No federal star rating | CMS overall, inspection, staffing and quality ratings |
Does Medicare pay for either one?
Medicare pays for neither as a long-term home; it covers a limited skilled nursing facility stay after a qualifying inpatient hospital admission, and it covers hospice and intermittent home health wherever the person lives.
That is why so many Baltimore placements start as a rehab stay in a nursing home and then become a decision about where to live next.
What signs mean assisted living is no longer enough?
Signs include needing two-person help to transfer, new wounds that need skilled treatment, frequent hospital returns, and needs beyond the program's licensed level that OHCQ will not cover with a resident-specific waiver.
A program can request a waiver to keep a resident whose needs exceed its level, but OHCQ caps waivers at half the program's beds and can deny them.
How do you compare nursing homes near Baltimore?
Use the nursing home directory, which shows CMS's official overall and health-inspection ratings, the latest survey date and deficiency count, and fines, then open each facility page for the specific citations.
For a rehab stay, weight the short-stay quality rating; for a permanent move, the long-stay rating and staffing hours.
How many nursing homes and assisted living beds are in the Baltimore metro?
OHCQ's directories list 107 licensed nursing homes and 934 assisted living programs with 13,633 licensed beds across Baltimore City and the six counties we cover.
Nursing homes are fewer and larger, and most sit near hospitals in Towson, Catonsville, Baltimore City and Annapolis. Assisted living is spread across hundreds of small homes and a smaller number of large communities, which is why the search usually starts with a ZIP code or county page rather than a single list. Both directories show the licensed capacity, so you can see at a glance whether a facility is a 40-bed building or a 200-bed campus.
