Last verified: October 2026
Licensing and levels of care
Who licenses assisted living in Baltimore?
The Office of Health Care Quality, part of the Maryland Department of Health, licenses every assisted living program in Baltimore City and the surrounding counties under COMAR 10.07.14.
There is no separate city or county license. Nursing homes are licensed by the same office and are also certified by CMS, while non-medical home care agencies hold a residential service agency license.
What does Level 3 mean on a Maryland assisted living license?
Level 3 is the highest of Maryland's three assisted living levels: staff must be able to provide extensive, frequent help with daily activities, administer medications and manage frequent behavioral changes.
Most Baltimore-area programs hold a Level 3 license, so the level alone does not distinguish them. Ask how the program staffs nights and how often its delegating nurse visits.
Can an assisted living program keep my mother if her needs increase?
Only within its licensed level, or with an OHCQ resident-specific level of care waiver, which the program must request and OHCQ must decide within seven calendar days.
Waivers cannot exceed half of a program's licensed beds, and a temporary increase of 30 days or less does not need one. Ask any program how it has handled residents who outgrew it.
Do small group homes in Baltimore follow the same rules as big communities?
Yes. A four-bed rowhouse program and a 150-bed community are licensed under the same Maryland regulation, for the same three levels of care, with the same delegating-nurse and manager requirements.
The difference is staffing depth: a small home may have one caregiver on duty, so overnight coverage and backup when the manager is away matter more.
Does a Maryland assisted living manager need a license?
Yes. Assisted living managers must be licensed by the Maryland board that licenses long-term care administrators, and managers of Level 3 programs need either a degree or health care experience with approved training.
Ask how long the manager has been in the role and who covers when the manager is off site.
Memory care
Is memory care a separate license in Maryland?
No. Memory care is an Alzheimer's Special Care Unit within a licensed assisted living program, and the program needs OHCQ's written approval of the unit before it may operate or advertise it.
The approved written description of the unit must be given to any family that asks and to the family before admission.
How much training do Maryland memory care staff need?
Direct-care staff on an approved Alzheimer's Special Care Unit need at least six hours of advanced cognitive-impairment training: two hours on communication, two on behavioral interventions and two on meaningful activities.
The unit description must also show annual dementia training hours by job title. Ask which staff on the night shift have completed it.
How do I find out what a Baltimore memory care unit costs?
Ask for the unit's OHCQ-approved written description, which must state its fee or fee structure; no published median exists for memory care in Maryland or anywhere else.
MHCC-reported daily rates help as a starting point for larger programs, but they usually exclude care-level charges.
Costs
What is the average cost of assisted living in Maryland?
CareScout's 2025 survey puts the Maryland median at $7,173 a month ($86,070 a year) for a private one-bedroom in assisted living, compared with $6,200 a month nationally.
No Baltimore-only median is published. Programs' own daily rates are listed in the MHCC consumer guide and summarized on our cost page.
What does a nursing home cost in Maryland per day?
The 2025 CareScout Maryland median is $425 a day for a semi-private room and $475 a day for a private room -- about $12,927 and $14,448 a month.
Medicare covers a limited skilled stay after a qualifying inpatient admission; Maryland Medicaid covers long-term care for those who qualify.
What does a home health aide cost per hour in Maryland?
The 2025 CareScout Maryland median for a non-medical home care aide is $35 an hour, or about $6,673 a month at 44 hours a week.
Agencies often require minimum visit lengths of three or four hours. Above roughly 47 hours a week, paid home care costs more than the assisted living median.
Are MHCC assisted living rates reliable?
They are useful but limited: each program reports its own daily rates to the Maryland Health Care Commission, the figures are not audited, and they often leave out care-level fees.
Treat them as list prices. The Uniform Disclosure Statement and the program's written fee schedule are the documents to compare.
Medicaid and benefits
Does Maryland Medicaid pay for assisted living?
Maryland Medicaid pays for assisted living services -- not room and board -- through the Community Options Waiver for people who need a nursing facility level of care and meet its income and asset rules.
The waiver has a registry: call Maryland Access Point at 844-627-5465 to be added. Nursing home residents whose stay Medicaid has paid for at least 30 days can apply without waiting.
What is the income limit for the Maryland Community Options Waiver in 2026?
Monthly income may not exceed 300 percent of the SSI benefit, which is $2,982 a month in 2026, and countable assets may not exceed $2,000 or $2,500 depending on eligibility category.
People above the income line who have lived in a nursing facility for at least six months may qualify for the Increased Community Services program, paying income above the line toward their care.
What is the Senior Assisted Living Subsidy in Maryland?
It is a Maryland Department of Aging program, run by local Area Agencies on Aging, that pays part of the monthly fee for eligible residents 62 and older in enrolled assisted living programs -- up to a local maximum between $650 and $1,000 a month.
Income must be under 60 percent of the state median income and below the program's approved fee; resources are capped at indexed limits set in COMAR 32.03.03.
Can a spouse keep money when the other spouse goes on Medicaid in Maryland?
Yes. Under 2026 federal spousal-impoverishment standards the spouse at home can keep between $32,532 and $162,660 in resources and an income allowance starting at $2,705 a month.
The home is generally protected while the spouse lives there. An elder law attorney can work out how Maryland applies the rules to a specific family.
How much does VA Aid and Attendance pay in 2026?
From December 1, 2025, the maximum annual pension with Aid and Attendance is $29,093 for a veteran with no dependents, $34,488 with one dependent, and $18,697 for a surviving spouse with no dependents.
The net worth limit is $163,699. Care costs that are unreimbursed medical expenses reduce countable income, which is how many veterans in assisted living qualify.
Local help
What is Maryland Access Point?
Maryland Access Point (MAP) is the state's front door for long-term services and supports, run through local aging offices, and reachable statewide at 844-627-5465.
In Baltimore City the MAP number is 410-396-CARE (2273); Howard County's is 410-313-1234. MAP provides options counseling and adds people to the Community Options Waiver registry.
Who is the Area Agency on Aging for Baltimore County?
The Baltimore County Department of Aging, at 611 Central Avenue in Towson (410-887-2594), is the county's Area Agency on Aging; its long-term care ombudsman program is at 410-887-4200.
Baltimore City is a separate jurisdiction with its own aging office in the city Health Department.
Who is the Area Agency on Aging for Anne Arundel County?
The Anne Arundel County Department of Aging and Disabilities (410-222-4257) is headquartered at the Heritage Complex on Riva Road in Annapolis, with a north county office on Ritchie Highway in Glen Burnie.
It administers the Senior Assisted Living Subsidy locally and serves as the county's Maryland Access Point.
Complaints and safety
How do I report abuse of an older adult in Maryland?
Call the Maryland Department of Human Services 24-hour hotline at 1-800-91-PREVENT (1-800-917-7383); local departments of social services investigate adult protective services reports. If someone is in immediate danger, call 911.
Problems with a licensed facility's compliance can also be reported to OHCQ, and the long-term care ombudsman can advocate for a resident.
How do I file a complaint against a Maryland assisted living program?
File it with the Office of Health Care Quality, preferably through OHCQ's online complaint form; the assisted living unit can also be reached at (410) 402-8217 or (800) 492-6005.
Billing disputes go to the Attorney General's Consumer Protection Division at 410-528-8662.
What does a long-term care ombudsman do in Maryland?
An ombudsman is a free, confidential advocate for residents of nursing homes and assisted living who works only with the resident's consent; ombudsmen do not license or fine facilities.
The state program is at the Maryland Department of Aging (410-767-1100 or 800-243-3425), with local ombudsmen in each jurisdiction.
Choosing and referral services
Do assisted living referral services have to register in Maryland?
Yes. Under Health-General 19-1813, anyone paid by assisted living programs to make referrals must register with OHCQ, disclose financial relationships, refer only to licensed programs and not refer only to programs that pay them.
Since SB 952 of 2024, referrers must also carry liability insurance, background-check employees, describe their services in writing and protect clients' medical information and personal data.
What should we bring to an assisted living tour in Baltimore?
Bring a list of current medications and diagnoses, the questions about night staffing and the delegating nurse, and a request for the Uniform Disclosure Statement, the resident agreement and -- for memory care -- the unit description.
Compare the license number posted in the building with the OHCQ directory, and plan a second visit at a mealtime or on a weekend.
