Maryland
Maryland licenses any residential or facility-based program that provides housing plus supportive services, supervision, personalized assistance or health-related services as an 'assisted living program'; the definition sets no minimum resident count, so small group homes are covered. Programs are licensed at Level 1 (low), Level 2 (moderate) or Level 3 (high) care. COMAR 10.07.14 was extensively rewritten effective April 28, 2025, and assisted living managers must hold a state license from July 1, 2026.
License categories
Assisted living program (Level 1 low / Level 2 moderate / Level 3 high care)
Key laws
Md. Code, Health-General § 19-1801 et seq.
Assisted Living Programs (statute) — official text
COMAR 10.07.14
Assisted Living Programs (comprehensively revised eff. April 28, 2025) — official text
Key requirements
- OHCQ license required before operating; typed application (handwritten applications are returned)
- License specifies level of care: Level 1 low, Level 2 moderate, Level 3 high (COMAR 10.07.14.05)
- Effective July 1, 2026, assisted living managers must be licensed by the State Board of Long-Term Care Administrators
- Manager must be 21+, keep first aid and hands-on CPR current (recertify every 2 years) and complete initial/annual fire safety, infection control, emergency and food safety training (COMAR 10.07.14.15)
- Delegating nurse requirements are set in COMAR 10.07.14.21; manager training courses are in .16–.17
Sources
- https://health.maryland.gov/ohcq/Pages/Assisted-Living-Programs.aspx
- https://health.maryland.gov/ohcq/Pages/Assisted-Living-Providers.aspx
- https://regs.maryland.gov/us/md/exec/comar/10.07.14
- https://regs.maryland.gov/us/md/exec/comar/10.07.14.05
- https://regs.maryland.gov/us/md/exec/comar/10.07.14.15
- https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg§ion=19-1801&enactments=false
- https://health.maryland.gov/bonha/Pages/Assisted-Living-Managers.aspx
- https://health.maryland.gov/ohcq/Pages/File-a-Complaint.aspx