Assisted Living in Maryland

The average monthly cost of assisted living in Maryland is about $6,100, according to A Place for Mom’s proprietary data. This is around $1,000 more than the national median cost, making Maryland among the costliest states for assisted living in the U.S.^[02] These numbers refer to the average final monthly costs paid by families living in our partner communities.

In Maryland, costs at A Place for Mom’s partner communities typically range from roughly $4,000 to just under $8,800 a month. Communities in large metropolitan areas like Baltimore or the suburbs of Washington, D.C., generally cost more than facilities in smaller or more rural locations. Costs also vary by amenities provided, the level of care a resident needs, and the community’s pricing structure.

Maryland divides its assisted living facilities into three levels of care: one, two, and three. Three provides the highest-level, most comprehensive care. Communities at any level must be additionally licensed to provide cognitive care to seniors with Alzheimer’s disease or another type of dementia.

Costs can correlate to the level of care provided. Residents in a level one community may need less monitoring or assistance with activities of daily living than seniors in a level three facility, so those communities might cost less.

The monthly average cost of $6,100 generally cover a senior’s complete care needs, including:

• Assistance with activities of daily living, such as dressing, bathing, and personal grooming
• 24-hour supervision and monitoring
• Three meals a day, plus snacks
• Laundry and housekeeping services
• Assistance with personal medication management or medication administration
• Planned social events and scheduled activities

Factors that affect the cost of assisted living in Maryland may include:

• Location. Urban centers, like Baltimore, may have assisted living facilities with higher monthly costs.
• Cognitive support services. Seniors with Alzheimer’s disease or another type of dementia generally pay more. That’s because unique cognitive therapies, safety features, and added care may increase monthly costs.
• Services and amenities. Additional amenities, like at-cost transportation, beauty salon services, and pet-friendly rooms, may add to an assisted living bill.
• Occupancy. Residents in single-occupancy apartments often pay less than those living in shared rooms.
• Level of care. The amount of assistance a senior needs can affect costs.

Medicare and Medicaid may offset some of the costs of medical care expenses in assisted living communities for qualifying seniors.

A senior’s personal financial resources, preferences, and care needs can affect the way they choose to pay for assisted living. The sooner you’re able to evaluate your family’s budget, the more options your loved one may have available.

Time is of the essence, especially if your loved one hasn’t yet signed up for Medicare or if they plan to apply for public assistance programs. Medicaid home and community based services (HCBS) waivers — which are available for lower-income seniors in Maryland — may require a waiting period. If you plan to use Medicare or Medicaid to cover any medical services in assisted living, an application and approval period may apply.

Maryland also offers a unique Senior Assisted Living Subsidy Program for low and moderate-income older adults. The program uses state funds to subsidize financially eligible seniors’ care needs in assisted living facilities licensed by the Maryland Department of Health. The financial access limit is 60% of the state’s current median income, and the subsidy covers the difference between monthly income and senior living costs, up to just over $1,000 a month.^[03]

Families generally use a mix of public payment methods and personal to cover the costs of assisted living. We’ll explore some of these options below. For a high-level overview of payment options, read through our complete guide to paying for long-term care.

The Maryland Department of Health Office of Health Care Quality licenses assisted living facilities based on the level of care they provide. The state doesn’t set a minimum number of residents for licensure, so any facility with two or more unrelated residents can be licensed as an assisted living community.

Facilities provide at least one level of care:

• Level one: Low level care
• Level two: Moderate level care
• Level three: Highest level of care

Communities are licensed to provide residents with a certain level of care. The level at which a community is licensed is determined by the needs of residents. Health, medication management, behavioral management, and assistance with ADLs are all taken into account. Communities with residents experiencing dementia or psychiatric conditions must be separately certified.^[01]

Here are some additional factors Maryland takes into consideration when licensing assisted living facilities:

• Assistance with activities of daily living. Staff must assist each resident with at least two activities of daily living, even in level one communities.
• Medication management requirement. Managers and staff who administer medications have to complete a medication administration course taught by a registered nurse who is approved by the Board of Nursing. Pharmacists must conduct on-site medication reviews for any resident who takes nine or more prescribed medications.
• Safety standards. Facilities must comply with the National Fire Protection Association Life Safety Code 101. They also must have emergency evacuation plans approved by the state. Assisted living communities with over 50 residents must have backup generators.
• Resident assessment requirements. All residents must be evaluated by a physician no more than 30 days prior to move-in. Additional evaluations are required within 48 hours of any non-routine hospital stay or significant change in condition.
• Occupancy. No more than two people can occupy a unit in an assisted living facility. There must be at least one bathroom per four residents.

Staffing requirements for Maryland assisted living facilities

Qualified staff must be on-site 24 hours a day when residents are present. An assessing physician or nurse can use Maryland’s Resident Assessment Tool to determine whether residents require awake overnight staff.

All assisted living facilities must have an agreement with a registered nurse whose job it is to delegate nursing tasks to employees. This nurse doesn’t have to be on-site at all times, depending on the level of care a community provides.

Level three — the highest level — assisted living facilities must have a qualified manager with a college degree and two or more years of experience in the health care field. They also must complete an 80-hour training program that covers aging, cognitive needs, and dementia.

Understanding Maryland’s system of regulation and records

We developed a system to rate each state based on the ease of information access, meaning how easy — or difficult — it is to find important assisted living records and reports. States with the most transparent records allow you to look up important information about each assisted living facility online, including inspections, complaints, survey results, violations, capacity, and Medicaid acceptance.

Access to Maryland assisted living records: Exceptional

Public access to assisted living records and reports for the state of Maryland is exceptional. Key findings that informed this rating include:

• Maryland is one of very few states to include information about the pricing of assisted living communities online.
• Maryland has one of the easiest to use and most attractive state websites for researching assisted living records. However, surveys for communities with less than 10 residents are not available.

How to look up Maryland assisted living licenses and records

Visit Maryland’s Guide to Consumer Long Term Care to find a listing of licensed providers.

• A second database with additional community types is available at this state of Maryland website.
• Visit the U.S. Administration on Aging’s Eldercare Locator to locate the appropriate long-term-care ombudsman who can often provide specific information about communities and their backgrounds.
• If you need to make a Freedom of Information Act (FOIA) request to get records, consider browsing the state-by-state resources from the National Freedom of Information Coalition, which includes sample state-specific FOIA letters.

How we arrived at our Maryland rating

We developed astandard methodology for state data collection and evaluation, and we based our rating primarily on the objective, state-specific accessibility criteria outlined in these questions:

1. Are licensed assisted living communities listed online in any form? Yes
 2. If Yes to #1, is the information updated frequently? Yes
 3. If Yes to #1, is the list of licensed communities searchable? Yes
 4. Does the state post inspections, complaints, survey results, or violations online? Yes
 5. If Yes to #4, is the information updated frequently (within 90 days)? Yes
 6. If Yes to #2 and #4, is the enforcement information included in the same place as licensed communities? No
 7. If Yes to #4 and No to #6, are violations and inspections searchable at all? Yes, or not applicable
 8. Is information about special licensing for care shown? Yes
 9. Is capacity shown? Yes
 10. Are payment types shown (e.g., Medicaid, private pay)? No
 11. Is the administrator/contact name shown? Yes
 12. Can the state fine a facility? Yes
13. What is the frequency of inspections? Every 15 months
 14. Does the website include pricing of facilities? Yes