Maryland Assisted Living


Maryland Assisted Living: Common terms, questions to ask, and how to pay for assisted living

The state of Maryland is known for healthy living and a robust economy. There is always something to do to promote healthy living: 50 state parks and over 15 national parks, and the long and luxuriant coastline, and the famous Chesapeake Bay. Maryland as something for everyone. Maryland is known for being a leader in healthcare, with excellent hospitals led by Johns Hopkins. Nearly 16% of the state’s 1.65 million residents are aged 65 and older. All these attractions make Maryland a premiere place for our aging population to call home. Assisted living is ideal for aging adults who may require some assistance with activities of daily living. Typically, when people think of senior care they imagine a nursing home. However, there are several other options aside from nursing homes. An assisted living community or facility describes a specific level of care, which allows seniors the benefit of security and peace of mind because they may experience increased socialization, classes for health and fitness and quality nutrition plans. All assisted living communities are licensed by the state, and provide a bedroom and restroom, meals, and assistance with care.

Maryland is home to several cities where residents may receive excellent healthcare: Baltimore, Annapolis, Ocean City, Bethesda, Rockville, Towson, Frederick, among many others.

Maryland offers a variety of senior living and care choices for your loved one, each providing care for specific needs and preferences.

Common terms that differentiate levels and types of senior living: 

  • Continuing Care Retirement Communities (CCRCs)- typically include independent living, assisted living, residential care and skilled nursing services all on one campus.  
  • Independent Living Communities – provide residents a setting without the burden of home ownership. Residents commonly live in fully equipped private apartments or cottages from a studio to large two-bedroom units.  
  • Care Home or Adult Family Care Home- are private residences in a home-like setting that provide care services to a smaller more limited number of residents (typically 5-12 residents, depending on each state’s regulations). 
  • Assisted Living- provides housing and supportive care in a community setting, but the residents do not require 24-hour nursing care. 
  • Memory Care- a care setting for residents with memory loss or confusion. The community typically has a “secured” entry for residents that may wander. This care can be provided in different care settings depending on the state licensing requirements. 
  • Skilled Nursing is state licensed to provide a safe, therapeutic environment for people who require rehabilitative care 24 hours a day.

Assisted Living requirements in Maryland


  • Single or double occupancy rooms are available to residents, and each must offer 80 to 120 feet respectively.
  • Locking doors.
  • 1 toilet for every 4 residents.
  • 1 bathtub for every 8 residents.

What do communities and facilities in Maryland offer?

Assisted living communities are NOT nursing homes. But it is common to hear this term when people refer to any/all senior housing. Though, similarly to a nursing home, plans in assisted living are put in place for residents, which outline the provided care for each aging adult, all specific to their requirements and preferences.

Typical services in assisted living

In Maryland, assisted living consists of three levels of care: LOW, MODERATE, HIGH. These levels are used to define the service needs of residents, like medication assistance, concerns regarding behavior and safety, or wandering.

Residents who require assistance with two activities of daily living is considered low or moderate. Further observation will determine the status of residents with further needs, in which case they may require a waiver to remain in the assisted living facility.

On-site care assistance is available for residents, which can include help with activities of daily living (also known as ADLs): 

  • Dressing 
  • Bathing 
  • Medication assistance and reminders 
  • Eating  
  • Toileting and incontinence management 
  • Transferring 
  • Incontinence Management

Laws and Regulations in Maryland


Assisted living in Maryland is licensed and regulated by the Maryland Department of Health. Maryland has strict regulations and enforcement regarding assisted living in the state.

Staffing requirements for assisted living in Maryland

There is no minimum staff to resident ratio in the state of Maryland. However, staff must be available at all times. 24/7 staff should be available for any resident in need. There must be one staff member awake at al hours if any resident requires 24 hour surveillance. Unless otherwise planned, staff may sleep during the night, but must be ready to be awakened.

Before hiring all staff must undergo a thorough criminal background check and upon hiring must complete orientation and continued education throughout the year.


Staff must always report any perceived abuses. All reports are made to the Maryland Office of Healthcare Quality, the Area Agency on Aging, or the appropriate authorities.

How much does assisted living in Maryland cost?

Maryland ranks high for assisted living affordability in the United States. However, the cost for a month of assisted living is still higher than the national average of $4,500. In Maryland assisted living is $4,900 per month on average. The costs in the region of the country vary, and Maryland sits in about the middle for average cost per month.

  • National average cost of assisted living per month: $4,500
  • Maryland: $4,900
  • Delaware: $6,000
  • Virginia: $5,300
  • Pennsylvania: $4,100
  • West Virginia: $4,200

Like all the states in the country, costs will vary city by city within Maryland as well.

  • Cumberland: $5,275
  • Salisbury: $5,000
  • Baltimore: $4,775

How to pay for assisted living in Maryland

You want to consider your payment options for assisted living, memory care, and care homes. For these services, Medicare is NOT an option for payment.

The most common payment for these services would be out of pocket Private Pay and assessing a combination of retirement funds, personal savings, and pension payments.

Medicaid can also be an option, be sure to see if you or a loved one qualifies.

Long-Term Care insurance is also a possible option in cases of chronic conditions, be sure to see if you or a loved one qualifies.

For our Veterans and spouses of veterans, be sure to assess Veteran Aid and your eligibility for these benefits.

Medicare – NO:

  • Medicare does NOT pay for Assisted Living.
  • People 65 years and older and individuals with end stage renal disease are eligible for Medicare benefits, no matter their income.
  • Coverage is meant for people in need of short-term care.

Private pay – YES:

  • Many families pay for assisted living with private funds.
  • Private pay can be a combination of retirement funds, personal savings, and pension payments.
  • Family members may contribute funds to pay for assisted living or other senior housing and care.

Medicaid – MAYBE:

  • Medicaid provides health coverage to millions of Americans. Eligible participants include: low-income adults, elderly adults and people with disabilities.
  • Medicaid is administered by state, according to federal requirements. The program is funded jointly by each state and the federal government.
  • Every state has their own individual Medicaid assistance program.
  • National guidelines are in place do decipher how states must spend Medicaid money, but with allowances toward the guidelines.
  • The state determines what levels of care will be covered by Medicaid, who is eligible, and how much the state will reimburse the care community.
  • If you are unsure whether you qualify for Medicaid, you should apply. You may be eligible depending on your household income, family size, age, disability and other factors.

Long-term Care Insurance – MAYBE:

Long term care insurance is a great way to pay for assisted living, and planning ahead is important when considering how to pay for senior housing and care. Nearly 75% of people over the age of 65 will require long-term care and services at some point. Buying into long-term care insurance when a person is in their 50s and 60s is the most common time to do so.

  • Long-term care insurance helps cover the costs of chronic medical conditions.
  • Individuals and couples with the ability to pay into long-term care insurance have the advantage of a head start in allocating funds for senior care.

Veteran Aid and Assistance – MAYBE:

This benefit is available to some military veterans and surviving spouses who live in an assisted living community and those who have in-home care.

  • There are specific guidelines, but a veteran may qualify for as much as $2,050 each month.
  • A veteran with a sick spouse may be eligible for $1,600 per month.
  • If a veteran has passed, their surviving spouse can qualify for $1,300 per month.

Questions to Ask

Finding an assisted living community, can be overwhelming. Here are some tips on things to be observant of:

  • Make sure the facility is clean and well maintained. You can tell a lot about the operation by noting What is clean and maintained. Are doorknobs loose or damaged? Do you see any frayed carpet or trip hazards?
  • Visit during lunch hour to observe what the residents are eating. Ask questions about the nutrition program. Is there diversity in meals, healthy fruits and vegetables served at all meals, drink options?
  • Speak to residents and/or family members to learn their perspective.
  • Ask about staff and resident engagement. Get a feel for how staff interact with residents.
  • Ask about the life enrichment programs. Activities are crucial when it comes to quality of life and play a key role in care for older adults.
  • And finally (there is a plethora of more things to consider), get to know the leadership in the building. If you feel good around the executive director, head nurse, lead activities director and even the chef or janitor, it is a good sign you can trust them with the care of your loved one.

Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on Find & compare plans in your area. Determine if you qualify for premium savings

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available. 

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Written by The Care Availability Team
Experts in the senior care & retirement living industries

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