People aged 65 and older in Maryland numbered 689,000 as of 2008, according to the U.S. Census Bureau. According to the Maryland Office of Health Care Quality, assisted living is a popular housing option in the state, with over 300 facilities in existence. The cost of assisted living ranges from $1,000 to over $5,000 per month and averages $2,000 per month. The Maryland Assisted Living Unit of the Office of Health Care Quality regulates assisted living in the state.

Scope of Care

Assisted living facilities in Maryland are licensed for three different levels of care, depending on how much assistance the facility offers its residents. Level one facilities offer services to residents who need a low level of care. Level two caters to residents with a medium level of care needed, and level three facilities care for residents who need a high level of care. Along with providing housing and meals, Maryland assisted living facilities provide social activities and assist residents with getting dressed, grooming and transportation.

Resident Assessment

A facility must complete an assessment to determine whether a resident is appropriate for a facility. Maryland uses a standardized form for assessments called the "Resident Assessment Tool." The assessment includes a physical assessment performed by a medical professional. Additionally, the facility manager must perform a functional assessment of residents to determine their personal care needs as well as desire and ability to participate in social activities. The facility manager must then formulate a service plan outlining what services will be provided to the resident and who will provide the services.

Medication Management

Maryland assisted living staff who help residents with medication must first pass a medication administration course taught by a registered nurse. Facilities must also arrange for a licensed pharmacist to perform an on-site review of medication management every six months for residents taking nine or more medications.


Maryland assisted living facilities must adhere to regulations of the National Fire Protection Association Life Safety Code 101. All staff members must know and be able to implement a fire safety plan. State regulations require facilities with six or more beds to have a sprinkler system and conduct fire drills for each shift quarterly. Once a year, facilities must also conduct and document disaster drills for events such as tornadoes and hurricanes.

Staffing Requirements

Assisted living facilities in Maryland must submit a staffing plan to the state Department of Health and Mental Hygiene, demonstrating an adequate number and quality of staff to care for residents. Depending on the level of the facility and needs of residents, the facility may use an electronic monitoring system instead of overnight staff. On-site nurses must be available if needed for the adequate care of residents.