How To Apply For Assisted Living Waiver In California

Senior Living
Assisted Living
Maryland

Average Monthly Costs

States near Maryland

Genworth lists the average cost of a private, one bedroom unit in an assisted living community in Maryland as $5,106. This places Maryland on the higher end of the scale at about $1,100 over the national average, and about $200 higher than the median cost of assisted living in nearby states.

Compare Monthly Care Costs

When it comes to care options, assisted living is just one of several choices available to seniors. Some care options, like part-time in-home care or independent living, may cost less, while others like memory care or skilled nursing are likely to cost significantly more. Seniors can speak with their medical practitioners to receive guidance on what level of care will best suit their needs and abilities.

Average Monthly Costs

Cities in Maryland

$6,447.00 California, Lexington Park

$5,512.00 Hagerstown, Martinsburg

$4,644.00 Baltimore, Columbia, Towson

When estimating the cost of assisted living, it's important to know that average prices can differ significantly between various parts of Maryland. For example, assisted living rates in areas such as California, Lexington Park are at least $1,300 more than the state average of $5,106, but in areas like Baltimore, Columbia, Towson, you're saving on average $500. The most affordable region in Maryland for assisted living is Cumberland at $3,988.

Maryland offers assistance for low- and moderate-income seniors through its Medicaid Home and Community-Based Services (HCBS) and state-funded Senior Assisted Living Group Home Subsidy programs.

The HCBS waiver program in Maryland provides a number of home and community-based services. Using the Medicaid 1915(c) HCBS Waiver, Maryland covers Level 2 and Level 3 ALP services for Medicaid beneficiaries.

Who Is Eligible?

To enroll in Medicaid and receive HCBS waiver benefits, applicants must:

Be 65 years of age or older
Be a resident of Maryland
Have no more than $2,024 in monthly income
Own no more than $2,500 in personal assets
Be a U.S. citizen or meet immigration status requirements
Have a valid social security number
Meet medical eligibility requirements

How to Apply

Maryland residents wishing to apply for Medicaid so they can be eligible for the HCBS waiver can visit myDHR or mail a completed application to, or visit, their local social services office.

The SALGHS program offers seniors subsidies for services provided by smaller ALPs licensed for 4 to 16 residents. The subsidies support the cost of personal care, daily meals and 24-hour supervision for seniors who are unable to live independently.

Who is Eligible?

To receive financial assistance under the SALGHS program, applicants must be:

Age 62 years or older
Physically or mentally impaired
In need of assistance with ADLs
A resident of a participating ALP home or approved for entry

Applicants must also meet financial eligibility requirements to participate in the SALGHS program. Financial eligibility requirements include having:

Net monthly income that's no higher than 60 percent of the state median income
Personal assets worth $11,000 or less for singles and $14,000 or less for couples

How to Apply

To apply for benefits under the SALGHS program, visit or contact your local Area Agency on Aging.

Maryland residents have several options to turn to when looking for information and programs for long-term senior care. Most agencies and nonprofit organizations offer services online, in person or through the mail.

Maryland Area Agencies on Aging

States can designate a public agency or private nonprofit organization as an Area Agency on Aging (AAA); they're typically spread throughout a state with each agency representing a geographic location. AAAs are intended to address the concerns and needs of local seniors, with a focus on maintaining their independent living.

Maryland is home to 19 Area Agencies on Aging, each with individual offices and websites.

Allegany County Human Resources Development Commission

125 Virginia Avenue, Cumberland, MD 21502
301-777-5970

Anne Arundel County Department of Aging and Disabilities

2666 Riva Road, Annapolis, MD 21401
410-222-4464

Baltimore City Division of Aging and Care Services

417 E. Fayette St., 6th Floor, Baltimore, MD 21202
410-396-4932

Baltimore County Department of Aging

611 Central Avenue, Towson, MD 21204
410-887-2594

Calvert County Office on Aging

450 West Dares Beach Road, Prince Frederick, MD 20678
410-535-4606

Caroline, Kent, Talbot Upper Shore Aging, Inc.

100 Schauber Road, Chestertown, MD 21620
410-778-6000

Carroll County Bureau of Aging and Disabilities

125 Stoner Avenue, Westminster, MD 21157
410-386-3800

Cecil County Department of Community Services

200 Chesapeake Boulevard, Suite 2550, Elkton, MD 21921
410-996-5295

Charles County Aging and Human Services

8190 Port Tobacco Road, Port Tobacco, MD 20677
301-934-9305

Dorchester, Somerset,Wicomico, Worcester MAC, Inc.

909 Progress Circle, Salisbury, MD 21804
410-742-0505

Frederick County Department of Aging

1440 Taney Avenue, Frederick, MD 21702
301-600-1605

Garrett County Area Agency on Aging

104 East Center Street, Oakland, MD 21550
301-334-9431

Harford County Office on Aging

145 North Hickory Avenue, Bel Air, MD 21014
410-638-3025

Howard County Office on Aging and Independence

6751 Columbia Gateway Drive,2nd Floor, Columbia, MD 21046
410-313-6410

Montgomery County Department of Health and Human Services

401 Hungerford Drive, 3rd Floor, Rockville, MD 20850
240-777-3000

Prince George's Department of Family Services

6420 Allentown Road, Camp Springs, MD 20748
301-265-8450

Queen Anne's County Area Agency on Aging

104 Powell Street, Centerville, MD 21617
410-758-0848

St. Mary's County Department of Aging Human Services

41780 Baldridge Street, Leonardtown, MD 20650
301-475-4200

Washington County Commission on Aging

535 E. Franklin Street, Hagerstown, MD 21740
301-790-0275

The VA provides qualified veterans with disabilities with health care and rehabilitation services. The VA can help eligible seniors with grants for building adapted homes or adapting their current one.

The VA in Maryland operates the Charlotte Hall Veterans Home, a 168-bed assisted living facility and 286-bed skilled nursing home on 126 acres of land in St. Mary's County.

Maryland Vet Centers and contact information:

Aberdeen Outstation

223 West Bel Air Ave on Law Street, Aberdeen, MD 21001
(410) 272-6771

Annapolis Vet Center

100 Annapolis Street Suite 102, Annapolis, MD 21401
(410) 605-7826

Baltimore Vet Center

1777 Reistertown Road Suite 199, Baltimore, MD 21208
(410) 764-9400

Dundalk Vet Center

1553 Merritt Boulevard, Dundalk, MD 21222
(410) 282-6144

Elkton Vet Center

103 Chesapeake Boulevard Suite A, Elkton, MD 21921
(970) 245-4156; (410) 392-4485

Prince George's County Vet Center

7905 Malcolm Road, Suite 101, Clinton, MD 20735
(301) 856-7173

Silver Spring Vet Center

2900 Linden Lane Suite 100, Silver Spring, MD 20910
(301) 589-1073

Salisbury Outstation

926 Snow Hill Road Bldg 3, Salisbury, MD 21804
(410) 912-7262

Maryland provides a state supplement to federal SSI recipients in assisted living programs and other long-term care facilities. Learn more about state supplementation and other social security benefits or visit your local Maryland Social Security office:

Abingdon Social Security Office 21009

Corporate Center Dr, Abingdon, MD 21009
1-800-772-1213 or TTY: 1-800-325-0778

Annapolis Social Security Office 21401

180 Adm Cochrane Dr, Annapolis, MD 21401
1-888-840-0684 or TTY: 1-800-325-0778

Baltimore Social Security Office 21201

1010 Park Ave, Baltimore, MD 21201
1-800-772-1213 or TTY: 1-800-325-0778

Baltimore Social Security Office 21213

2401 Belair Rd, Baltimore, MD 21213
1-800-772-1213 or TTY: 1-800-325-0778

Baltimore Social Security Office 21211

711 West 40th Street, Baltimore, MD 21211
1-800-772-1213 or TTY: 1-800-325-0778

Baltimore Social Security Office 21215

6100a Wabash Avenue, Baltimore, MD 21215
1-800-772-1213 or TTY: 1-800-325-0778

Baltimore Social Security Office 21237

6820 Hospital Dr, Baltimore, MD 21237
1-800-772-1213 or TTY: 1-800-325-0778

Baltimore Social Security Office 21227

1531 S Edgewood Street, Baltimore, MD 21227
1-800-772-1213 or TTY: 1-800-325-0778

Cambridge Social Security Office 21613

828 Airpax Road, Cambridge, MD 21613
1-888-347-9277 or TTY: 1-800-325-0778

Charlotte Hall Social Security Office 20622

30071 Business Ctr Dr, Charlotte Hall, MD 20622
1-800-772-1213 or TTY: 1-800-325-0778

Columbia Social Security Office 21045

8865 Stanford Blvd, Columbia, MD 21045
1-800-772-1213 or TTY: 1-800-325-0778

Cumberland Social Security Office 21502

217 Glenn St, Cumberland, MD 21502
1-866-964-7409 or TTY: 1-301-722-5175

Elkton Social Security Office 21921

101 Chesapeake Blvd, Elkton, MD 21921
1-866-331-2218 or TTY: 1-800-325-0778

Frederick Social Security Office 21703

5340 Spectrum Drive, Frederick, MD 21703
1-866-331-7089 or TTY: 1-800-325-0778

Glen Burnie Social Security Office 21061

337 Hospital Dr, Glen Burnie, MD 21061
1-800-772-1213 or TTY: 1-800-325-0778

Hagerstown Social Security Office 21740

1710 Underpass Way, Hagerstown, MD 21740
1-866-331-7125 or TTY: 1-800-325-0778

Owings Mills Social Security Office 21117

5 Park Center Court, Owings Mills, MD 21117
1-800-772-1213 or TTY: 1-800-325-0778

Rockville Social Security Office 20850

315 N Washington St, Rockville, MD 20850
1-800-772-1213 or TTY: 1-800-325-0778

Salisbury Social Security Office 21801

2414 Northgate Dr, Salisbury, MD 21801
1-866-273-5083 or TTY: 1-800-325-0778

Seabrook Social Security Office 20706

7401c Forbes Blvd, Seabrook, MD 20706
1-800-772-1213 or TTY: 1-800-325-0778

Silver Spring Social Security Office 20903

10230 New Hampshire Ave, Silver Spring, MD 20903
1-800-772-1213 or TTY: 1-800-325-0778

Suitland Social Security Office 20746

6110 Allentown Road, Suitland, MD 20746
1-800-772-1213 or TTY: 1-800-325-0778

Towson Social Security Office 21204

28 Allegheny Avenue, Towson, MD 21204
1-800-772-1213 or TTY: 1-800-325-0778

Westminster Social Security Office 21157

125 Airport Dr, Westminster, MD 21157
1-800-772-1213 or TTY: 1-800-325-0778

An LTC Ombudsman serves as an independent advocate for seniors in nursing homes, board and care homes, and assisted living programs. It provides free, confidential services to help resolve the problems of individual residents with a goal of improving overall long-term care for elders. To find an Ombudsman in Maryland, look here.

Assisted Living Laws and Regulations in Maryland

Maryland provides laws and regulations to ensure that the needs of residents in long-term care facilities and homes are met effectively. Some key information is highlighted below.

Assisted Living Service Plan Requirements

A service plan is a document that outlines the specific details of care a resident receives, including the costs of those services. ALP facility staff members create a service plan after performing an assessment to evaluate a resident's ability to perform ADL and iADL activities.

Assessments also include evaluations of a resident's social and recreational needs, habits and cognitive abilities. They account for risk factors, problematic behaviors and the ability to self-administer medications.

Maryland requires ALP communities and homes to perform a review of the assessment at a minimum of once every six months, but certain events can trigger the need for a full reassessment, such as:

A significant change in a resident's condition
Nonroutine hospitalization

A licensed health care practitioner must evaluate residents, and ALP staff must adjust a service plan if an assessment results in a score change in any of these areas:

Cognitive and behavioral needs
Ability to self-administer medications

Assisted Living Admission Requirements

Without a waiver, assisted living communities and residential homes may not admit or retain applicants requiring:

Treatment of Stage III or IV skin ulcers
Ventilator services
More than intermittent nursing care
Skilled monitoring, testing or adjustment of medications or treatment
Monitoring of chronic conditions that can't be controlled through common medications or treatment
Treatment for a reportable communicable disease
More than contact isolation for a disease or condition
Monitoring for behaviors that present a danger to themselves or others

Assisted Living Scope of Care

There are three progressive levels of licensure for Maryland ALPs that detail the services a home or community provides.

Level 1 ALPs

Level 1 ALPs are not eligible for the Medicaid waiver program. Assisted living communities with a Level 1 license must provide:

Medication self-administration assistance
Assistance with accessibility and coordination of health services
Social and recreation service assistance
Supervision or occasional assistance with at least two ADLs
Simple interventions to address infrequent disruptive or harmful behavior
Simple interventions and monitoring to address infrequent psychological issues

Level 2 ALPs

Any facility or home with a Level 2 license must provide the services detailed in Level 1 as well as:

Significant support with at least two ADLs
Medication administration
Monitoring and intervention for disruptive or harmful behaviors
Monitoring and prompt intervention for frequent psychological episodes
Ongoing social and recreational service assistance

Level 3 ALPs

Level 2 and Level 3 ALPs are eligible providers under the Medicaid waiver program. Level 3 ALPs must provide the services detailed for Level 1 and Level 2 ALPs as well as:

Coordination of comprehensive health services
Full and frequent assistance with ADLs
Provision and monitoring of ongoing therapeutic intervention or intensive supervision for chronic disruptive or harmful behaviors
Monitoring and management of different psychological or MD-4 psychiatric episodes

Assisted Living Medicaid Policy

Maryland residents may be eligible for financial assistance and subsidies available through Maryland's Medicaid program by using the HCBS waiver program. Not all facilities accept Medicaid as payment for services, so it's important to confirm with any prospective property regarding their Medicaid policy and the terms of your benefits.

Maryland residents receiving supplemental security income (SSI) automatically qualify for Medicaid; however, they must still meet the eligibility requirements noted above to receive ALP assistance.

Assisted Living Facility Requirements

Maryland sets standards for all ALPs concerning toilets, showers and room occupancy.

All programs must have at least one toilet for every four residents.
Multilevel buildings with at least nine residents must maintain that ratio on each level that residents occupy.
Resident units may contain a maximum of two people.
ALPs with eight or fewer residents must provide at least one bathtub or shower for every four.
Communities with more than eight residents must maintain a ratio of one shower or bathtub for every eight.

Medication Management Regulations

All licensed ALPs in Maryland must provide self-administered medication assistance, which includes reminders, help with packaging and removal of medication from a package. A licensed health professional must review a resident's ability to self-administer medication quarterly.

To administer medications, ALP staff members must complete a Board of Nursing program.

For residents taking nine or more medications, ALPs must arrange for an on-site review by a licensed pharmacist of prescriptions, orders and resident records every six months. Medications include as-needed and OTC drugs.

In addition, all new residents' medication must be reviewed by a licensed health professional within 14 days of admission.

Staffing Requirements

Maryland does not require minimum staffing ratios; however, communities are required to employ or contract specific staff types and provide sufficient coverage to meet the planned and unplanned needs of all residents.

Management: ALPs must employ a manager for daily operations. For times when the manager is not available, ALPs must also have an identified alternate manager.
Nursing: All residential homes and communities must have a contracted or employed registered nurse to provide nursing services.
Overnight staff: Awake, overnight staff is required unless a qualified nurse or doctor determines that residents don't need it. In these cases, the ALP must obtain a waiver to use an electronic monitoring system instead.
Medication technicians: ALPs that offer medication administration must have staff who have completed the required Board of Nursing program.

Direct care: ALPs must employ staff members to provide personal care to residents.

Staff Training Requirements

Maryland helps ensure staffing competence by requiring specific knowledge and ongoing training for management and staff. ALP managers at locations with five or more residents must complete 20 hours of approved continuing education every two years.

All staff, in addition to their job training, must receive onboarding and continuing training in:

Infection control
Basic food safety
Basic first aid
Fire and life safety
Emergency disaster plans
Resident assessment process
Service plan usage
Resident rights

Any staff member providing personal care must complete a state-approved course on cognitive impairment and mental illness within 90 days of employment. Further, a delegating nurse must first determine competence before a direct care staff member provides personal-care services.

Background Checks for ALP Staff in Maryland

To receive a license to operate an assisted living program in Maryland, an ALP applicant must provide the state with current criminal background checks or criminal records for:

Owner
Applicant
Manager
Alternate manager
Other staff
Other household members (for owner-occupied homes)

After licensure, the ALP manager must continue to conduct background checks for all prospective employees.

Requirements for Reporting Abuse

Health practitioners and human service workers are mandated reporters of suspected abuse, neglect or exploitation of a vulnerable adult.

Maryland Adult Protective Services has a hotline for telephone reports at 800-91-PREVENT or 800-917-7383 and a website for online reporting.

Assisted Living Facilities in Maryland

Cities

Counties

Top-Rated Caring Stars Winners in Maryland

Caring.com's Caring Stars award program recognizes the best assisted living facilities across the U.S. based on reviews from family caregivers and older adults. This award is meant to help older adults and their loved ones find the best assisted living or in-home care option in their area. The list below shows up to 10 listings that have won the most Caring Stars annual awards in their state, sorted by their current overall average rating. For a complete list of Caring Stars winners for each year, please visit our Caring Stars info center.