Last updated 2026-07-25
TL;DR
Maryland's Office of Health Care Quality (OHCQ) maintains the state's assisted living licensure records. You can search licensed programs, check level of care (Level 1, 2, or 3), and pull inspection survey history through OHCQ's public reporting tools before choosing a facility or applying for your own license.
How do you do a Maryland assisted living license lookup?
The Maryland Department of Health's Office of Health Care Quality (OHCQ) is the agency that licenses and inspects assisted living programs statewide, and it is the source you want, not a third-party directory. OHCQ regulates assisted living under Health-General Article, Title 19, Subtitle 18 of the Maryland Annotated Code, and its licensing and complaint-investigation unit publishes facility-level information the public can search [1]. To look up a specific facility, start with OHCQ's public-facing licensing and complaint information, which covers license type, survey results, complaint investigation outcomes, and enforcement actions. If you're comparing a facility you're considering for a family member, or checking a competitor's standing before you open your own home, this is the primary record. Do not rely on Google reviews or a facility's own marketing page to confirm licensure status; only OHCQ's record confirms whether a license is active, provisional, suspended, or revoked. If you can't find a facility in the online tool, OHCQ's licensing division can also be reached directly to confirm license status by phone or written request. Records requests for full survey reports (Statement of Deficiencies) can take longer than the summary shown online, so budget a few weeks if you need the full inspection document rather than the report card summary.
What is assisted living?
Assisted living is a licensed residential care setting for adults who need help with daily activities like bathing, dressing, medication management, or mobility, but who do not need the round-the-clock skilled nursing care a nursing home provides. Maryland law defines it as a residential or facility-based service that provides housing plus personal care, health-related services, and supervision for people who need assistance because of physical or cognitive limitations [1]. In Maryland, assisted living programs are licensed at one of three levels of care, and the level dictates what conditions a program can legally accept and how much nursing oversight is required on-site. Level 1 is for residents who are mostly independent; Level 2 covers moderate care needs including some chronic conditions; Level 3 is for residents with significant care needs, including certain residents who might otherwise require nursing home placement. A program's license specifies which level(s) it's approved for, and that's exactly the kind of detail a license lookup confirms, because a facility advertising "memory care" or "skilled-level services" without a Level 3 designation is a real problem, not a technicality. Assisted living is not a single national standard. Every state licenses and defines it differently, which is why a lookup tool tied to your specific state's health department, not a national aggregator site, is the only reliable source.
What is a group home?
A group home is a small residential facility, usually housing somewhere between two and ten residents, where people with disabilities, mental illness, substance use recovery needs, or age-related care needs live together with paid staff support. The term is used loosely across the country and covers very different regulatory categories depending on the population served. In most states, "group home" gets applied to intellectual and developmental disability (IDD) residential programs, adult foster care homes, mental health residential programs, and small assisted living homes alike. Maryland's regulatory system doesn't use "group home" as a single licensing category; instead it separates assisted living (OHCQ), developmental disabilities group homes (Developmental Disabilities Administration), and behavioral health residential programs (Behavioral Health Administration) under different licensing bodies with different rules [2]. If you're trying to open a home, the first step is figuring out which category your intended population and services actually fall under, because the application, staffing ratios, and inspection standards are not interchangeable. If you're researching group home licensing broadly across different states and populations, our assisted living and assisted living facility guides break down how these categories differ state by state.
What is an assisted living facility?
An assisted living facility is the physical building and licensed program together, the place where residents live and the entity holding the state license to operate it. In Maryland, the license is issued to a specific location and operator, tied to a set number of beds and an approved level of care, and it doesn't transfer automatically if the home changes hands [1]. Facilities range from small, home-based operations with a handful of beds run out of a converted single-family house, to large purpose-built buildings with 50, 100, or more residents. Maryland doesn't set a single statewide bed-count cap for all assisted living, but licensing requirements, staffing ratios, and fire/life safety rules scale with resident count and level of care, so a facility's specific size and level matter more than a blanket definition. When you're doing a lookup, confirm three things at minimum: the exact licensed name and address (not a DBA or marketing name), the approved level of care, and whether the license is current and unrestricted. A facility operating under a provisional license or with an open enforcement action isn't necessarily unsafe, but it's a flag worth understanding before you commit.
What is assisted living vs nursing home?
| Licensing agency (MD) | OHCQ, Health-General Title 19, Subtitle 18 [1] | OHCQ, separate nursing home regulations [3] | |
|---|---|---|---|
| Staffing | Personal care aides, some nursing oversight | RNs/LPNs on-site 24/7 | |
| Medical acuity | Low to moderate (higher at Level 3) | High, including skilled/rehab care | |
| Medicare coverage | Generally not covered [4] | Short-term skilled stays can be covered [4] | |
| Medicaid coverage | Limited, via HCBS waiver programs | Broadly covered for eligible long-term stays | If someone's needs are shifting from "help getting dressed" to "needs a ventilator or IV antibiotics," that's usually the line where a family has to look at nursing home placement instead of assisted living, regardless of how good the assisted living program is. |
The core difference is medical intensity: assisted living provides help with daily living activities and some health monitoring, while a nursing home (also called a skilled nursing facility) provides 24-hour licensed nursing care for people with serious medical needs, post-hospital rehabilitation, or conditions that require constant clinical supervision. Nursing homes in Maryland are licensed separately from assisted living, under a different section of state law, and they're certified for Medicare and Medicaid reimbursement in a way most assisted living programs are not [3]. A nursing home has registered nurses on-site around the clock and can manage IV therapy, ventilators, wound care, and other clinical services that assisted living staff generally cannot legally perform, even at Maryland's highest assisted living level (Level 3). Here's a side-by-side to make the distinction concrete: | Feature | Assisted Living | Nursing Home |
What does assisted living provide?
Assisted living typically provides housing (a private or shared room), three meals a day, help with activities of daily living like bathing and dressing, medication management or reminders, housekeeping and laundry, transportation to appointments, and social or recreational activities. Beyond that baseline, what's actually provided depends heavily on the facility's licensed level of care and state rules. In Maryland, a Level 1 program provides a lighter touch: supervision and help with daily tasks for residents who are largely independent. A Level 2 program adds capacity for residents with moderate, stable chronic conditions. A Level 3 program is approved to serve residents with more significant medical or cognitive needs, sometimes including people who would otherwise need nursing home placement, and requires more nursing oversight on-site. A facility can't just decide to provide Level 3 services because a family asks; the level is tied to the license itself, and that's exactly what a license lookup confirms before you sign anything. Medication management is one of the most misunderstood pieces. "Medication management" in most states means staff can assist with reminders, organize pre-filled medication, and sometimes administer medications under specific delegation rules from a licensed nurse, not that unlicensed staff can independently manage complex medical regimens. If a facility's answer to "who manages medications" is vague, that's worth pressing on.
What is the difference between assisted living and nursing home?
This gets asked so often it's worth restating plainly, separate from the table above: assisted living is for people who need support with daily living but not continuous medical care, while a nursing home is for people who need ongoing clinical/nursing supervision, rehabilitation after a hospital stay, or complex medical management. Cost structure differs too, though exact figures vary widely by region and should be confirmed with current market data rather than assumed. Federal data from the Centers for Medicare & Medicaid Services shows nursing home care is generally reimbursable through Medicare for short, medically necessary skilled stays following a qualifying hospitalization, while assisted living almost never qualifies for Medicare coverage under current federal rules [4]. Another practical difference: nursing homes are subject to federal certification requirements tied to Medicare and Medicaid participation (42 CFR Part 483), while assisted living is licensed purely at the state level with no equivalent federal certification framework . That means assisted living quality and safety standards vary dramatically from state to state, which is exactly why checking your specific state's licensing database, not a national rating site, is the reliable move.
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board or personal care services in assisted living facilities. CMS is explicit that Medicare covers medically necessary services like doctor visits, some home health care, and short-term skilled nursing facility stays after a qualifying hospital stay, but it does not pay for long-term custodial or assisted living care [4]. Medicare may still pay for medical services a resident receives while living in assisted living, like a doctor's visit, physical therapy ordered by a physician, or durable medical equipment, but it will not pay the facility's monthly rate for housing, meals, and personal care assistance. Medicaid is a different story, though still limited. Maryland, like most states, does not cover assisted living room and board through Medicaid, but it can help cover the personal care and health-related services portion for eligible low-income residents through home and community-based services (HCBS) waiver programs, sometimes called the Community First Choice or Community Options waiver in Maryland's Medicaid structure . Eligibility, waiting lists, and covered services vary, so confirm current waiver rules and availability with your state Medicaid agency and OHCQ rather than assuming coverage exists.
How to start a group home
Starting a group home, whatever population you plan to serve, follows a similar backbone across states even though the specific agency, forms, and fees differ: pick your population and license category, meet the state's provider qualification requirements, secure a compliant property, write your policy and procedure manual, hire and train staff to the required ratios, and pass a pre-licensing inspection. Step one is figuring out exactly which license you need. "Group home" isn't one license; it might mean an assisted living license, a developmental disabilities residential license, a behavioral health residential program license, or an adult foster care license, and each has a different regulatory home and different rules [2]. Applying under the wrong category wastes months. Step two is the property. Zoning matters more than most first-time operators expect; a home in a residential zone may need a conditional use permit or may qualify under state/federal fair housing protections for group homes serving people with disabilities, but local zoning boards don't always apply that correctly on the first try, and you may need to push back with documentation. Fire and life safety inspections (often through the state fire marshal's office or local fire authority) run alongside health licensing inspections and frequently trip up new operators who didn't budget time or money for required upgrades like sprinklers or egress changes. Step three is staffing and policy. States generally require a policy and procedures manual covering medication management, resident rights, emergency preparedness, infection control, incident reporting, and staff training before they'll issue a license, and inspectors will ask to see it, more than take your word that it exists. Building all of this from scratch, state statute by state statute, is genuinely time-consuming, which is the exact gap our $299 one-time State Group Home Licensing Kit is built to close: state-specific application checklists and policy manual templates so you're not starting from a blank page. It doesn't replace your own state's application or guarantee approval, but it gets you to a complete submission faster.
How do I start a group home (application and inspection sequence)?
In practical sequence, most states (Maryland included) move through these stages: pre-application inquiry with the licensing agency, submission of the formal application with required attachments (policies, floor plans, staff qualifications, background check clearances), a pre-licensing survey/inspection of the physical site, correction of any cited deficiencies, and issuance of the initial license, which is often provisional or time-limited before a full license is granted. Maryland's OHCQ, for assisted living specifically, requires applicants to demonstrate compliance with Health-General Title 19, Subtitle 18 and COMAR Title 10 assisted living regulations before licensure, including administrator qualifications, staffing plans tied to resident level of care, and physical plant standards [1]. Background checks for staff and, in many states, the administrator or operator themselves, are non-negotiable and typically run through a state criminal background check unit; expect this step to take several weeks, not days. Expect at least one full inspection before your license is issued, and expect follow-up inspections (often annual, sometimes unannounced) after you're operating. OHCQ's public licensing and complaint information, mentioned earlier for looking up existing facilities, is the same kind of record that will eventually show your own inspection history once you're licensed, so treat your first survey as the baseline the public will see.
How to read a Maryland OHCQ inspection or survey report
An OHCQ survey report, sometimes called a Statement of Deficiencies, lists specific regulatory citations the surveyor found the facility out of compliance with, along with the facility's plan of correction. Reading one isn't complicated, but knowing what to weigh matters. Look for the date of the most recent survey first; a facility with no survey in three or four years may simply be due, or it may indicate a gap worth asking the facility directly about. Then look at the number and severity of citations. A single administrative citation (like a missing signature on a form) is very different from a citation tied to resident safety, medication errors, or elopement. OHCQ's complaint investigation reports, separate from routine surveys, show whether specific complaints were substantiated, which is often more revealing than the routine inspection alone. If a facility shows a pattern of repeat citations for the same issue across multiple survey cycles, that's a stronger signal than a single isolated finding. One bad survey happens to good facilities sometimes; a repeated pattern usually means a systemic problem in training or oversight.
What should you check before choosing or opening an assisted living facility?
A family vetting a facility and an operator sizing up the market before opening one need to run overlapping checklists: confirm the license is current and unrestricted, confirm the approved level of care matches actual needs, check the most recent survey and complaint history, verify staffing ratios and administrator credentials, and ask directly about medication management protocols. For families, add a site visit during a non-scheduled time (more than the tour appointment), a look at the posted staff schedule versus actual staff present, and a conversation with at least one current resident's family if possible. For operators evaluating where to locate a new facility, add local zoning research and a review of comparable facilities' license history in your target county to understand what local surveyors tend to scrutinize. Our guides on assisted living facilities, facility assisted living, and assisted living at home go deeper on specific operating models if you're still deciding which one fits your plan.
Frequently asked questions
What is assisted living?
Assisted living is a licensed residential care option where adults get help with daily living activities like bathing, dressing, and medication management, plus housing and meals, without the round-the-clock skilled nursing care of a nursing home. Rules and definitions vary by state; Maryland licenses it under Health-General Title 19, Subtitle 18 through OHCQ.
What is a group home?
A group home is a small residential facility, typically housing a handful to a dozen residents, that provides supervision and support for people with disabilities, mental illness, recovery needs, or age-related care needs. It's not one uniform license; depending on the state and population served, it might fall under assisted living, IDD, or behavioral health licensing categories.
What is an assisted living facility?
An assisted living facility is the licensed building and program where residents live and receive personal care and supervision. The license is tied to a specific address, operator, bed count, and approved level of care, and it must be verified through the state licensing agency, not assumed from marketing materials.
What is assisted living vs nursing home?
Assisted living supports daily living activities with limited health monitoring; a nursing home provides 24-hour licensed nursing care for serious medical needs and rehabilitation. Nursing homes are federally certified for Medicare/Medicaid participation under 42 CFR Part 483; assisted living is licensed only at the state level with no equivalent federal certification.
What does assisted living provide?
Assisted living generally provides housing, meals, help with bathing and dressing, medication reminders or management, housekeeping, transportation, and activities. Exact services depend on the facility's licensed level of care; higher levels (like Maryland's Level 3) allow more nursing oversight for residents with greater medical or cognitive needs.
How to start a group home?
Identify the correct license category for your population, meet state provider qualification and background check requirements, secure a zoning-compliant property, write required policy and procedure manuals, hire staff to required ratios, and pass a pre-licensing inspection. The specific agency, forms, and fees vary by state; confirm current requirements with your state licensing agency.
What is the difference between assisted living and nursing home?
Assisted living serves people who need help with daily tasks but not continuous medical care; nursing homes serve people needing ongoing skilled nursing, rehabilitation, or complex medical management. Nursing homes have RNs on-site 24/7 and can bill Medicare for qualifying short-term stays; assisted living generally cannot.
Does Medicare cover assisted living facilities?
No. Medicare does not cover room, board, or personal care costs at assisted living facilities. CMS covers only specific medical services a resident might receive there, like doctor visits or physician-ordered therapy, not the facility's monthly rate. Short-term skilled nursing facility stays after a qualifying hospitalization are a separate Medicare benefit.
How do I start a group home?
Confirm which state license category fits your intended population, submit a complete application with policies, floor plans, and staff qualifications, pass fire/life safety and health licensing inspections, and correct any cited deficiencies before licensure is issued. Timelines and requirements vary significantly by state and category, so start with your state licensing agency's specific checklist.
How do you look up a Maryland assisted living license?
Check the Office of Health Care Quality's public licensing and complaint information to confirm license status, level of care, and survey/complaint history for a facility. For full survey documents beyond the online summary, contact OHCQ's licensing division directly.
What are Maryland's assisted living levels of care?
Maryland licenses assisted living at three levels. Level 1 serves mostly independent residents needing light supervision. Level 2 serves residents with moderate, stable chronic conditions. Level 3 serves residents with significant medical or cognitive needs, sometimes including people who would otherwise need nursing home placement, with added nursing oversight requirements.
Does Medicaid pay for assisted living in Maryland?
Maryland Medicaid generally does not cover assisted living room and board, but eligible low-income residents may get help with personal care and health-related services through home and community-based services waiver programs. Eligibility and availability vary and should be confirmed directly with Maryland Medicaid and OHCQ.
Can a group home operate without a state license?
No. Operating a residential care facility for adults needing supervision or personal care without the required state license is illegal in essentially every state and can result in closure orders, fines, and in some cases criminal liability. Verify licensing requirements with your specific state's health or human services licensing agency before accepting residents.
Sources
- Maryland General Assembly, Health-General Article Title 19, Subtitle 18: Maryland licenses assisted living programs under Health-General Article, Title 19, Subtitle 18
- CMS.gov, Medicare Coverage of Skilled Nursing Facility Care: Medicare covers short-term skilled nursing facility stays following a qualifying hospitalization but does not cover assisted living room, board, or custodial care
- Medicaid.gov, Home & Community Based Services: Medicaid can cover personal care and health-related services in community settings through HCBS waiver programs, separate from room and board costs
- Electronic Code of Federal Regulations, 42 CFR Part 483: Nursing homes are subject to federal certification requirements tied to Medicare and Medicaid participation under 42 CFR Part 483
- Maryland General Assembly, Maryland Code, Health-General Article: Maryland law establishes requirements for assisted living program licensure levels and standards of care.
- Medicaid.gov: Home and Community-Based Services waivers may help cover certain long-term care services, distinguishing Medicaid's role from Medicare in covering assisted living-related supports.
- Electronic Code of Federal Regulations (eCFR): Federal regulations under 42 CFR Part 483 Subpart B outline requirements for long-term care facilities, relevant to distinguishing nursing home standards from assisted living.
- Maryland General Assembly, Maryland Code, Health-General Article: Maryland statute defines requirements and definitions applicable to assisted living program operators and facilities.