Operating an ALF in the State of Maryland requires a license issued by the Office of Health Care Quality,
which is the regulatory agency for ALFs in the state. See the following regulation as to how to properly
ensure good standing with the issued license:
.07 Licensing Procedure.
A. Application for License.
(1) To obtain and maintain a license, an applicant shall meet all of the requirements of:
(a) This chapter;
(b) Other applicable federal, state, and local laws and regulations; and
(c) Health-General Article, §19-311, Annotated Code of Maryland, if the program provides services to 17 or
(2) An applicant shall submit:
(a) An application on a written or electronic form developed by the Department;
(b) The completed Uniform Disclosure Statement on a form developed by the Department; and
(c) A nonrefundable license fee.
(3) Fees. The annual license fee schedule for assisted living programs is as follows:
(a) 1—4 beds — $50 annually;
(b) 5—15 beds — $75 annually;
(c) 16—49 beds: — $125 annually;
(d) 50—99 beds: — $165 annually;
(e) 100—149 beds: — $250 annually; and
(f) 150 plus beds: — $375 annually.
(4) If a facility fails to comply with the regulations of this chapter and requires the Department to conduct more
than one on-site pre-licensure visit, the Department may:
(a) Charge $250 per additional on-site visit; or(b) Deny the license.
(5) At a minimum, the applicant shall provide:
(a) Verification that the applicant or corporate representative is 21 years old or older;
(b) Documentation of any prior denial, suspension, or revocation of a license or certification to provide care
to third parties;
(c) Identification of any individual or corporate owner of 25 percent or more interest in the assisted living
(d) Documentation of any conviction and current criminal background check or criminal history records
check of the owner, applicant, assisted living manager, alternate assisted living manager, other staff, and any
(e) Ownership information as specified on an addendum to the application;
(f) Verification that the facility is owned, leased, or otherwise under the control of the applicant;
(g) The level of care to be provided by the assisted living program, its location, and the name of the proposed
assisted living manager;
(h) Documentation of zoning approval, if zoning approval is required by the local jurisdiction in which the
the assisted living program will be located; and
(i) Where applicable, approvals from the local health department, local or state fire authority, and local area
agency on aging.
B. Additional Requirements for Initial Licensure.
(1) The Secretary shall require an applicant for initial licensure to submit:
(a) Information concerning any license or certification held by the applicant under Health Occupations
Article or Health-General Article, Annotated Code of Maryland including the prior or current operation by the
the applicant of a health care facility or similar health care program;
(b) Information demonstrating financial or administrative ability to operate an assisted living program in
compliance with this chapter, which shall include a business plan and 1-year operating budget;
(c) Policies and procedures to be implemented as designated in the application for licensure; and
(d) Other reasonably relevant information, if required by law or local jurisdiction, such as:
(i) Verification of Workers’ Compensation insurance;
(ii) Facility plan review documentation;
(iii) Foodservice permit; and
(iv) Rental license. (2) The owner, manager, alternate manager, or board member of an assisted living program that has had its license suspended or revoked by the Department may not own, operate, lease, or manage another assisted living program for 10 years without good cause shown. After 10 years, the applicant shall submit evidence to the
Department that the applicant is capable of owning, managing, or operating an assisted living program.
(3) If an owner, manager, or alternate manager of an assisted living program operates, leases, or manages an
assisted living facility and the facility has had sanctions imposed or deficiencies cited within the last 2 years and has
not corrected the deficiencies which present a risk to the health or safety of residents for a currently licensed assisted
the living facility, that owner, manager, or alternate manager may not apply to open an additional assisted living facility
until those deficiencies have been corrected as approved by the Department.
(4) The Department reserves the right to deny licensure for an assisted living program based on the owner’s or
(a) History of violations of assisted living regulations; or
(b) Criminal history that the Department determines may be potentially harmful to residents.
(5) Based on the information provided to the Department by the applicant and the Department’s own investigation,
the Secretary shall:
(a) Approve the application unconditionally;
(b) Approve the application conditionally, which may include, among other conditions, requiring the
applicant to use the services of a management firm approved by the Secretary; or
(c) Deny the application.
(6) The Secretary may not require the use of a management firm for a period in excess of 24 months.
(7) A licensee may not:
(a) Operate an assisted living program until a provisional license or license has been issued; or
(b) Operate multiple sites until each site has been inspected and approved by the Department.
(8) A person aggrieved by a decision of the Secretary under this section to deny a license application may
appeal the Secretary’s action by filing a request for a hearing consistent with Regulation .64 of this chapter.
C. Duration of License.
(1) A license is valid for 2 years from the date of issuance unless suspended or revoked.
(2) License Renewal. A licensee shall apply for license renewal:
(a) At least 30 days before the expiration of its current license;
(b) On written or electronic forms provided by the Department; and
(c) By submitting a license renewal fee based on the fee schedule in §A(3) of this regulation.
D. Licenses for Less than 2 Years. The Department may issue a provisional license if:(1) An assisted living program is not in full compliance with this chapter:
(a) But in the opinion of the Department, the noncompliance does not constitute a safety or health hazard; and
(b) The applicant or licensee has submitted a plan of correction acceptable to the Department which
satisfactorily addresses the correction of each deficiency within a time frame acceptable to the Department; or
(2) Departmental administrative delays have occurred which:
(a) Are beyond the control of the applicant or licensee; and
(b) Have prevented the Department from completing its licensure activity