Licensing Procedure

  1. 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 more residents.

(2) An applicant shall submit:

(a) An application on a 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] 2-year license fee schedule for [assisted living] programs is as follows:

(a) 1—4 beds: [$200 annually] $400;

(b) 5—15 beds: [$300 annually] $600;

(c) 16—49 beds: [$450 annually] $900;

(d) 50—99 beds: [$650 annually] $1300;

(e) 100—149 beds: [$1,000 annually] $2,000; and

(f) 150 plus beds: [$1,500 annually]  $3,000.

(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) If a facility fails to file a timely renewal application, the facility shall pay a late fee of $10 per day, which shall begin accruing on the license expiration date, in addition to the renewal fee.

(6) 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 program;

(d) Signed disclosure form, provided by the Department, of any previous convictions and [Documentation] 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 household member;

(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;

(g) The program’s location and the name of the proposed manager;

(h) Documentation of zoning approval, if zoning approval is required by the local jurisdiction in which 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.

  1. 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 applicant of a health care facility or similar health care program;

(b) Information demonstrating financial [or]and administrative ability to operate [an assisted living] a 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 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] a program based on the owner’s or manager’s prior:

(a) History of violations of assisted living regulations; [or]

(b) Criminal history that the Department determines may be potentially harmful to residents.

(b) Convictions of the following crimes:

(i) a conviction as described in 42 U.S.C. § 1320A–7(A);or

(ii) a conviction as described in Criminal Law Article, §14-101, Annotated Code of Maryland; or

(c) Behavior that shows the owner or manager cannot be trusted to comply with statutes and regulations related to the operation of assisted living programs.

(5) In making a determination about a license application, the Department shall consider the following factors:

(a) The age at which the crime was committed;

(b) The circumstances surrounding the crime;

(c) The length of time that has passed since the crime;

(d) Subsequent work history;

(e) Employment and character references; and

(f) Other evidence that demonstrates whether the applicant poses a threat to public health or safety.

(6) 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.

(7) The Secretary may not require use of a management firm for a period in excess of 24 months.

(8) 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.

(9) 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] .59 of this chapter.

  1. 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] 14 days before the expiration of its current license;

(b) On forms provided by the Department; and

(c) By submitting a license renewal fee based on the fee schedule in §A(3) of this regulation.

  1. Licenses for Less than 2 Years. The Department may issue a provisional license if:

(1) [An assisted living] A 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; or

(3) A licensee has failed to file a timely and sufficient renewal application but has subsequently filed a sufficient renewal application and paid all required fees

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