Assisted Living Facilities: Finding Information on ALF Licensing & Renewal

The Maryland Department of Health and Mental Hygiene, through the Office of Health Care Quality, requires you to obtain a license to operate an assisted living facility. COMAR 10.07.14.03

• Before October 1, 2006, the penalty for not obtaining a license was a misdemeanor with a penalty of $1,000 for a first offense. (Fines increased for later violations.)

• As of October 1, 2006, you can be charged with a felony for operating without a license. The penalty can be up to 5 years in jail and/or a fine of up to $10,000.  Although not in the Maryland Code, COMAR states that in addition to the criminal penalties, a person found to be operating an assisted living facility without a license is also subject to a civil fine up to $10,000.

• A person may not falsely advertise that an assisted living facility provides a service that it is not licensed to provide.  The penalty for false advertising is a civil fine up to $10,000.

The Basics of ALF Licensing and Renewal in Maryland

Oversight agency - The Maryland Office of Health Care Quality (OHCQ) oversees assisted living facilities as well as other health care facilities. OHCQ is a part of the Maryland Department of Health and Mental Hygiene.

Who may apply – An individual who is 21 or older may apply for an assisted living provider license.  In addition to the age requirement, an applicant will be required to provide:

1. Documentation of any prior denial, suspension, or revocation of a license or certification to provide care to third parties;
2. Documentation of any felony conviction of the applicant, assisted living manager, or household member;
3. Ownership information as specified on an addendum to the application;
4. Verification that the facility is owned, leased, or otherwise under the control of the applicant;
5. The level of care to be provided by the assisted living program, its location, and the name of the proposed assisted living manager;
6. Documentation of zoning approval, if zoning approval is required by the local jurisdiction in which the assisted living program will be located; and
7. Notification to the local health department and local area agency on aging of the ALF's request for licensure.

License suspension and license revocation – The state has the right to suspend or revoke your license to operate an ALF. The notice must be in writing and tell you the reasons for its action. COMAR 10.07.14.52 You have 30 days to request a hearing. If you ask for a hearing, you can continue to operate until the hearing decision. COMAR 10.07.14.53

Initial Applications COMAR 10.07.14.06

As of October 2007,

• Application packets are not available on-line – If you are interested in obtaining an assisted living facility license, you must contact the Office of Health Care Quality by phone, mail or in person. They will send you a comprehensive application. The packet will include all of the forms that you need in order to apply. In addition, the packet will include descriptions of the regulations that you must follow. (Online application packet will be available soon.)

• Fees - Be prepared to pay an application fee of $200 and a materials fee of $25 for a total of $225. The fee must be paid either by business checks or money orders. Each fee requires a separate check made payable to “DHMH”. Please note, the $200 application fee applies to those facilities containing 15 or fewer beds. If your facility will have more than 15 beds, you will be required to submit an additional $12 per each additional bed over 15.

License Limitations COMAR 10.07.14.03

• A separate license is required for each assisted living program. This is true even when the same person operates the programs. For example, Joe operates two facilities in two separate houses on the same street. He buys all of his supplies together and the staff rotates between the facilities. He needs two licenses.

• A license is issued for a specified number of beds and a specified level of care.

• You are not permitted to provide services beyond the authority granted to you by the license.

License Renewal COMAR 10.07.14.06

• Your license must be renewed every two years. The Office of Health Care Quality recommends that you apply for license renewal at least 90 days before your two-year license expires.

• In order to renew the license, you must contact the OHCQ either by phone, mail, or in person to request a renewal application. There is no on-line application. The State will send out a surveyor to conduct an inspection before the renewal license is granted.