1. A. General Information Related to Licensure.

   1. (1) A licensee shall immediately notify the Department of any change in the information the licensee had submitted with the most recent application.
   2. (2) A license is valid only in the name of the licensee to whom it is issued, and is not subject to sale, assignment, or other transfer.
   3. (3) A license is valid only for the premises for which it was originally issued.
   4. (4) A licensee shall forward to the Department a copy of any report or citation of a violation of any applicable building codes, sanitary codes, fire safety codes, or other regulations affecting the health, safety, or welfare of residents within 7 calendar days of receipt of the report or citation. An assisted living program’s failure to notify the Department may result in the imposition of a sanction.

2. B. Increase in Licensed Beds.

   1. (1) An assisted living program may not provide assisted living services to more residents than the number of beds approved in writing by the Department.

   2. (2) To request an increase in the number of beds, a licensed assisted living program shall:

      1. (a) Submit the request for an increase in licensed beds on the form developed by and in the manner established by the Department; and
      2. (b) Attach the required documents, including, at a minimum, proof of compliance with all local requirements for fire safety, use and occupancy, and zoning permits.
   3. (3) If approved, the Department shall issue a new license to the assisted living program that includes the approved number of beds.
   4. (4) Upon receipt of a new license, all use of the previously issued assisted living program license shall cease.

3. C. Increase in Level of Care.

   1. (1) An assisted living program may not provide a higher level of care for residents than is approved by the Department unless a specific resident has a waiver to receive a higher level of care.

   2. (2) To request an increase in the level of care, an assisted living program shall:

      1. (a) Submit the request for an increase in the level of care on the form developed by and in the manner established by the Department; and
      2. (b) Attach supporting documentation, including any changes in staffing, training, or policies and procedures.
   3. (3) If approved, the Department shall issue a new license to the assisted living program that includes the approved level of care.
   4. (4) Upon receipt of a new license, all use of the previously issued assisted living program license shall cease.

4. D. Name Change.

   1. (1) An assisted living program shall have a revised license from the Department to change its name or the name under which the program is doing business.

   2. (2) To request a name change, an assisted living program shall:

      1. (a) Submit the request for a name change on the form developed by and in the manner established by the Department; and
      2. (b) Attach the required attachments, including a letter of good standing from the Maryland State Department of Assessments and Taxation (SDAT) Business Express.
   3. (3) Upon processing, the Department shall issue a new license to the assisted living program that includes the new name of the licensee.
   4. (4) Upon receipt of a new license, all use of the previously issued assisted living program license shall cease.

5. E. Change of Location.

   1. (1) Prior to operating an assisted living program at a new location, the applicant shall have an assisted living program license issued by the Department.

   2. (2) To request an assisted living program license for a new location, an applicant shall:

      1. (a) Submit an application for an assisted living program license on the form developed by and in the manner established by the Department; and
      2. (b) Submit all required attachments.

   3. (3) An assisted living program shall notify the Department in writing of a relocation:

      1. (a) Within 60 calendar days in advance of the effective date if licensed for 49 or fewer beds; or
      2. (b) Within 75 calendar days in advance of the effective date if licensed for 50 or more beds.

   4. (4) An assisted living program shall notify residents and resident representatives in writing of a relocation:

      1. (a) Within 60 calendar days in advance of the effective date if licensed for 49 or fewer beds; or
      2. (b) Within 75 calendar days in advance of the effective date if licensed for 50 or more beds.
   5. (5) If approved, the Department shall issue a license to the assisted living program at the new location.
   6. (6) Upon receipt of a new license, all use of the previously issued assisted living program license shall cease.

6. F. Change of Ownership — Sale, Transfer, or Lease of a Facility.

   1. (1) If a sale, transfer, or lease of a facility causes a change in the person or persons who control or operate the assisted living program, the assisted living program shall be considered a new program and the new owner shall apply for a license and conform to all regulations applicable at the time of transfer of operations.
   2. (2) The transfer of any stock which results in a change of the person or persons who control the program or the transfer of any stock in excess of 25 percent of the outstanding stock, constitutes a sale.
   3. (3) For the purposes of Life Safety Code enforcement, the program is considered an existing facility if it has been in continuous use as an assisted living program.

   4. (4) An assisted living program shall notify the Department in writing of a change of ownership, sale, transfer, or lease of a facility:

      1. (a) Within 60 calendar days in advance of the effective date if licensed for 49 or fewer beds; or
      2. (b) Within 75 calendar days in advance of the effective date if licensed for 50 or more beds.

   5. (5) An assisted living program shall notify residents and resident representatives in writing of a change of ownership, sale, transfer, or lease of a facility:

      1. (a) Within 60 calendar days in advance of the effective date if licensed for 49 or fewer beds; or
      2. (b) Within 75 calendar days in advance of the effective date if licensed for 50 or more beds.

   6. (6) If a change of ownership of the assisted living program is occurring, the new owner shall:

      1. (a) Submit an application for an assisted living program license on the form developed by and in the manner established by the Department; and
      2. (b) Submit all required attachments.
   7. (7) If approved, the Department shall issue a license to the assisted living program.
   8. (8) Upon receipt of a new license, all use of the previously issued assisted living licensee shall immediately cease.
   9. (9) A licensee named in the original license shall remain responsible for the operation of the assisted living program until a new license is issued to the new owner, and the current licensee shall remain responsible for correction of all outstanding deficiencies or impending sanctions until a new license is issued to the new owner.

7. G. Voluntary Closure.

   1. (1) An assisted living program shall notify the Department of any intention to voluntarily close:

      1. (a) Within 60 calendar days in advance of the closure if licensed for 49 or fewer beds; or
      2. (b) Within 75 calendar days in advance of the closure if licensed for 50 or more beds.

   2. (2) The assisted living program shall include the following information in the notice to the Department:

      1. (a) The method for informing residents and resident representatives of its intent to close, change ownership, change location, or sell its assisted living program; and
      2. (b) The actions the assisted living program will take to assist residents in securing comparable housing and assistance, if necessary.

   3. (3) An assisted living program shall notify residents and resident representatives of a voluntary closure, in writing:

      1. (a) Within 60 calendar days in advance of the closure if licensed for 49 or fewer beds; or
      2. (b) Within 75 calendar days in advance of the closure if licensed for 50 or more beds.

   4. (4) The assisted living program shall provide at least weekly updates to the OHCQ, including:

      1. (a) Number of residents remaining in the facility;
      2. (b) Number of residents with plans for relocation; and
      3. (c) Number of residents with no plans for relocation.

   5. (5) In addition to the notice to the Department required by §B of this regulation, after a program closes, the assisted living program shall:

      1. (a) Notify the Department of the date of closure and the place of relocation of each resident; and
      2. (b) Cease all use of the previously issued assisted living program license.

8. H. Voiding of License.

   1. (1) Maryland State Department of Assessments and Taxation (SDAT).

      1. (a) A licensed assisted living program shall remain in good standing with (SDAT).
      2. (b) If the assisted living program fails to return to good standing 60 calendar days after receipt of notification of noncompliance from SDAT or another government agency, the Department may void the assisted living program’s license.

   2. (2) Ceases the Provision of Services.

      1. (a) A license is void if the assisted living program ceases to provide services to residents for a period of 180 consecutive days.
      2. (b) The owner shall immediately cease all use of the previously issued assisted living program license when the license is voided.

9. I. Surrender of License.

   1. (1) Unless the Department agrees to accept the surrender of a license, an assisted living program may not surrender a license to operate an assisted living program nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.
   2. (2) The Department may set conditions on its agreement with the licensee under investigation or against which charges are pending to accept surrender of the license.

Authority: Health-General Article, Title 19, Subtitle 18, Annotated Code of Maryland

Effective date: January 1, 1999 (25:26 Md. R. 1923)

Regulation .02B amended effective November 1, 1999 (26:22 Md. R. 1692); July 22, 2002 (29:14 Md. R. 1074)

Regulation .02B amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .03 amended effective August 21, 2000 (27:16 Md. R. 1523)

Regulation .04 amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .06 amended as an emergency provision effective August 15, 2000 (27:18 Md. R. 1664); amended permanently effective November 27, 2000 (27:23 Md. R. 2147)

Regulation .06E adopted effective March 29, 2004 (31:6 Md. R. 508)

Regulation .09B, C amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .12D, E amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .15-1 adopted effective October 10, 2005 (32:20 Md. R. 1655)

Regulation .15-2 adopted effective October 10, 2005 (32:20 Md. R. 1655)

Regulation .17B amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .17E—G adopted effective October 10, 2005 (32:20 Md. R. 1655)

Regulation .21F, K amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .21P adopted effective March 29, 2004 (31:6 Md. R. 508)

Regulation .26A amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .27C, E amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .28D amended, and E—K adopted, effective November 1, 1999 (26:22 Md. R. 1692)

Regulation .29B amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .36A amended effective March 29, 2004 (31:6 Md. R. 508); December 19, 2005 (32:25 Md. R. 1941)

Regulation .46 amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .49B amended effective July 22, 2002 (29:14 Md. R. 1074)

Regulations .01—.53 repealed and new Regulations .01—.64 adopted effective December 29, 2008 (35:26 Md. R. 2249)

Regulation .07A amended effective August 19, 2013 (40:16 Md. R. 1344); August 29, 2016 (43:17 Md. R. 953); March 13, 2017 (44:5 Md. R. 292)

Regulation .07C amended effective March 13, 2017 (44:5 Md. R. 292)

Regulation .13A amended effective June 25, 2012 (39:12 Md. R. 745)

Regulation .24D amended effective June 25, 2012 (39:12 Md. R. 745)

Regulation .29 amended effective June 25, 2012 (39:12 Md. R. 745)

Chapter revised effective April 28, 2025 (52:8 Md. R. 357)