1. A. Definition. “Unit of service” means a day of service and does not include days that the participant was not residing in the provider's assisted living facility, meaning that the participant:

   1. (1) Had not yet moved into the facility;
   2. (2) Had moved out of the facility;
   3. (3) Was an inpatient at a hospital, nursing facility, or other medical institution for one or more nights; or
   4. (4) Was absent from the provider's facility for more than 7 nights during a calendar month at the participant's choice for personal reasons, such as to visit family or take a vacation.

2. B. Assisted living services shall include the provision of:

   1. (1) A structured, supportive environment in a home-like setting;

   2. (2) Personal care and chore services including:

      1. (a) Assisting the participant, as necessary, with performing activities of daily living and instrumental activities of daily living, including cuing the participant to perform these activities;
      2. (b) Routine housekeeping, laundry, household care, and chore services needed to maintain the facility as a clean, sanitary, and safe environment; and
      3. (c) Menu planning, food shopping, and meal preparation and serving;

   3. (3) Basic personal hygiene supplies, including but not limited to:

      1. (a) Soap;
      2. (b) Bathroom tissue;
      3. (c) Paper towels;
      4. (d) Toothpaste;
      5. (e) Toothbrush; and
      6. (f) Shampoo;
   4. (4) 24-hour supervision of participants to assure health and safety;
   5. (5) Assistance with medication administration, in accordance with COMAR 10.27.11 and COMAR 10.07.14;
   6. (6) Recreational and social activities;
   7. (7) Reminding the participant of medical appointments;
   8. (8) Assistance with transportation arrangements to Program and other needed services;
   9. (9) Conferring with the participant's case manager about the participant's status and service needs;
   10. (10) Assisting the participant in accessing needed medical or mental health services in emergency situations; and
   11. (11) Other services specified for assisted living programs in COMAR 10.07.14.
3. C. Assisted living services shall reflect the participants' individualized needs and preferences.
4. D. Assisted living services reimbursed under this chapter may not include room and board.

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Effective date: June 11, 2012 (39:11 Md. R. 687)

Regulation .40C amended effective July 4, 2016 (43:13 Md. R. 712)

Regulation .41 amended effective July 4, 2016 (43:13 Md. R. 712)

Regulation .41 repealed effective December 11, 2025 (52:23 Md. R. 1198)

Regulation .41 adopted effective December 11, 2025 (52:23 Md. R. 1198)