New assisted living regulations that were “many years in the making” have been finalized, with Maryland senior living organizations working to support providers as they work to comply.

The updated regulations went into effect April 28 and cover manager requirements, staffing levels, services, resident rights, licensing, staff training and emergency preparedness. 

According to the Maryland Department of Health’s Office of Health Care Quality, the process of updating the regulations began in 2015 and involved hundreds of stakeholders through multiple in-person and online public meetings and comments.

The OHCQ stated that the purpose of the updated rules was to “set minimum, reasonable standards for licensure of assisted living programs” in Maryland and to maximize independence and promote individuality, personal dignity, freedom of choice and fairness for residents.

Allison Roenigk Ciborowski, LeadingAge Maryland’s president and CEO, told McKnight’s Senior Living that she is glad that the updates have been finalized and that the organization is working to support its members to fully comply with the new requirements. 

Similarly, LifeSpan Network said it appreciates that the regulations have finally been enacted, adding that it is working with OHCQ, its membership and the industry to educate assisted living programs on the changes.

“We do believe that the regulations will increase quality and remove unnecessary administrative burdens from providers, that will subsequently provide more opportunity to focus on care and services,” LifeSpan President Kevin Heffner told McKnight’s Senior Living. “We are also glad to see that OHCQ has increased its survey capabilities and will be able to achieve the requirements under the law.”

The regulations clarified terminology, including the addition of a new definition for assisted living: a residential or facility-based program for two or more beds that provides housing and supportive services. 

Among the changes are requirements and licensure processes for assisted living managers that are targeted to go into effect in July 2026. Under the rules, managers must have a four-year college degree, two years of experience in the healthcare field and one year of experience as an assisted living manager, or two years of experience in the healthcare field with the completion of an 80-hour assisted living manager training course. The course includes education on bloodborne pathogens, safe injections practices, personal protection equipment and cleaning/disinfection equipment. Managers also are required to take a CPR course.

A resident bill of rights also must be created and posted by each community. Additionally, assessments for new residents must be completed before move-in by the assisted living manager in collaboration with the community’s director of nursing.

Also, admission requirements now prohibit of discrimination of anyone based on race, color, national origin, sexual orientation, gender identity, religion, physical or mental disability. 

Communities also now must have “sufficient” staff to comply with the standards of care for a community’s residents, and assisted living communities that have memory care units will be required to have awake overnight staff. Direct care staff members also will be required to complete six hours of behavioral health training.