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Senate Bill 509 Health Care Facilities - Nursing Homes - Acquisitions and Licensure

Nursing Home Acquisitions and Licensures Recommendations Report released January 10, 2024 

Maryland law (SB509/HB288) requires the Maryland Health Care Commission (MHCC), when evaluating a notice of acquisition or transfer of interest of a nursing home, to provide specified written findings and recommendations to the Office of Health Care Quality (OHCQ). The Secretary of Health must consider MHCC’s findings and recommendations before taking action to approve, deny, approve with conditions, or revoke a nursing home license. 

By December 1, 2023, MHCC, in consultation with specified stakeholders, must (1) complete a specified study regarding the expansion of the Certificate of Need (CON) program over the acquisition of nursing homes and (2) submit a specified report to the Senate Finance Committee and the House Health and Government Operations Committee. The bill’s provisions relating to the required study and report take effect July 1, 2023. 

Workgroup Co-Chairs

Jeanne-Marie Gawel, Acting Chief, Certificate of Need  410.764.3371 (

Stacy Howes, Chief, Long Term Care and Health Benefit Plan Quality Initiatives  410-764-3575 (

Workgroup Members

Meeting 6: Thursday, December 7, 11:00 am - 12 noon 

Meeting 5: Monday, November 13, 2023, 10 am - noon

Meeting 4: Friday, September 15, 12 noon - 2:00 pm

Meeting 3:  Friday, August 25, 2:30 pm - 4:30 pm 

Meeting 2: Friday, August 4, 2023 2 pm - 4 pm 

Meeting 1:  Friday, July 14, 2023 10 am - 12 noon 

Tentative Upcoming Dates 

Friday October 27 10a-12p

Additional Resources

COMAR 10.24.20 State Health Plan for Facilities and Services: Comprehensive Care Facilities 

ASPE Changes in Ownership of Skilled Nursing Facilities from 2016 to 2021: Variations by Geographic Location and Quality July 7, 2022 

GAO Nursing Homes: CMS Should Make Ownership Information More Transparent for Consumers January 2023

JAMA Health Forum Association  of Private Equity Investment in US Nursing Homes with the Quality and Cost of Care for Long-Stay Residents  November 19, 2021 

The Wall Street Journal The Upheaval at America's Disappearing Nursing Homes, in Charts August 23, 2023

White House Fact Sheet  Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes February 28, 2022

Washington Post An investment firm snapped up nursing homes during the pandemic. Employees say care suffered. December 2020 

CMS Provider Data Catalog Nursing Homes including rehab services datasets Ownership  updated June 1, 2023

Last Updated: 4/29/2024