Nursing Home
The Maryland Health Care Commission (MHCC) regulates nursing homes, also known as Comprehensive Care Facilities (CCFs), in Maryland to support quality care, demonstrated need, and appropriate distribution of long-term care resources across the state. This page provides an overview of how nursing homes are regulated, along with access to facility data, reports, and information on Certificate of Need and related regulatory processes.
About Nursing Homes / Comprehensive Care Facilities (CCF) in Maryland
A Comprehensive Care Facility (CCF), commonly referred to as a nursing home, is a licensed health care facility that provides 24-hour nursing care and supervision, as well as assistance with daily living activities, to individuals who require ongoing medical and personal care. Services may include skilled nursing care, rehabilitation services, and long-term custodial care.
The Maryland Health Care Commission (MHCC) regulates Comprehensive Care Facilities through the Certificate of Need (CON) program. MHCC reviews and approves the establishment of new facilities, expansions of bed capacity, relocations, and certain changes in services to ensure consistency with the State Health Plan, demonstrated need, and appropriate distribution of long-term care resources. MHCC may also review proposed changes in ownership or control through its review processes, as applicable.
Quick Facts: Comprehensive Care Facilities
A Comprehensive Care Facility (CCF), commonly known as a nursing home, provides 24-hour nursing care, rehabilitation, and long-term custodial care.
Establishing, relocating, or expanding bed capacity
- Requires Certificate of Need (CON) review
Certain changes in services
- May require CON review
Acquisitions and ownership changes
- Review pathway varies by transaction type, from determination review to formal acquisition application
Facility Data and Reports
Quality & Performance
Access information on the quality and performance of nursing homes in Maryland.
Facility Data
Request public use files containing inventory and utilization information on nursing homes in Maryland.
Reports
Browse staff reports and recommendations on nursing home facilities in Maryland, prepared by the Commission in accordance with the State Health Plan.
Regulatory Process
Comprehensive Care Facilities (CCFs) in Maryland are subject to the Certificate of Need (CON) program administered by the Maryland Health Care Commission (MHCC). A CON is required for the establishment of a new facility, expansion of bed capacity, relocation, or certain changes in services. Applicants must demonstrate need and meet State Health Plan standards as part of the CON review process.
The CON process begins with the submission of a Letter of Intent (LOI), followed by a pre-application conference with MHCC staff. The applicant then files a formal CON application, which is reviewed by MHCC for completeness. Once deemed complete, the application enters a formal review period that includes opportunities for public comment and, if applicable, comparative review with competing applications. The CON review schedules are posted on the MHCC website.
MHCC staff evaluate the application in accordance with the State Health Plan and applicable review criteria, including project need, cost-effectiveness, impact on existing providers, financial feasibility, and health equity. A staff report and recommendation are prepared and presented to the Commission. The Commission then issues a final decision to approve, approve with conditions, or deny the application.
The Commission administers an annual survey application, conducted by the Health Facility Planning division around the first quarter of every year.
Acquisitions or changes involving a Comprehensive Care Facility (CCF) may be subject to review by the Maryland Health Care Commission (MHCC), depending on the nature of the transaction. There are several types of acquisitions, including real property acquisitions, transfers of ownership (operations), and changes involving existing owners.
Certain transactions, such as a change of existing owners without changes to operations or services, may be reviewed through a determination Other transactions, particularly those involving the acquisition of bed rights, operations or control of a nursing home facility, require the submission of a formal acquisition application which may be subject to Commission review.
On October 1, 2024, new Nursing Home Acquisition legislation went into effect. Senate Bill 1000/HB 1122 (Chs. 816 and 817). This legislation was a part of a broader revision to the State Health Plan for Facilities and Services: Comprehensive Care Facility (Nursing Home) Services MD COMAR 10.24.20.
Before closing on a contractual arrangement to acquire a health care facility that exists pursuant to a Certificate of Need or other authority recognized by the Commission, the person acquiring the facility shall notify the Commission in writing regarding the intent to acquire the facility, and must include certain information as required in the attached forms.
Contact Us
Any questions regarding the process, the procedural rules, or the State Health Plan Chapter related to a Notice of an Acquisition or Transfer of Ownership Interest may be directed to:
Director, Health Care Facilities Planning and Development
Maryland Health Care Commission
wynee.hawk1@maryland.gov
mhcc.confilings@maryland.gov.