How to Report an Assisted Living Complaint in Maryland

Where to File a Complaint

Maryland handles assisted living complaints through two separate channels, depending on the nature of the concern.

Office of Health Care Quality (OHCQ) — the primary regulatory body for all licensed assisted living programs in Maryland. OHCQ investigates complaints about facility licensing violations, inadequate staffing, medication errors, unsafe conditions, abuse, neglect, and exploitation. You can file by phone, mail, or through the OHCQ website.

Long-Term Care Ombudsman Program — an independent advocacy program that focuses on residents' rights and quality-of-life concerns. The ombudsman handles complaints about involuntary discharge notices, billing disputes, restrictions on visitors, loss of personal belongings, and dignity-of-care issues. Ombudsman services are free, confidential, and available to any resident of a licensed facility or their family.

For serious safety concerns — suspected physical abuse, sexual abuse, medication administration errors causing harm, or conditions that put residents at immediate risk — report to OHCQ first. Ombudsman complaints are appropriate for quality-of-care concerns that are not immediately dangerous but are degrading the resident's wellbeing.

Both channels accept complaints from family members; you do not need to be the resident to file.

What to Include in Your Complaint

A vague complaint ("the care isn't good") is harder to investigate than a specific one. When filing, document:

• Dates and times of the incidents you are reporting
• Names of staff members involved, if known
• What you observed — describe the specific behavior, condition, or failure (e.g., "my mother was found on the floor at 3 AM and staff said they last checked on her at 11 PM" is more actionable than "they don't check on her enough")
• Photos of injuries, unsanitary conditions, or hazardous environments, if you have them
• Prior complaints — note if you have raised the issue with facility management and what their response was

If you are concerned about retaliation — the facility reducing your parent's level of care, restricting your visits, or threatening discharge in response to a complaint — state that concern explicitly so it is part of the complaint record, and ask OHCQ or the ombudsman what protections and next steps apply.

What Happens After You Report to OHCQ

OHCQ prioritizes complaints by severity. For allegations of conditions that have caused or are likely to cause serious injury or death, report the danger immediately and state clearly that it is an urgent safety concern. For other regulatory violations, provide the specific facts and ask OHCQ how the complaint will be handled and when to expect follow-up.

Investigations may include unannounced facility visits, staff interviews, record reviews, and interviews with the resident and family. If OHCQ confirms violations, it may cite the facility and require corrective action; further enforcement depends on the severity and the facility's history.

You can check a facility's complaint and inspection history through the OHCQ public database — useful both for evaluating facilities before placement and for understanding whether your complaint is part of a pattern.

When the Ombudsman Is the Right Call

The Long-Term Care Ombudsman is the better path for concerns that are not safety emergencies but are seriously affecting your parent's daily life:

• Involuntary discharge notice. Maryland facilities must follow specific regulatory protocols before discharging a resident. The ombudsman can explain the resident's rights, review whether the facility followed proper procedures, and help the family challenge a discharge that violates the regulations.
• Billing changes without adequate notice. If the facility increased the monthly rate or added new charges, ask the ombudsman to review whether the change matches the Uniform Disclosure Statement and contract.
• Restriction of family visits. If a facility restricts visiting hours or family access, ask the ombudsman to review the reason and process.
• Care plan disagreements. If the family disagrees with the facility's care plan — particularly around medication changes, activity restrictions, or the use of physical or chemical restraints — the ombudsman can advocate for a care conference and represent the resident's interests.

Ombudsman services are free and confidential. They do not replace OHCQ for regulatory enforcement, but they provide hands-on advocacy that OHCQ's investigation process is not designed to deliver.

Protecting Your Parent During the Process

Filing a complaint does not require removing your parent from the facility. In many cases, the complaint process leads to improved care — the facility corrects the deficiency, adjusts staffing, or modifies the care plan. But if you believe your parent is in immediate danger, you are not required to wait for an investigation to conclude before making a change.

If you need to move your parent to a different facility, the transition process involves the same licensing verification and care level assessment as the original placement. Before moving, confirm how the parent's coverage and authorization will transfer and that the new facility participates in the relevant program (HCBOW for assisted living or standard Medicaid for nursing homes).

For families navigating both complaints and broader care coordination — from facility evaluation to Medicaid program transitions — the Maryland Dementia & Memory Care Guide covers the regulatory framework and family advocacy process alongside the financial and placement planning.

See more Maryland guides →