This is the one page on the site worth reading slowly if you're new to the DC metro: three jurisdictions, three regulators, three sets of rules, all within a 25-mile radius. A community licensed in Bethesda answers to a completely different regulator than one two miles away in Chevy Chase, DC, or twenty minutes south in Alexandria. None of it is interchangeable, and knowing which system applies to which building is exactly the kind of thing a generic national placement service gets wrong.
Below: the regulator, the license type, and how to verify it yourself, for each of the three jurisdictions DC Senior Advisor covers.
District of Columbia
The District regulates assisted living through DC Health's Health Regulation and Licensing Administration under the Assisted Living Residence Regulatory Act of 2000 (D.C. Official Code Section 44-101.01 et seq.). DC Medicaid, run by the Department of Health Care Finance, offers home- and community-based support through the Elderly and Persons with Physical Disabilities (EPD) Waiver, and the DC Department of Aging and Community Living (DACL) is the District's free options-counseling agency and Area Agency on Aging.
- Regulator: DC Health, Health Regulation and Licensing Administration (HRLA)
- Assisted living license: an Assisted Living Residence license under the Assisted Living Residence Regulatory Act of 2000 (D.C. Official Code Section 44-101.01 et seq.)
- Medicaid home care: the Elderly and Persons with Physical Disabilities (EPD) Waiver
- Verify a license: DC Health's Health Regulation and Licensing Administration inspection and licensing records
Maryland (Montgomery & Prince George's counties)
Maryland licenses assisted living through the Department of Health's Office of Health Care Quality (OHCQ) under COMAR 10.07.14, rating each program Level 1 through 3 by service intensity, while nursing homes are OHCQ-licensed comprehensive care facilities. Maryland Medical Assistance funds home- and community-based care through the Community Options Waiver and Community First Choice, and Montgomery and Prince George's counties each run their own Area Agency on Aging alongside the statewide Maryland Access Point (MAP) referral line.
- Regulator: the Maryland Department of Health, Office of Health Care Quality (OHCQ)
- Assisted living license: an Assisted Living Program license under COMAR 10.07.14, rated Level 1, 2, or 3 according to how much hands-on care the program is approved to provide
- Medicaid home care: the Community Options (CO) Waiver and Community First Choice (CFC), with the Senior Assisted Living Group Home Subsidy available to some lower-income assisted living residents
- Verify a license: the Maryland OHCQ facility directory and published survey results
Northern Virginia (Arlington, Alexandria & Fairfax)
Northern Virginia's assisted living facilities are licensed by the Virginia Department of Social Services (VDSS) under 22VAC40-73, while the Virginia Department of Health (VDH) licenses nursing facilities separately. Virginia Medicaid, run by DMAS, now delivers managed care under the Cardinal Care umbrella, and the Auxiliary Grant - co-administered with the Department for Aging and Rehabilitative Services (DARS) - helps eligible residents cover assisted living room and board. Arlington, Alexandria, and Fairfax each operate their own Area Agency on Aging.
- Regulator: the Virginia Department of Social Services (VDSS), Division of Licensing Programs, for assisted living, and the Virginia Department of Health (VDH), Office of Licensure and Certification, for nursing facilities
- Assisted living license: an Assisted Living Facility (ALF) license issued by VDSS under 22VAC40-73
- Medicaid home care: Cardinal Care/CCC Plus home- and community-based waiver services, plus the Auxiliary Grant, which helps cover room and board in an assisted living facility or adult foster care home and is jointly administered with the Department for Aging and Rehabilitative Services (DARS)
- Verify a license: the VDSS assisted living facility search tool and VDH nursing-facility inspection records
Why this matters when you tour
Because the three systems don't cross-recognize each other, a license problem in one jurisdiction has no bearing on a community two miles away in a different one - you have to check each community against its own regulator. That's part of why DC Senior Advisor tracks all three side by side rather than specializing in just one, and why we recommend every family verify a license themselves before touring, not just take a community's word for it.
