Last verified: October 2026
What is an Alzheimer's Special Care Unit in Maryland?
It is a distinct part of a licensed assisted living program designed for people with Alzheimer's disease or a related dementia, and Maryland requires written OHCQ approval before a program operates, advertises or markets one.
COMAR 10.07.14.32: a program needs written OHCQ approval before operating, advertising or marketing an Alzheimer's Special Care Unit, and must give the unit's written description to anyone who asks and to the family before admission. The description must cover staff-to-resident ratios over 24 hours, awake overnight staff, at least 6 hours of advanced cognitive-impairment training for direct-care staff (2 hours communication, 2 behavioral interventions, 2 meaningful activities), admission and discharge criteria, activities and the unit's fee structure.
Source: COMAR 10.07.14.32
How many Baltimore-area programs report memory care?
103 programs in the Baltimore metro report either special care beds to OHCQ (51 programs) or a secure Alzheimer's unit to the Maryland Health Care Commission.
The memory care directory lists each one with beds, level and reported rates. A program that markets "memory care" but cannot produce an OHCQ-approved unit description is a red flag worth reporting.
What should the unit description tell you?
Use it as a checklist on the tour.
| Item the description must include | What to ask |
|---|---|
| Staff-to-resident ratio over 24 hours | What is it at 2 a.m., and who covers breaks? |
| Use of awake overnight staff | Is someone awake on the unit all night, not just in the building? |
| 6 hours of advanced dementia training | Who has completed it, and how is it refreshed each year? |
| Admission and discharge criteria | What behavior would lead to a discharge notice? |
| Activities, frequency and type | Can we see this week's activity calendar for the unit? |
| Fee or fee structure | What does the unit cost compared with assisted living here? |
Does the description have to stay current?
Yes. The rule requires the description to reflect how the unit actually operates, and substantive changes must be resubmitted to OHCQ, which responds within 30 days.
OHCQ can restrict admissions or close a unit that does not comply or puts residents at risk. If what you see on a tour does not match the description, raise it with the manager and, if needed, with OHCQ's assisted living unit at (410) 402-8217.
Is a secure unit the same as a locked psychiatric unit?
No. It is a home-like setting with secured exits, not a treatment ward.
| Alzheimer's Special Care Unit | Locked psychiatric unit |
|---|---|
| Assisted living license plus OHCQ unit approval | Hospital or psychiatric license |
| Long-term residence | Short-term treatment |
| Dementia-trained aides, delegating RN | Psychiatrists and nursing staff |
Families can also compare units on the MHCC consumer guide, where larger programs report whether they have a secure Alzheimer's unit and which stages of dementia they accept.
