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*hb0945*
HOUSE BILL 945
J3, O2 6lr3158
By: Delegate Sample –Hughes Delegates Sample –Hughes, Alston, Bagnall,
Cullison, Guzzone, Hill, Hutchinson, S. Johnson, Kaufman, Kipke, Lopez,
Martinez, Reilly, Rosenberg, Ross, Taveras, and White Holland
Introduced and read first time: February 5, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 7, 2026
CHAPTER ______
AN ACT concerning 1
Nursing Homes – Complaints – Notification and Consultation 2
Nursing Homes and Assisted Living Facilities – Notification of Investigations 3
and Establishment of the Health Care Quality Improvement Initiative 4
FOR the purpose of requiring the Maryland Department of Health to notify and consult 5
with the local health department for the county in which a nursing home is located 6
if the Department initiates an investigation of a nursing home complaint alleging 7
actual harm; establishing the Health Care Quality Improvement Initiative to 8
identify strategies to improve the quality of care and the affordability and 9
accessibility of services in nursing homes and assisted living programs and 10
determine how the State can best use and share available data and expertise for 11
certain purposes; establishing a task force to carry out the purposes of the Initiative; 12
requiring the Department to staff the Initiative; and generally relating to nursing 13
home complaints homes and assisted living programs. 14
BY repealing and reenacting, with amendments, 15
Article – Health – General 16
Section 19–1408 17
Annotated Code of Maryland 18
(2023 Replacement Volume and 2025 Supplement) 19
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 20
That the Laws of Maryland read as follows: 21
2 HOUSE BILL 945
Article – Health – General 1
19–1408. 2
(a) (1) Subject to subsection (c) of this section, the Department shall make a 3
site visit and conduct a full survey of each licensed nursing home at least once per calendar 4
year. 5
(2) Unless otherwise required by federal law, all surveys shall be 6
unannounced. 7
(b) (1) Subject to [paragraph] PARAGRAPHS (2) AND (3) of this subsection, 8
the Department shall initiate an investigation of a nursing home complaint alleging actual 9
harm within 10 business days after receiving the complaint. 10
(2) If the Department receives a complaint against a nursing home alleging 11
immediate jeopardy to a resident, the Department: 12
(i) Shall make every effort to investigate the complaint within 24 13
hours after receiving the complaint; and 14
(ii) Shall investigate the complaint not later than 48 hours after 15
receiving the complaint. 16
(3) (I) IF THE DEPARTMENT INITIATES AN INVESTIGATION OF A 17
NURSING HOME COMPLAINT UNDER THIS SUBSECTION, THE DEPARTMENT SHALL: 18
(I) 1. NOTIFY IMMEDIATELY THE LOCAL HEALTH 19
DEPARTMENT FOR THE COUNTY IN WHICH THE NURSING HOME IS LOCATED WITHIN 20
24 HOURS AFTER INITIATING THE INVESTIGATION; AND 21
(II) 2. TO THE EXTENT PRACTIC ABLE WITHIN THE TIME 22
REQUIREMENTS ESTABLISHED UNDER PARAGRAPH (2) OF THIS SUBSECTION AND AS 23
PERMITTED BY FEDERAL LAW, CONSULT AND COORDINA TE WITH THE LOCAL 24
HEALTH OFFICER DEPARTMENT ON THE COMPL AINT INVESTIGATION A ND 25
RESPONSE. 26
(II) THIS PARAGRAPH MAY NO T BE CONSTRUED TO RE QUIRE A 27
LOCAL HEALTH DEPARTM ENT TO ASSIST WITH O R OTHERWISE ASSUME T HE 28
NURSING HOME OVERSIGHT RESPONSIBILITIES OF THE DEPARTMENT AS REQUIRED 29
BY FEDERAL OR STATE LAW. 30
(c) If ownership of a licensed nursing home is transferred to a person that does 31
not own or operate another nursing home in the State at the time of the transfer, the 32
Department shall conduct: 33
HOUSE BILL 945 3
(1) The first full survey of the licensed nursing home as requir ed under 1
subsection (a) of this section within 3 months after the date of transfer; and 2
(2) An unannounced, on –site follow –up survey of the licensed nursing 3
home that covers any deficiencies noted in the full survey within 120 days after the full 4
survey was completed. 5
(d) (1) Beginning July 1, 2025, and every 3 months thereafter, the Department 6
shall report to the Senate Finance Committee and the House Health [and Government 7
Operations] Committee, in accordance with § 2–1257 of the State Government Article, the 8
number of surveys conducted in each county, disaggregated by the following types of 9
surveys: 10
(i) Standard survey; 11
(ii) Complain survey; 12
(iii) Follow–up survey; 13
(iv) Revisit survey; 14
(v) Special focus facility survey; 15
(vi) Abbreviated survey; and 16
(vii) Life safety code survey. 17
(2) Beginning July 1, 2025, and every 6 months thereafter, the Office of 18
Health Care Quality shall report to the local area agency on aging for each county the name 19
of each nursing home in the c ounty that was surveyed in the immediately preceding 6 20
months and the date each survey was conducted. 21
SECTION 2. AND BE IT FURTHER ENACTED, That: 22
(a) (1) There is a Health Care Quality Improvement Initiative. 23
(2) The purpose of the Initiative is to: 24
(i) identify strategies to improve the quality of care and the 25
affordability and accessibility of services in nursing homes and assisted living programs; 26
and 27
(ii) determine how the State can best use and share available data 28
and expertise for the purposes of analysis, monitoring, public transparency, and oversight 29
of nursing homes and assisted living programs. 30
4 HOUSE BILL 945
(3) The Initiative shall be carried out by a task force established in 1
accordance with subsection (b) of this section. 2
(b) The task force consists of the following members: 3
(1) one member of the Senate who is a member of the Senate Finance 4
Committee, appointed by the President of the Senate; 5
(2) one member of the House of Delegates who is a member of the House 6
Health Committee, appointed by the Speaker of the House; 7
(3) the Attorney General, or the Attorney General’s designee; 8
(4) the Secretary of Health, or the Secretary’s designee; 9
(5) the Secretary of Aging, or the Secretary’s designee; 10
(6) the Secretary of Human Services, or the Secretary’s designee; 11
(7) the Deputy Secretary for Public Health Services, or the Deputy 12
Secretary’s designee; 13
(8) the Deputy Secretary of Maryland Medicaid, or the Deputy Secretary’s 14
designee; 15
(9) the Executive Director of the Off ice of Health Care Quality, or the 16
Executive Director’s designee; 17
(10) the Executive Director of the Maryland Health Care Commission, or the 18
Executive Director’s designee; and 19
(11) the Chief Executive Officer of the Maryland Patient Safety Center, or 20
the Chief Executive Officer’s designee. 21
(c) The Secretary of Health shall designate the chair of the task force. 22
(d) The Maryland Department of Health shall provide staff for the task force. 23
(e) A member of the task force: 24
(1) may not receive compensation as a member of the task force; but 25
(2) is entitled to reimbursement for expenses under the Standard State 26
Travel Regulations, as provided in the State budget. 27
(f) The task force shall study: 28
HOUSE BILL 945 5
(1) the feasibility of quality standards and potential use of the Centers for 1
Medicaid and Medicare Quality Assurance and Performance Improvement framework for 2
maintaining and improving safety and quality for assisted living facilities; and 3
(2) barriers and policy recommendations regarding: 4
(i) recruitment and retention of the nursing home and assisted 5
living program workforce; 6
(ii) the quality of required staff training for nursing home and 7
assisted living program staff; 8
(iii) oversight of small assisted living programs, including whether a 9
different regulatory structure should be implemented; 10
(iv) post–acute care involving discharges from the hospital; 11
(v) sharing data that is transparent to the public; and 12
(vi) any other issues the task force determines will improve the 13
quality of care, oversight, and affordability of nursing homes and assisted living programs 14
and the accessibility of services in nursing homes and assisted living programs. 15
(g) To complete the work of the task force, the task force: 16
(1) shall engage with members of the health care industry, advocacy 17
organizations, and the nursing home and assisted living communities; 18
(2) may establish workgroups to conduct its work that may include the 19
stakeholders described in item (1) of this subsection; 20
(3) shall collaborate with the Maryland Health Care Commission 21
regarding the use and sharing of available data and expertise for the purposes of analysis, 22
monitoring, public transparency, and oversight of nursing homes and assisted living 23
programs; 24
(4) shall hold a virtual meeting to seek feedback and recommendations 25
from frontline workers and family members involved in the care of individuals receiving 26
care from nursing homes and assisted living programs; and 27
(5) comply with the meeting requirements established under subsection (h) 28
of this section. 29
(h) (1) The task force shall meet once every 3 months. 30
(2) At each meeting, the Office of Health Care Quality shall report data 31
from the immediately preceding 6–month period regarding: 32
6 HOUSE BILL 945
(i) the number of nursing homes and assisted living programs 1
inspected; 2
(ii) the number of complaints received regarding nursing homes and 3
assisted living programs; 4
(iii) the number of complaints investigated regarding nursing homes 5
and assisted living programs; and 6
(iv) de–identified aggregate data on citations issued to nursing 7
homes and assisted living programs. 8
(3) (i) Within 30 days after each meeting, the task force shall provide a 9
public update, consistent with applicable federal and S tate confidentiality laws and 10
privileges, that includes the date of the meeting, general topics discussed at the meeting, 11
and any nonconfidential next steps of the task force. 12
(ii) The public update required under subparagraph (i) of this 13
paragraph may be posted on the Maryland Department of Health’s website. 14
(i) (1) Subject to paragraph (2) of this subsection, the task force may not 15
request or receive complaint information for identifiable individual facilities, protected 16
health information, or survey evidence, including records, documentation, observations, 17
survey notes, interviews, or other materials collected or created by the Office of Health Care 18
Quality in connection with a survey, inspection, or complaint investigation of a facility. 19
(2) The task force may request or receive redacted statements of 20
deficiencies. 21
(j) The task force shall: 22
(1) compile feedback received under subsection (g)(4) of this section and 23
otherwise through the work of the task force from frontline workers and family members 24
involved in the care of individuals receiving care from nursing homes and assisted living 25
programs; 26
(2) develop recommendations for the Secretary of Health to further the 27
purpose of the Initiative established under subsection (a)(2) of this section; 28
(3) identify resources required to implement the recommendations 29
developed in accordance with item (2) of this subsection; and 30
(4) (i) on or before December 1, 2027, report its preliminary findings 31
and recommendations to the Governor and , in accordance with § 2 –1257 of the State 32
Government Article, the General Assembly; and 33
HOUSE BILL 945 7
(ii) on or before December 1, 2028, report its final findings and 1
recommendations to the Governor and, in accordance with § 2 –1257 of the State 2
Government Article, the General Assembly. 3
SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 4
October 1, 2026. Section 2 of this Act shall remain effective for a period of 2 years and 9 5
months and, at the end of June 30, 2029, Section 2 of this Act, wi th no further action 6
required by the General Assembly, shall be abrogated and of no further force and effect. 7
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.