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Living and Care Options

Independent Living

 

OVERVIEW

​Independent living is designed for active older adults who want a maintenance-free lifestyle with social activities and community amenities, but require little to no personal care or assistance. 

​

COST CONSIDERATIONS

The cost structure centers on home ownership or rental plus ongoing monthly HOA fees, with no personal care, meals, or medical services included. When considering this option, ensure you also research potential property taxes, homeowners/renters insurance, and utilities.

 

55+ COMMUNITIES

These are typically age-restricted (55+) more lifestyle-focused neighborhoods of houses, condos, or apartments with amenities and social activities but little to no formal care services or meals. The following are the leading 55+ national directories:

  • 55places: The most comprehensive directory for 55+ active adult communities, featuring real estate listings, HOA fees, floor plans, and detailed community reviews across all 50 states. 

  • RetireNet: A nationwide directory specializing in active retirement living, manufactured homes, and oceanfront age-restricted communities. 

  • PrivateCommunities: A curated database covering gated, golf, and 55+ master-planned developments, allowing you to browse by specific regions. 

  • Hometown America: A major owner and operator of 55+ communities, featuring resort-style amenities and manufactured home living. 

  • Del Webb: For new construction, this premier national builder specializes exclusively in active adult neighborhoods.

  • Easton Club East and K. Hovnanian's Four Seasons at Easton are the two 55+ communities in Talbot County. 

  • Click here to read about the pros and cons of 55+ living communities.

​

62+ APARTMENTS OR COTTAGES FOR ACTIVE SENIORS

This type of independent living is reflected in senior-only apartments, maintenance-free cottage homes, and resort-style amenities for active seniors who need no daily health care. In Talbot County, 62+ senior living is available at:

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CO-HOUSING LIVING

Connection is one of the core principles of cohousing, a type of residential building design. Defined by the National Cohousing Alliance as ”an intentional community that combines private living spaces with shared indoor and outdoor spaces, designed to support connection, collaboration and an interdependent life,” cohousing has gained more attention in the past few years in a search to find a remedy for isolation. Senior Planet (from AARP) gives a great overview here. 

 

Explore cohousing communities across the United States through this directory.

 

The Seniors in Cohousing Committee of the National Cohousing Alliance holds a casual, hour-long discussion each month for individuals interested in senior cohousing or intergenerational communities. This complimentary event takes place on the 20th of every month at 10 AM Mountain Time.

​​​​​​

LGBTQIA-FRIENDLY SENIOR LIVING COMMUNITIES

Finding a senior living community that affirms, rather than merely tolerates, your sexual orientation and gender identity is crucial. Use these expert-backed tips to help you identify the right community for you. ​

Aging In Place

​

OVERVIEW​

Aging in Place means living in your own home and community safely, independently, and comfortably as you grow older, instead of moving to a nursing home or assisted living facility.

 

Most older adults prefer to stay in their own homes and communities as they age. AARP research shows about 75-90% of adults 50+ want to age in place, valuing familiarity, independence, and connections to family and neighbors. With planning, home modifications, and community support, many seniors can remain independent at home.

​

Also, read the Senior Home Care (non-medical care)  and Senior Home Care (medical care needed) sections below for related information.

​​

COST CONSIDERATIONS

Aging in place is frequently less expensive than facility care when needs are light to moderate, and home modifications and repairs are planned strategically. Costs rise sharply with higher care hours or major renovations. Compare your full all-in picture (housing + modifications + care) against alternatives, explore assistance programs to make home repairs and modifications, and reassess as needs change. Early planning and prioritization of fall-prevention upgrades deliver the best value.

​

The National Council on Aging (NCOA) offers practical advice on Aging in Place resources, including home safety, financial planning, and local care options.​​​

​

IF YOU QUALIFY FOR OR ARE COVERED BY MEDICAID

​

COMMUNITY FIRST CHOICE PROGRAM (CFC): In addition to all Medicaid-covered services and benefits, you may also receive additional services through the CFC, like accessibility adaptations, assistive technology, consumer training, environmental assessments, home-delivered meals, nurse monitoring, personal assistance, personal emergency response systems, supports planning, and transition services. To qualify for the program, the participant must require an institutional nursing home level of care but choose to live in a non-institutional community environment like their own home. Click here for more information and to apply to this program. 

​

COMMUNITY PERSONAL ASSISTANCE SERVICES PROGRAM (CPAS): In addition to all Medicaid-covered services and benefits, you may also receive nurse monitoring, personal assistance services, and supports planning. CPAS is strictly limited to individuals living in their own private homes, the home of a relative/friend, or an adult foster care home. Click here for more information and to apply to this program. 

​

INCREASED COMMUNITY SERVICES PROGRAM (ICS): The ICS program is a specialized Medicaid program designed to transition individuals who have resided in nursing facilities for a minimum period back into the community, such as their private home. In addition to the services already covered by Medicaid, you may receive assisted living, assistive technology, behavioral consultation services, consumer training, dietitian/nutrition services, environmental assessment, environmental accessibility adaptation, family training, home-delivered meals, medical day care, personal assistance, personal emergency response system, respite, and supports planning. The ICS program has distinct financial eligibility criteria, often allowing individuals with slightly higher incomes to qualify for coverage. Click here for more information and to apply to this program.​

​

HOME AND COMMUNITY-BASED OPTIONS WAIVER FOR OLDER ADULTS (HCBOW): HCBOW, commonly known as the Community Options (CO) Waiver, is a Medicaid waiver that provides comprehensive long-term supports for older adults in their homes who meet a nursing home level of care. It includes assistance with daily activities such as bathing, dressing, and grooming, as well as environmental assessments and home modifications. Click here to learn more about this program.

​

ADDITIONAL RESOURCES​

​​

HOME HEALTH AGENCIES

Find information on home health agencies on the Maryland Health Care Commission's website.

​

NATIONAL INSTITUTE ON AGING

The National Institute on Aging (NIA) offers a comprehensive guide to Aging in Place: Growing Older at Home, including planning, home safety, and support services.

​

AARP

​Access AARP's tools like the Home Checklist for Aging in Place and resources on modifications, transportation, and community livability.​​

 

MARYLAND ACCESS POINT (MAP)

​MAP is Maryland’s Aging and Disability Resource Center, established as the single entry point for individuals seeking a range of community supports and long-term care programs. Counselors at MAP offices help you navigate the complex system of long-term care services and options through individual, free, person-centered counseling. Click here for details and contact information.​

 

SUPPORTING OLDER ADULTS WITH RESOURCES (SOAR) PROGRAM

​The SOAR Program is a statewide initiative that provides case management and funding for services to people 65 or older who may be at risk of nursing home placement. SOAR provides a comprehensive assessment of an individual’s needs, a case manager to secure and coordinate services, and a pool of gap-filling funds to purchase services for individuals who meet program eligibility requirements. Services may include personal care, chore service, medications, medical supplies, adult day care, respite care, home-delivered meals, transportation, and emergency response systems. For further information on eligibility and to access SOAR, contact the Talbot County Health Department SOAR program at (410) 819-4700 or click here for more information.​​​

 

ASSESSMENT EVALUATION & REVIEW SERVICES (AERS)

​AERS is a Maryland program based in local health departments that provides assistance to frail, aged, and disabled adults. The AERS team member creates personalized care plans and connects clients to community resources, promoting independence and preventing unnecessary entry into a nursing home or other residential care facility.​ Individuals who are generally served by AERS are those who: 

  • Are at risk of being placed in a care facility or face a change in their normal living situation.

  • Have chronic medical conditions.

  • Need help with activities of daily living, such as bathing, dressing, meal preparation, or mobility.

Learn how and when to make a referral to be considered for this program.​​​​​​

 

AVAILABLE SOCIAL SERVICES

Visit our Social Services page to learn about the many resources that may be available to you and could help you gain more independence and stay in your home longer.

​​

HOME REPAIRS & MODIFICATIONS

Visit our Home Repairs & Modifications page to learn about the resources that may be available to you to age in place comfortably and safely, which often means making necessary updates to your home.

Living With a Loved One

​

OVERVIEW

Moving in with a loved one to receive care can be a comfortable, familiar option. The individual can enjoy time with family and feel happier and more satisfied. The flip side is that family members who provide care may become emotionally and financially burned out, especially if they also work full time and/or are caring for children and grandchildren in the home.
​​

COST CONSIDERATIONS

The Maryland Healthcare Commission reports that approximately 33% of caregivers provide 30 hours – or more – of care per week to a loved one who needs long-term care. Half of those who provide caregiving estimate that they lost around 33% of their income. If a long-term care event lasts an average of three years, that’s potentially a full year’s worth of income lost during a single long-term care event.

​

​Read this article to understand the main factors when moving in with a loved one. It covers important home safety, financial, legal, and Medicaid considerations to help ensure a smooth transition and avoid caregiver burnout.

​​​​​

ADULT DAY CARE & ADULT MEDICAL DAY CARE

Adult day care and medical adult day care are often very relevant for families needing support for their senior loved one during the workday. These facilities provide daytime supervision, activities, meals, and sometimes medical/nursing support. Adult day care or medical adult day care can be a good option before full-time residential care. Learn more about this option, including costs, benefits, services, and how to find a center. Costs can vary widely by facility type. Daily rates for Maryland-based medical adult day care facilities are available on the Maryland Health Commission's website. ​​

​

This type of care allows the older adult to live at home or with a family member while remaining engaged, active, and safe while the primary caregiver works. With this option, it's important to consider that the individual might need transportation to and from the adult daycare center, and a full day of activities may prove exhausting.

 

COMPARING ADULT MEDICAL DAYCARE IN MARYLAND

The Maryland Health Care Commission (MHCC) is a state agency that offers a consumer-friendly website, Maryland Quality Reports, that allows you to search for and compare adult medical daycare facilities and more. The website reports quality information from federal and state government sources and consumer satisfaction surveys.

​

IF YOU QUALIFY FOR OR ARE COVERED BY MEDICAID

​

MEDICAL DAY CARE SERVICES WAIVER: If you are currently on Medicaid and need medical adult day care while living with a loved one, you might be eligible for the Medical Day Care Services Waiver. In addition to all Medicaid-covered services and benefits, you may also receive at least four hours a day, up to seven days a week, of medical day care activity programs, meals, medication monitoring, nutrition services, skilled nursing and nursing assessments, social work services, therapy, and transportation. ​Click here for more information and to apply for the waiver.

​

COMMUNITY FIRST CHOICE PROGRAM (CFC): In addition to all Medicaid-covered services and benefits, while living with a loved one, you may also receive additional services through the CFC, like accessibility adaptations, assistive technology, consumer training, environmental assessments, home-delivered meals, nurse monitoring, personal assistance, personal emergency response systems, supports planning, and transition services. To qualify for the program, the participant must require an institutional nursing home level of care but choose to live in a non-institutional community environment, like the home of a loved one. Click here for more information and to apply to this program. 

​

COMMUNITY PERSONAL ASSISTANCE SERVICES PROGRAM (CPAS): In addition to all Medicaid-covered services and benefits, you may also receive nurse monitoring, personal assistance services, and supports planning. CPAS is strictly limited to individuals living in their own private homes, the home of a relative/friend, or an adult foster care home. Click here for more information and to apply to this program. 

​

INCREASED COMMUNITY SERVICES PROGRAM (ICS): The ICS program is a specialized Medicaid program designed to transition individuals who have resided in nursing facilities for a minimum period back into the community, such as a family home. In addition to the services already covered by Medicaid, you may receive assisted living, assistive technology, behavioral consultation services, consumer training, dietitian/nutrition services, environmental assessment, environmental accessibility adaptation, family training, home-delivered meals, medical day care, personal assistance, personal emergency response system, respite, and supports planning. The ICS program has distinct financial eligibility criteria, often allowing individuals with slightly higher incomes to qualify for coverage. Click here for more information and to apply to this program.​

​

HOME AND COMMUNITY-BASED OPTIONS WAIVER FOR OLDER ADULTS (HCBOW): HCBOW, commonly known as the Community Options (CO) Waiver, is a Medicaid waiver that provides comprehensive long-term supports in the home of a loved one for older adults who meet a nursing home level of care. It includes assistance with daily activities such as bathing, dressing, and grooming, as well as environmental assessments and home modifications. Click here to learn more about this program.

 

ADDITIONAL RESOURCES​

​​

HOME HEALTH AGENCIES

Find information on home health agencies on the Maryland Health Care Commission's website.

​

​​MARYLAND ACCESS POINT (MAP)

​MAP is Maryland’s Aging and Disability Resource Center, established as the single entry point for individuals seeking a range of community supports and long-term care programs. Counselors at MAP offices help you navigate the complex system of long-term care services and options through individual, free, person-centered counseling. Click here for details and contact information.​

 

SUPPORTING OLDER ADULTS WITH RESOURCES (SOAR) PROGRAM

​The SOAR Program is a statewide initiative that provides case management and funding for services to people 65 or older who may be at risk of nursing home placement. SOAR provides a comprehensive assessment of an individual’s needs, a case manager to secure and coordinate services, and a pool of gap-filling funds to purchase services for individuals who meet program eligibility requirements. Services may include personal care, chore service, medications, medical supplies, adult day care, respite care, home-delivered meals, transportation, and emergency response systems. For further information on eligibility and to access SOAR, contact the Talbot County Health Department SOAR program at (410) 819-4700 or click here for more information.​​​

 

ASSESSMENT EVALUATION & REVIEW SERVICES (AERS)

​AERS is a Maryland program based in local health departments that provides assistance to frail, aged, and disabled adults. The AERS team member creates personalized care plans and connects clients to community resources, promoting independence and preventing unnecessary entry into a nursing home or other residential care facility.​ Individuals who are generally served by AERS are those who: 

  • Are at risk of being placed in a care facility or face a change in their normal living situation.

  • Have chronic medical conditions.

  • Need help with activities of daily living, such as bathing, dressing, meal preparation, or mobility.

Learn how and when to make a referral to be considered for this program.​​​​​​

 

AVAILABLE SOCIAL SERVICES

Visit our Social Services page to learn about the many resources that may be available to you and could help you gain more independence and stay in the home of your loved one longer.

​

HOME REPAIRS & MODIFICATIONS

Visit our Home Repairs & Modifications page to learn about the resources that may be available to you to make necessary home repairs or modifications to the home of the loved one you will live with. 

​

AGING IN PLACE & IN-HOME CARE 

View the Aging in Place, In-Home Care (for non-medical care), and In-Home Care (for needed medical care) on this page to learn if some of the assistance and resources could be extended to you if living in a home of a loved one (compared to living by yourself). 

Senior Home Care (for non-medical care)

 

OVERVIEW

This option allows the individual to remain in a comfortable, familiar environment and maintain some independence. Various support services, such as companion care, personal care, or skilled care, provided in the senior’s own home can help provide the needed care. These caregivers usually do not have formal healthcare licensing, and their training differs across companies. This category involves help with activities of daily living (ADLs), such as dressing, bathing, and eating, but does not require continuous medical care at home.

​

Services generally encompass:

  • Light housekeeping, including cleaning and laundry

  • Meal preparation or delivery, along with diet monitoring

  • Assistance with personal care tasks

  • Support with shopping and errands

  • Providing companionship and social interaction

  • Transportation services

​

Also, read the Aging in Place section for additional related information.

​

COST CONSIDERATIONS

Depending on the level of care needed, support services can be costly, especially during nights and weekends. At-home care personnel are typically paid by the hour.​​​ The senior or their family typically pays out of pocket for this form of care.​​​​ Learn more about the cost of non-medical senior home care and how to pay for it.

​​

CARE OPTIONS

​

NURSE REFERRAL SERVICE AGENCIES

Agencies that screen and refer licensed nurses, home health aides, homemakers, live-in caretakers, and companions for individuals needing help in their home. The person seeking assistance contracts directly with the individual who will provide the service and may pay the agency or the provider for services. The Office of Health Care Quality maintains a directory of Nurse Referral Service Agencies. Click here for the directory, then under the column titled "Type of Provider," scroll down to download the spreadsheet for "Nurse Referral Service Agencies."

​

RESIDENTIAL SERVICES AGENCIES (RSA)

Provide supportive home care services, for example, assistance with Activities of Daily Living (ADLs), therapy, skilled nursing and aide services, or may provide Durable Medical Equipment, such as oxygen compressors, wheelchairs, walkers and hospital beds. The person seeking assistance contracts with the agency. RSA services are often paid for by the person using services but may be paid for by insurance under some circumstances.

 

The Office of Health Care Quality maintains a directory of RSAs. Click here for the directory, then under the column titled "Type of Provider," scroll down to download the spreadsheet for "Residential Service Agency."

​

HOME HEALTH AGENCIES

Find information on home health agencies on the Maryland Health Care Commission's website.

​

IF YOU QUALIFY FOR OR ARE COVERED BY MEDICAID

​

COMMUNITY FIRST CHOICE PROGRAM (CFC): In addition to all Medicaid-covered services and benefits, you may also receive additional services through the CFC, like accessibility adaptations, assistive technology, consumer training, environmental assessments, home-delivered meals, nurse monitoring, personal assistance, personal emergency response systems, supports planning, and transition services. To qualify for the program, the participant must require an institutional nursing home level of care but choose to live in a non-institutional community environment, like their own home. Click here for more information and to apply to this program. 

​​

COMMUNITY PERSONAL ASSISTANCE SERVICES PROGRAM (CPAS): In addition to all Medicaid-covered services and benefits, you may also receive nurse monitoring, personal assistance services, and supports planning. CPAS is strictly limited to individuals living in their own private homes, the home of a relative/friend, or an adult foster care home. Click here for more information and to apply to this program. 

​

INCREASED COMMUNITY SERVICES PROGRAM (ICS): The ICS program is a specialized Medicaid program designed to transition individuals who have resided in nursing facilities for a minimum period back into the community, such as their private home. In addition to the services already covered by Medicaid, you may receive assisted living, assistive technology, behavioral consultation services, consumer training, dietitian/nutrition services, environmental assessment, environmental accessibility adaptation, family training, home-delivered meals, medical day care, personal assistance, personal emergency response system, respite, and supports planning. The ICS program has distinct financial eligibility criteria, often allowing individuals with slightly higher incomes to qualify for coverage. Click here for more information and to apply to this program.​​

​

HOME AND COMMUNITY-BASED OPTIONS WAIVER FOR OLDER ADULTS (HCBOW): HCBOW, commonly known as the Community Options (CO) Waiver, is a Medicaid waiver that provides comprehensive long-term supports for older adults in their homes who meet a nursing home level of care. It includes assistance with daily activities such as bathing, dressing, and grooming, as well as environmental assessments and home modifications. Click here to learn more about this program.

​

ADDITIONAL RESOURCES​

​​

MARYLAND ACCESS POINT (MAP)

​MAP is Maryland’s Aging and Disability Resource Center, established as the single entry point for individuals seeking a range of community supports and long-term care programs. Counselors at MAP offices help you navigate the complex system of long-term care services and options through individual, free, person-centered counseling. Click here for details and contact information.​

 

SUPPORTING OLDER ADULTS WITH RESOURCES (SOAR) PROGRAM

​The SOAR Program is a statewide initiative that provides case management and funding for services to people 65 or older who may be at risk of nursing home placement. SOAR provides a comprehensive assessment of an individual’s needs, a case manager to secure and coordinate services, and a pool of gap-filling funds to purchase services for individuals who meet program eligibility requirements. Services may include personal care, chore service, medications, medical supplies, adult day care, respite care, home-delivered meals, transportation, and emergency response systems. For further information on eligibility and to access SOAR, contact the Talbot County Health Department SOAR program at (410) 819-4700 or click here for more information.​​​

 

ASSESSMENT EVALUATION & REVIEW SERVICES (AERS)

​AERS is a Maryland program based in local health departments that provides assistance to frail, aged, and disabled adults. The AERS team member creates personalized care plans and connects clients to community resources, promoting independence and preventing unnecessary entry into a nursing home or other residential care facility.​ Individuals who are generally served by AERS are those who: 

  • Are at risk of being placed in a care facility or face a change in their normal living situation.

  • Have chronic medical conditions.

  • Need help with activities of daily living, such as bathing, dressing, meal preparation, or mobility.

Learn how and when to make a referral to be considered for this program.​​​​​​

 

IN-HOME AIDES SERVICES

Maryland's Office of Adult Services has a program that offers aide services in the home of an adult with a functional disability to support their ability to remain living at home and avoid unnecessary or premature moves to a nursing home or other out-of-home placements. This program provides assistance with personal care, dressing, bathing, transferring, grooming, eating, and chores, including cooking, laundry, light cleaning, shopping, and other activities of daily living. We also provide ongoing case management to assist with planning and exploring other needed services. Click here to learn more about this program.

​

MARYLAND ATTENDANT CARE PROGRAM (ACP)

The Attendant Care Program (ACP) assists with funding personal care services, enabling adults aged up to 64 with severe physical disabilities to remain in their homes. Benefits may cover personal care, transportation, and household tasks. Click here to learn more about the program and how to apply. 

​​

AVAILABLE SOCIAL SERVICES

Visit our Social Services page to learn about the many resources that may be available to you and could help you gain more independence and stay in your home longer.

​​

HOME REPAIRS & MODIFICATIONS

Visit our Home Repairs & Modifications page to learn about the resources that may be available to you to age in place comfortably and safely, which often means making necessary updates to your home.

Senior Home Health Care (medical care needed)

 

OVERVIEW

This type of care, involving medical and personal support, is delivered by a licensed professional—such as a registered nurse or physical therapist—under a doctor's orders. It is intended for older adults recovering from illness, injury, or surgery, or those managing chronic health conditions that need professional medical attention.​

​​​

​Also, read the Aging in Place section for additional related information.

 

COST CONSIDERATIONS
Medicare or a private insurer typically covers these services, but it's important to verify your specific policy. Usually, before coverage begins, you must have an in-person evaluation by a doctor to confirm your need for home health care.​​

​​

MEDICARE

Medicare covers home health care services under Part A and/or Part B when specific eligibility criteria are met. This is designed for medically necessary, part-time or intermittent skilled care in your home to help you recover, maintain function, or slow decline—not for ongoing custodial or 24-hour care.

​

If you have Medicare, you are required to choose a home health agency approved by Medicare. You can use Medicare’s Care Compare tool, ask your primary healthcare provider to help find local agencies, or use the Maryland Health Care Commission's Home Health Agency directory.

​

After choosing an agency - typically based on insurance, availability, and services offered - a personalized care plan, as described earlier, is developed.

​

Medicare-certified agencies recertify skilled care every 60 days, making adjustments as health conditions evolve. Families can request updates or changes at any time to ensure the senior gets the appropriate level of support. The process is intended to be flexible and responsive, aiming to provide seniors with a suitable balance of medical and supportive services.

​

Services generally encompass:

  • Skilled nursing, including wound dressing, IV therapy, health monitoring, pain management, and various nursing tasks

  • Physical and occupational therapy

  • Speech-language pathology services

  • Injectable osteoporosis medications for women

  • Durable medical equipment and other home-use medical supplies

  • In-home doctor visits or telemedicine consultations

  • Medical social services, such as counseling and assistance in locating community resources

  • Medication management and reminder services

​​

IF YOU QUALIFY FOR OR ARE COVERED BY MEDICAID

​

COMMUNITY FIRST CHOICE PROGRAM (CFC): In addition to all Medicaid-covered services and benefits, you may also receive additional services through the CFC, like accessibility adaptations, assistive technology, consumer training, environmental assessments, home-delivered meals, nurse monitoring, personal assistance, personal emergency response systems, supports planning, and transition services. To qualify for the program, the participant must require an institutional nursing home level of care but choose to live in a non-institutional community environment, like their own home. Click here for more information and to apply to this program. 

​​

COMMUNITY PERSONAL ASSISTANCE SERVICES PROGRAM (CPAS): In addition to all Medicaid-covered services and benefits, you may also receive nurse monitoring, personal assistance services, and supports planning. CPAS is strictly limited to individuals living in their own private homes, the home of a relative/friend, or an adult foster care home. Click here for more information and to apply to this program. 

​

INCREASED COMMUNITY SERVICES PROGRAM (ICS): The ICS program is a specialized Medicaid program designed to transition individuals who have resided in nursing facilities for a minimum period back into the community, such as their private home. In addition to the services already covered by Medicaid, you may receive assisted living, assistive technology, behavioral consultation services, consumer training, dietitian/nutrition services, environmental assessment, environmental accessibility adaptation, family training, home-delivered meals, medical day care, personal assistance, personal emergency response system, respite, and supports planning. The ICS program has distinct financial eligibility criteria, often allowing individuals with slightly higher incomes to qualify for coverage. Click here for more information and to apply to this program.​​

​

HOME AND COMMUNITY-BASED OPTIONS WAIVER FOR OLDER ADULTS (HCBOW): HCBOW, commonly known as the Community Options (CO) Waiver, is a Medicaid waiver that provides comprehensive long-term supports for older adults in their homes who meet a nursing home level of care. It includes assistance with daily activities such as bathing, dressing, and grooming, as well as environmental assessments and home modifications. Click here to learn more about this program.​​

​

COMPARING HOME HEALTH AGENCIES IN MARYLAND

The Maryland Health Care Commission (MHCC) is a state agency that offers a consumer-friendly website, Maryland Quality Reports, that allows you to search for and compare home health agencies and more. The website reports quality information from federal and state government sources and consumer satisfaction surveys.

​

HOME HEALTH AGENCY CHECKLIST

The Maryland Health Care Commission provides this home health agency checklist that you can download to help you review each organization in-depth that you are considering.

​

CARE OPTIONS

 

NURSE REFERRAL SERVICE AGENCIES

Agencies that screen and refer licensed nurses, home health aides, homemakers, live-in caretakers, and companions for individuals needing help in their home. The person seeking assistance contracts directly with the individual who will provide the service and may pay the agency or the provider for services. The Office of Health Care Quality maintains a directory of Nurse Referral Service Agencies. Click here for the directory, then under the column titled "Type of Provider," scroll down to download the spreadsheet for "Nurse Referral Service Agencies."

​​

RESIDENTIAL SERVICES AGENCIES (RSA)

Provide supportive home care services, for example, assistance with Activities of Daily Living (ADLs), therapy, skilled nursing and aide services, or may provide Durable Medical Equipment, such as oxygen compressors, wheelchairs, walkers and hospital beds. The person seeking assistance contracts with the agency. RSA services are often paid for by the person using services but may be paid for by insurance under some circumstances.

 

The Office of Health Care Quality maintains a directory of RSAs. Click here for the directory, then under the column titled "Type of Provider," scroll down to download the spreadsheet for "Residential Service Agency."

​​

HOME HEALTH AGENCIES

Find information on home health agencies on the Maryland Health Care Commission's website.

​​​​​

ADDITIONAL RESOURCES​

​​​

MARYLAND ACCESS POINT (MAP)

​MAP is Maryland’s Aging and Disability Resource Center, established as the single entry point for individuals seeking a range of community supports and long-term care programs. Counselors at MAP offices help you navigate the complex system of long-term care services and options through individual, free, person-centered counseling. Click here for details and contact information.​

 

SUPPORTING OLDER ADULTS WITH RESOURCES (SOAR) PROGRAM

​The SOAR Program is a statewide initiative that provides case management and funding for services to people 65 or older who may be at risk of nursing home placement. SOAR provides a comprehensive assessment of an individual’s needs, a case manager to secure and coordinate services, and a pool of gap-filling funds to purchase services for individuals who meet program eligibility requirements. Services may include personal care, chore service, medications, medical supplies, adult day care, respite care, home-delivered meals, transportation, and emergency response systems. For further information on eligibility and to access SOAR, contact the Talbot County Health Department SOAR program at (410) 819-4700 or click here for more information.​​​

 

ASSESSMENT EVALUATION & REVIEW SERVICES (AERS)

​AERS is a Maryland program based in local health departments that provides assistance to frail, aged, and disabled adults. The AERS team member creates personalized care plans and connects clients to community resources, promoting independence and preventing unnecessary entry into a nursing home or other residential care facility.​ Individuals who are generally served by AERS are those who: 

  • Are at risk of being placed in a care facility or face a change in their normal living situation.

  • Have chronic medical conditions.

  • Need help with activities of daily living, such as bathing, dressing, meal preparation, or mobility.

Learn how and when to make a referral to be considered for this program.​​​​​​

 

AVAILABLE SOCIAL SERVICES

Visit our Social Services page to learn about the many resources that may be available to you and could help you gain more independence and stay in your home longer.

​

HOME REPAIRS & MODIFICATIONS

Visit our Home Repairs & Modifications page to learn about the resources that may be available to you to age in place comfortably and safely, which often means making necessary updates to your home.

Continuing Care Retirement Communities (CCRCs)

 

OVERVIEW

These are “all-in-one” campuses that offer the full continuum (independent living → assisted living → memory care → skilled nursing) on a single property. Residents can age in place without moving to a new community as their needs change, e.g., the premium community, Bayleigh Chase in Easton.

​

Learn how to age in place with progressive care, including how these communities work, services and living arrangements, different levels of care, benefits and limitations of this type of progressive care, and questions to ask when considering a CCRC.

​

CCRCs may limit admission into the assisted living and the skilled nursing units to current residents of their independent living units.  

​​​

COST CONSIDERATIONS

Residence at a CCRC requires a signed contract, an entrance fee, and monthly fees. The CCRC offers shelter and health-related services to persons 60 years of age or older. These shelter and services are provided under a contract that lasts for more than one year, usually for life.​

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Expect a substantial entrance fee (often in the mid-to-high hundreds of thousands on average) plus monthly fees typically in the $3,000–$5,500 range for independent living in many communities, with wider variation by location and contract. The true long-term cost depends heavily on the contract type and how care needs evolve. Always review the full residency agreement, recent financial statements, and fee-increase history with a financial advisor or elder-law attorney before committing. Costs and terms vary significantly by community, so obtain current quotes for specific places of interest.

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Medicaid coverage is very limited in most CCRCs. Many do not accept it, or only for a small number of beds after assets are depleted.

Assisted Living

 

OVERVIEW

Assisted living provides a supportive environment that helps with daily activities such as bathing, dressing, medication management, and meals, while still promoting independence. In this type of facility, the older adult can receive tailored care, with services ranging from assistance with chores to hands-on care. Living near and socializing with others is known to improve well-being and happiness. Assisted living residences in Maryland are licensed by the Office of Health Care Quality to provide up to three separate levels of care to residents. When choosing a facility, consider how much care is necessary for the safety and well-being of the resident. The majority of facilities are licensed to provide Level 2 and Level 3 care. 

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Click the following links to learn more about:

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Assisted living facilities in Talbot County include Candle Light Cove in Easton and Heartfields Assisted Living at Easton.

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COST CONSIDERATIONS

The cost of residing in an assisted living facility is usually paid for out of private funds, long-term care insurance, or Veterans' benefits. Assisted living facilities are not covered by Medicare. Click here for a guide to assisted living costs and payment options.

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Costs can vary widely by facility type. Daily rates for Maryland-based assisted living communities are available on the Maryland Health Commission's website. 

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MEDICARE

Assisted living facilities are generally not covered by Medicare. Medicare may cover related medical services wherever someone lives, such as:

  • Doctor visits, cognitive assessments, and care planning

  • Physical/occupational/speech therapy when ordered and medically necessary

  • Durable medical equipment

  • Certain medications (via Part D)

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IF YOU QUALIFY FOR OR ARE COVERED BY MEDICAID

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​INCREASED COMMUNITY SERVICES PROGRAM (ICS): The ICS program is a specialized Medicaid program designed to transition individuals who have resided in nursing facilities for a minimum period back into the community, such as a state-licensed assisted living residence. In addition to the services already covered by Medicaid, you may receive assisted living, assistive technology, behavioral consultation services, consumer training, dietitian/nutrition services, environmental assessment, environmental accessibility adaptation, family training, home-delivered meals, medical day care, personal assistance, personal emergency response system, respite, and supports planning. The ICS program has distinct financial eligibility criteria, often allowing individuals with slightly higher incomes to qualify for coverage. Click here for more information and to apply to this program.​

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HOME AND COMMUNITY-BASED OPTIONS WAIVER FOR OLDER ADULTS (HCBOW): HCBOW, commonly known as the Community Options (CO) Waiver, is a Medicaid waiver that provides comprehensive long-term supports for older adults in licensed assisted living facilities who meet a nursing home level of care. It includes assistance with daily activities such as bathing, dressing, and grooming, as well as environmental assessments. Click here to learn more about this program. Special Notes: 

  • While the separate program Community First Choice Program (CFC) (see description under Aging in Place) cannot be used in assisted living, individuals concurrently enrolled in the Community Options (CO) Waiver can bundle their CFC benefits with waiver-covered assisted living services.

  • While the waiver pays for extensive care packages within these settings, it strictly excludes room and board costs. The participant remains responsible for paying their monthly rent or facility room and board fees out of pocket.

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FINDING & COMPARING ASSISTED LIVING FACILITIES IN MARYLAND

The Maryland Health Care Commission is a state agency that offers a consumer-friendly website, Maryland Quality Reports, that allows you to search for and compare assisted living facilities and more. The website reports quality information from federal and state government sources and consumer satisfaction surveys.

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ASSISTED LIVING CHECKLIST

The Maryland Health Care Commission provides this assisted living checklist that you can download to help you review each facility in-depth that you are considering.

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MARYLAND LONG-TERM CARE OMBUDSMAN PROGRAM

The Maryland Long-Term Care Ombudsman Program champions the health, safety, well-being, and rights of residents in assisted living facilities. Their services are confidential and free, operating with the resident’s consent and at their request. The program also advocates for laws, regulations, and policies designed to safeguard residents' rights and enhance their quality of life. Contact the Upper Shore Aging's Long-Term Care Ombudsman for assistance.

Nursing Home

 

OVERVIEW

Skilled nursing (also called nursing home care) offers 24-hour medical and nursing care for those with more complex health needs or recovering from illness or surgery. Skilled nursing is provided in a nursing home.

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Click the following links to learn more about:

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The nursing home in Talbot County is The Pines Nursing & Rehab in Easton.

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If you are considering a nursing home, be sure to educate yourself on nursing home abuse, what it looks like, different types of abuse, warning signs, causes, risk factors, how to report it, nursing home abuse laws, and how to prevent nursing home abuse.

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COST CONSIDERATIONS

Click the following links to learn more about:

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Costs can vary widely by facility type. Daily rates for Maryland-based nursing home facilities​ are available on the Maryland Health Commission's website.
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MEDICARE

Nursing homes are generally not covered by Medicare. Medicare Part A can cover short-term skilled nursing facility (SNF) care for up to 100 days per benefit period, but only if strict criteria are met:

  • A qualifying inpatient hospital stay of at least 3 consecutive days (observation status does not count).

  • The care must be skilled (nursing or therapy that requires professional skills) and medically necessary, typically for recovery after illness, injury, or surgery.

  • Admission to a Medicare-certified SNF usually within 30 days of hospital discharge.

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Medicare may cover related medical services wherever someone lives, such as:

  • Doctor visits, cognitive assessments, and care planning

  • Physical/occupational/speech therapy when ordered and medically necessary

  • Durable medical equipment

  • Certain medications (via Part D)

 

IF YOU QUALIFY FOR OR ARE COVERED BY MEDICAID

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HOME AND COMMUNITY-BASED OPTIONS WAIVER FOR OLDER ADULTS (HCBOW): HCBOW, commonly known as the Community Options (CO) Waiver, is a Medicaid waiver that provides comprehensive long-term supports for older adults in licensed assisted living facilities who meet a nursing home level of care. It includes assistance with daily activities such as bathing, dressing, and grooming, as well as environmental assessments. Click here to learn more about this program.

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NURSING HOME MEDICAID: Also known as Medical Assistance or Long-Term Care Medical Assistance, it covers the cost of care in Medicaid-certified nursing facilities for eligible residents who require a nursing-facility level of care and meet specific financial limits. Applications can be filed through the Talbot County Department of Social Services by making an in-person appointment by calling (410) 770-4848, or requesting an appointment via email to talbot.customer@maryland.gov.​

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FINDING & COMPARING NURSING HOMES IN MARYLAND

The Maryland Health Care Commission is a state agency that offers a consumer-friendly website, Maryland Quality Reports, that allows you to search for and compare nursing homes and more. The website reports quality information from federal and state government sources and consumer satisfaction surveys.

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NURSING HOME CHECKLIST

The Maryland Health Care Commission (MHCC) provides this nursing home checklist that you can download to help you review each facility in-depth that you are considering. The MHCC also provides a separate nursing home checklist if there is an immediate need for a nursing home bed.

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​​OTHER OPTIONS PRIOR TO NURSING HOME PLACEMENT ​​​

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MARYLAND ACCESS POINT (MAP)

​MAP is Maryland’s Aging and Disability Resource Center, established as the single entry point for individuals seeking a range of community supports and long-term care programs. Counselors at MAP offices help you navigate the complex system of long-term care services and options through individual, free, person-centered counseling. Click here for details and contact information.​

 

SUPPORTING OLDER ADULTS WITH RESOURCES (SOAR) PROGRAM

​The SOAR Program is a statewide initiative that provides case management and funding for services to people 65 or older who may be at risk of nursing home placement. SOAR provides a comprehensive assessment of an individual’s needs, a case manager to secure and coordinate services, and a pool of gap-filling funds to purchase services for individuals who meet program eligibility requirements. Services may include personal care, chore service, medications, medical supplies, adult day care, respite care, home-delivered meals, transportation, and emergency response systems. For further information on eligibility and to access SOAR, contact the Talbot County Health Department SOAR program at (410) 819-4700 or click here for more information.​​​

 

ASSESSMENT EVALUATION & REVIEW SERVICES (AERS)

​AERS is a Maryland program based in local health departments that provides assistance to frail, aged, and disabled adults. The AERS team member creates personalized care plans and connects clients to community resources, promoting independence and preventing unnecessary entry into a nursing home or other residential care facility.​ Individuals who are generally served by AERS are those who: 

  • Are at risk of being placed in a care facility or face a change in their normal living situation.

  • Have chronic medical conditions.

  • Need help with activities of daily living, such as bathing, dressing, meal preparation, or mobility.

Learn how and when to make a referral to be considered for this program.​​​​​​

 

AVAILABLE SOCIAL SERVICES

Visit our Social Services page to learn about the many resources that may be available to you and could help you gain more independence and stay in your home longer.​​​​

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MARYLAND LONG-TERM CARE OMBUDSMAN PROGRAM

The Maryland Long-Term Care Ombudsman Program champions the health, safety, well-being, and rights of residents in nursing homes. Their services are confidential and free, operating with the resident’s consent and at their request. The program also advocates for laws, regulations, and policies designed to safeguard residents' rights and enhance their quality of life. Contact the Upper Shore Aging's Long-Term Care Ombudsman for assistance.

Memory Care

 

OVERVIEW

Memory care is a specialized form of assisted living or skilled nursing designed specifically for individuals living with Alzheimer’s disease, dementia, or other memory-related conditions, featuring secure environments, structured routines, and trained staff.

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Memory care facilities in Talbot County include Candle Light Cove in Easton and Heartfields Assisted Living at Easton.

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COST CONSIDERATIONS​

Read this helpful article to discover the costs of memory care and explore various financing options like government programs, private insurance, and others. 

 

MEDICARE

Memory care facilities are generally not covered by Medicare, but Medicare may cover related medical services wherever someone lives, such as:

  • Doctor visits, cognitive assessments, and care planning

  • Physical/occupational/speech therapy when ordered and medically necessary

  • Durable medical equipment

  • Certain medications (via Part D)

​

IF YOU QUALIFY FOR OR ARE COVERED BY MEDICAID

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​INCREASED COMMUNITY SERVICES PROGRAM (ICS): The ICS program is a specialized Medicaid program designed to transition individuals who have resided in nursing facilities for a minimum period back into the community, such as a dedicated memory care community. In addition to the services already covered by Medicaid, you may receive assisted living, assistive technology, behavioral consultation services, consumer training, dietitian/nutrition services, environmental assessment, environmental accessibility adaptation, family training, home-delivered meals, medical day care, personal assistance, personal emergency response system, respite, and supports planning. The ICS program has distinct financial eligibility criteria, often allowing individuals with slightly higher incomes to qualify for coverage. Click here for more information and to apply to this program.​

​

HOME AND COMMUNITY-BASED OPTIONS WAIVER FOR OLDER ADULTS (HCBOW): HCBOW, commonly known as the Community Options (CO) Waiver, is a Medicaid waiver that provides comprehensive long-term supports for older adults in memory care communities who meet a nursing home level of care. It includes assistance with daily activities such as bathing, dressing, and grooming, as well as environmental assessments. Click here to learn more about this program.

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ADDITIONAL RESOURCES​

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MARYLAND ACCESS POINT (MAP)

​MAP is Maryland’s Aging and Disability Resource Center, established as the single entry point for individuals seeking a range of community supports and long-term care programs. Counselors at MAP offices help you navigate the complex system of long-term care services and options through individual, free, person-centered counseling. Click here for details and contact information.​

Key Differences

 

Below are links to articles that highlight the key differences between different living and care options:​​

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Hospice

 

​OVERVIEW

Hospice care focuses on comfort, dignity, and quality of life for individuals with a terminal illness (typically a life expectancy of six months or less if the illness runs its normal course). Hospices are required to provide four levels of care (routine home care, continuous home care, respite care, and general in-patient care), and patients often have a choice of where they receive their care. Care emphasizes pain and symptom management, advance directives integration, emotional and spiritual support, and help for both the patient and family rather than curative treatment. Most hospice care is provided in the patient’s home (or in an assisted living or nursing facility). Limited inpatient care is available when needed for symptom management or caregiver respite. A physician must certify the terminal prognosis for eligibility.​​

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The primary hospice serving Talbot County is Talbot Hospice.

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COST CONSIDERATIONS​

Many end-of-life services are covered by Medicare, Medicaid, or private insurance when eligibility criteria are met. Medicare Part A covers hospice care (nearly all related services) at little to no cost for those who qualify and elect the benefit through a Medicare-certified provider. Palliative care and certain medical services may be covered under Medicare Parts A or B when ordered as medically necessary. Room and board in a facility is generally not covered by the Medicare hospice benefit. Medicaid covers hospice and some related supports for eligible individuals in Maryland. Private insurance often mirrors Medicare rules. Advance care planning conversations with physicians may be covered under Medicare. Many local providers and hospices offer financial assistance or sliding-scale options so that cost does not become a barrier.

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COMPARING HOSPICES IN MARYLAND

The Maryland Health Care Commission (MHCC) is a state agency that offers a consumer-friendly website, Maryland Quality Reports, that allows you to search for and compare hospices and more. The website reports quality information from federal and state government sources and consumer satisfaction surveys.

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HOSPICE CHECKLIST

The Maryland Health Care Commission provides this hospice checklist that you can download to help you during this decision-making process.

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ADDITIONAL RESOURCES

 

HOSPICE FOUNDATION OF AMERICA: Offers Hospice Foundation of America educational courses, caregiver tips, and grief support newsletters.

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CARINGINFO: Provides CaringInfo guides on advance directives, financial navigation, and choosing a provider.

 

NATIONAL COALITION FOR HOSPICE AND PALLIATIVE CARE: Shares clinical guidelines, toolkits, and health equity reports via the National Coalition for Hospice and Palliative Care Resource Center.​

End-of-Life

 

​OVERVIEW

End-of-life planning involves the practical steps that help families manage the days and weeks after a death. This includes arranging a funeral or memorial service, deciding between burial and cremation, writing an obituary or death notice, and making sure money is available to cover final expenses. Taking care of these details in advance reduces stress for loved ones and helps ensure that personal wishes are followed. Conversations about funeral and burial/cremation preferences, values, and practical arrangements can begin long before they are needed. Consider writing or updating an obituary or personal note in advance so that key facts, stories, and wishes are clear for family members when the time comes.​​​​​

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COST CONSIDERATIONS

Funeral and related costs can be high. National medians in recent years show a traditional funeral with viewing and burial often ranging from roughly $7,000–$12,000 (before cemetery plot, vault, or marker costs), while a funeral with cremation is typically lower. Direct cremation is usually the least expensive option. Prices vary by location, funeral home, and the specific services chosen.

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Medicare does not pay for funeral, burial, or cremation expenses. Medicaid generally does not cover these costs either, though limited state or local burial assistance may be available for those who qualify based on financial need. Social Security provides a one-time lump-sum death payment of $255 to an eligible surviving spouse or child. Veterans and their eligible family members may qualify for burial benefits through the Department of Veterans Affairs.

 

Common ways to cover or plan for these costs in advance include:

  • Setting aside funds in a dedicated savings or payable-on-death account

  • Purchasing final-expense or burial insurance

  • Establishing a prepaid funeral plan or irrevocable funeral trust (these can also help with Medicaid asset limits in many states when structured properly)

  • Including clear instructions in an advance directive or other written document

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ADDITIONAL RESOURCES

 

THE CONVERSATION PROJECT: Tools and starter kits to help families begin discussions about end-of-life wishes.

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FUNERAL CONSUMERS ALLIANCE OF MARYLAND & ENVIRONS: Independent consumer information on funeral costs, pre-planning, and rights under Maryland law.

 

MARYLAND BOARD OF MORTICIANS AND FUNERAL DIRECTORS: Guidance on pre-need (prepaid) funeral contracts and consumer protections.

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SOCIAL SECURITY ADMINISTRATION - SURVIVORS BENEFITS: Information on the $255 lump-sum death payment and other possible benefits.

 

U.S. DEPARTMENT OF VETERANS AFFAIRS - BURIAL BENEFITS: Details on burial allowances, cemetery options, and related benefits for eligible veterans and families.

Long-Term Care Planning

 

OVERVIEW

The Maryland Insurance Administration makes available a long-term care planning guide and related resources  for your personal needs. For additional information or questions, email mhcc.qualityteam@maryland.gov or call (877) 245-1762.​

Long-Term Care Insurance

 

OVERVIEW

Long-Term Care (LTC) insurance can cover all or some of the cost for long-term care and is available in multiple forms.​​

 

MARYLAND INSURANCE ADMINISTRATION

The Maryland Insurance Administration regulates the sale of LTC insurance policies in Maryland and maintains a list of the insurance companies approved to sell individual LTC policies in Maryland. Or, call (410) 468-2000 for more information.

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KEY COST FACTORS

  • Gender: Women face higher rates than men because they statistically live longer and file more claims.

  • Health Status: Good health allows you to qualify for "preferred" discount rates, while pre-existing conditions raise costs or cause denial.

  • Benefit Amount: Higher monthly maximum payouts and longer benefit periods increase the premium.

  • Inflation Protection: Adding riders that increase your benefit value by 2% to 5% each year will significantly raise the monthly cost.

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ADDITIONAL RESOURCES

This article also gives an excellent overview of LTC insurance, including average premium costs, uses, what it covers, and alternatives.​​

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Click here  for additional consumer information about LTC insurance from the National Association of Insurance Commissioners, as well as the Shopper's Guide to Long-Term Care Insurance, which you can download.

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COMPLAINTS OR FRAUD

Click here to learn how to file a complaint about your long-term care insurance provider or agent, or to report suspected long-term care insurance fraud.

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