Amid $1.4B deficit, Maryland lawmakers vow to address unlicensed senior facilities

by TESSA BENTULAN

The Maryland Department of Health is headquartered at 201 W. Preston St. in Baltimore. (Zackary Lang / Spotlight on Maryland)

MARYLAND (WBFF) — Maryland lawmakers will return to Annapolis in January facing a projected $1.4 billion budget deficit, a challenge expected to dominate the 2026 legislative session. But some lawmakers say the state cannot afford to sideline another growing problem: the rise of unlicensed senior living facilities.

A Spotlight on Maryland investigation has found more than 115 suspected unlicensed assisted living facilities in Baltimore, with many older adults found living in substandard and sometimes unsafe conditions — often with no trained medical staff and little to no state oversight. Many residents end up in these homes in exchange for their Social Security or disability checks, a practice some attorneys have described as a form of senior “trafficking.”

Although Maryland passed a law in 2023 that made operating an unlicensed assisted living facility a felony, enforcement has lagged. Some homes continue to operate in violation of the statute, raising questions about whether regulators and prosecutors are using the tools available to them.

In interviews last week, three senior House lawmakers — Republican Del. Jason Buckel, Democratic Del. Bonnie Cullison and Republican Del. Jesse Pippy — all said they expect the issue to be taken up during the session despite the state’s fiscal constraints.

Spotlight on Maryland requested interviews with nine Democrats and four Republicans, all of whom are senior leaders in the House and Senate. The majority either did not respond to Spotlight on Maryland’s inquiry or declined because of prior commitments.

Cullison is a member of the majority party that has controlled the General Assembly for decades and the vice chair of the House Health and Government Operations Committee, which handles nearly all health care–related legislation. She said she expects the topic of senior care to reemerge.

“The discussion will absolutely happen,” Cullison said. “One of the discussions we’re going to be having is enforcement.”

Enforcement has become the central bipartisan concern regarding unlicensed assisted living facilities. Maryland’s 2023 law strengthened penalties, but regulators have continued to identify unlicensed operations without meaningful intervention.

Buckel, the House minority leader, said state agencies and prosecutors need to act more decisively.

“What we have to do through the regulatory process and through the state’s attorney general’s office is say, ‘If we’ve identified these places today, we’re going after them tomorrow,’” Buckel said. He argued that consistent enforcement could deter future illegal operators.

Cullison said her committee hears concerns about senior care “every single session.” She said the core challenge is finding unlicensed facilities in the first place and then deciding how the state should enforce standards of care.

“It’s really complaint-based,” she said. “If we don’t know about a facility that is acting in this role, then there’s no way for us to be able to monitor them.”

Cullison also acknowledged the state is operating with limited health care dollars — constraints she said are partly driven by federal cuts.

“We’re going to be seeing cuts to Medicaid, increased costs for SNAP,” she said.

The state had a $5 billion surplus in January 2023 — more than $2 billion in the general fund and an additional $2.9 billion in the rainy day fund. Gov. Wes Moore shared this information with the public just days into his administration. That dwindled to a $3.3 billion budget deficit, which had to be balanced last year.

Lawmakers will again face another deficit when they head to Annapolis next month. Still, Cullison said the priority will remain on safety, even if the state does not currently have enough licensed senior living facilities to meet the demand.

“We’re going to do whatever we can to help [older adults],” she said.

That could mean considering interim or imperfect solutions, Cullison added.

“We want to make sure we are having the discussion that, at least, meets some of their needs,” she said. “Here’s an example: ideally, a senior would have their own room. It may be an example of some kind of compromise. I’m not saying this would happen, but part of the discussion might be we have to have two people in a room.”

Pippy, the House minority whip, expressed similar urgency while acknowledging that the budget deficit will take up a lot of time.

“It should have been addressed before. It appears the state has let down a lot of our senior citizens,” he said.

In his legislative career, Pippy has introduced a number of public safety bills and bills protecting vulnerable groups, including seniors.

“[The state budget] is going to be a lot, but we’re going to have to balance that with all these other priorities as well.”

As lawmakers prepare for the session, the question remains whether the General Assembly, already bracing for a prolonged debate over deep budget cuts, will commit the time, staff and resources needed to address the spread of unlicensed senior living facilities.

Spotlight on Maryland will monitor proposed legislation and committee hearings throughout the session. It will continue asking lawmakers how they plan to address the issue if it is not brought forward. 

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Amid $1.4B deficit, Maryland lawmakers vow to address unlicensed senior facilities