Same Metro, Different Rulebook: Why Virginia Splits Facility Licensing and DC/Maryland Don't

Ask three different families in this metro where to find a facility's inspection record, and you'll get three different correct answers - because the underlying agency structure genuinely isn't the same across the three jurisdictions.

DC and Maryland: one agency, every level of care

In the District, DC Health's Health Regulation and Licensing Administration licenses and inspects Assisted Living Residences and nursing facilities alike. In Maryland, the Office of Health Care Quality does the same across Montgomery and Prince George's counties (and the rest of the state) - Assisted Living Programs and comprehensive care facilities both fall under OHCQ. One search, one office, either level of care.

Virginia: two agencies, split by care type

Northern Virginia works differently. The Virginia Department of Social Services (VDSS), Division of Licensing Programs, licenses Assisted Living Facilities under 22VAC40-73. Nursing facilities are an entirely separate matter, licensed by the Virginia Department of Health (VDH), Office of Licensure and Certification. A facility that offers both assisted living and a skilled-nursing wing - common at larger CCRC campuses in Fairfax County - can actually carry licenses from both agencies for different wings of the same address.

Practical takeaway

• Touring in Washington, DC? Everything runs through DC Health/HRLA.
• Touring in Bethesda, Silver Spring, Rockville, Gaithersburg, Wheaton, Hyattsville, or College Park? Everything runs through Maryland OHCQ.
• Touring in Arlington, Alexandria, Fairfax, McLean, Reston, Falls Church, or Springfield? Assisted living is VDSS; nursing/skilled care is VDH. Confirm which one applies to the specific unit or wing your parent would live in.