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Census 2025 estimates · CMS September 2026 · CDC 2020

Senior housing development in Maryland

Maryland had 494,794 residents aged 75 and older in July 2025, +24.5% since April 2020 (US +23.4%), and 126,255 aged 85 and older (+12.7%). Its 221 certified nursing homes hold 27,235 beds, 215.7 for every 1,000 people 85 and older, fewer than the US ratio of 222.6. Certificate of need for nursing home beds: yes; for assisted living: not listed.

Age 75+ (2025)
494,794
Growth since 2020
+24.5%
Nursing beds per 1,000 aged 85+
215.7
Assisted living beds per 1,000 aged 75+
39.6

Demand: the older population

Age groupApril 2020July 2025ChangeUS change
75 and older397,425494,794+24.5%+23.4%
85 and older112,062126,255+12.7%+11.3%

Nationally, the Census Bureau's 2023 projections have the 75+ population growing 21% from 2025 to 2030 and the 85+ population 59% from 2025 to 2035. The bureau publishes those projections for the US only, not by state.

Supply: licensed beds

SettingBedsPer 1,000 aged 75+Per 1,000 aged 85+Source
Nursing homes (Medicare or Medicaid certified)27,23555.0215.7CMS, September 2026
Residential care / assisted living19,60039.6155.2CDC survey, 2020

US: 222.6 nursing beds and 170.1 assisted living beds per 1,000 aged 85+. Assisted living beds are CDC's 2020 survey estimate, its latest with state detail, set against 2025 population, so the ratio understates any supply added since.

Certificate of need

Nursing home beds
Yes
Assisted living
Not listed
Notes
None

From NCSL's certificate of need table (updated April 29, 2025, covering January 2025) with later changes checked on state sites on October 24, 2026. "Not listed" means NCSL does not name assisted living, not that it is exempt. Confirm with the state health planning agency before relying on it. HUD requires a state CON for nursing home beds where the state has one (Handbook 4232.1, 2.5.EE).

Counties

The 24 counties with the most residents aged 75+, with certified nursing home beds per 1,000 aged 85+.

CountyAge 75+Since 2020Share of populationAge 85+Nursing homesBeds per 1,000 aged 85+
Montgomery County90,177+28.0%8.4%25,18634184
Baltimore County74,635+18.0%8.8%20,44243253.4
Prince George's County64,296+29.5%6.6%15,49119180.5
Anne Arundel County45,441+26.7%7.5%11,07314144.1
Baltimore city37,672+16.3%6.6%9,28127374.9
Howard County25,486+36.4%7.5%6,220697.7
Harford County22,025+25.9%8.3%5,0396163.1
Frederick County21,734+35.8%7.2%5,3068182.2
Carroll County15,854+22.2%9%4,06510222.1
Washington County13,791+14.6%8.7%3,85510258.9
Charles County10,948+30.6%6.2%2,4374208
Wicomico County8,538+19.7%8%1,9714311
Cecil County8,347+29.2%7.8%1,9303225.9
Worcester County7,463+20.6%13.7%1,8523165.8
Allegany County7,458+9.5%11.2%2,0368448.9
St. Mary's County7,433+22.5%6.4%1,6893338.1
Calvert County7,431+26.7%7.9%1,8623156.8
Talbot County6,099+15.9%16%1,6462178.6
Queen Anne's County5,454+34.0%10%1,256195.5
Dorchester County3,549+17.5%10.6%8122317.7
Garrett County3,395+16.4%12%9764323.8
Kent County2,845+20.7%14.5%7263314
Caroline County2,689+17.7%7.9%6492288.1
Somerset County2,034+12.9%8.1%4552463.7

Fastest growth in the 75+ population

  1. Howard County: +36.4% (25,486)
  2. Frederick County: +35.8% (21,734)
  3. Queen Anne's County: +34.0% (5,454)
  4. Charles County: +30.6% (10,948)
  5. Prince George's County: +29.5% (64,296)
  6. Cecil County: +29.2% (8,347)
  7. Montgomery County: +28.0% (90,177)
  8. Anne Arundel County: +26.7% (45,441)
  9. Calvert County: +26.7% (7,431)
  10. Harford County: +25.9% (22,025)

Counties with at least 2,000 residents aged 75+.

Fewest nursing beds per 1,000 aged 85+

  1. Queen Anne's County: 95.5 (120 beds, 1,256 aged 85+)
  2. Howard County: 97.7 (608 beds, 6,220 aged 85+)
  3. Anne Arundel County: 144.1 (1,596 beds, 11,073 aged 85+)
  4. Calvert County: 156.8 (292 beds, 1,862 aged 85+)
  5. Harford County: 163.1 (822 beds, 5,039 aged 85+)
  6. Worcester County: 165.8 (307 beds, 1,852 aged 85+)
  7. Talbot County: 178.6 (294 beds, 1,646 aged 85+)
  8. Prince George's County: 180.5 (2,796 beds, 15,491 aged 85+)
  9. Frederick County: 182.2 (967 beds, 5,306 aged 85+)
  10. Montgomery County: 184 (4,633 beds, 25,186 aged 85+)

Counties with at least 1,000 residents aged 85+.

HUD Section 232 construction in Maryland

Since fiscal 2001 HUD has insured 19 new construction or substantial rehabilitation loans on care facilities in Maryland (6 assisted living, 13 nursing homes), $142.9 million of original principal, 2 of them since fiscal 2016.

  • FY2021: Woman's Mill Assisted Living and Memory Care, Frederick, assisted living, $26.9 million
  • FY2016: Autumn Lake Healthcare at Chestertown, Chestertown, nursing home, $4.7 million

Planning a building in Maryland? Model the budget, lease-up and a HUD 232 construction loan.

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Sources: Census Bureau Vintage 2025 county population estimates; CMS Nursing Home Provider Information (September 2026); CDC/NCHS National Post-acute and Long-term Care Study (2020); HUD Office of Healthcare Programs endorsement database (data run 07/08/2026); NCSL. Absorption is operated by Janover Capital LLC and is not affiliated with any of them. Methodology.