BALTIMORE (WBFF) — Across Baltimore, more than 115 seemingly ordinary homes – from brick apartment buildings to small rowhouses with tidy lawns – quietly serve as the last stop for potentially thousands of elderly and vulnerable residents. Behind many of those doors, seniors are warehoused in unlicensed assisted living facilities with little oversight, few inspections, and often no trained medical staff.

For years, state and local officials have known about this shadow network of unlicensed care homes, where older and disabled Marylanders often end up in exchange for their Social Security or disability checks. Lawyers have called it “trafficking,” benefit exploitation, and outright neglect.

A Spotlight on Maryland investigation found that state and local agencies have repeatedly failed to shut down dozens of known unlicensed facilities, allowing an underground industry to flourish in Baltimore’s neighborhoods. Hundreds of emergency calls, thousands of documents, and interviews with lawyers, families, caregivers, and business owners reveal a grim pattern: people in their final years left to die in squalor while government agencies look away again and again.

The Office of Health Care Quality (OHCQ) — the Maryland Department of Health agency responsible for monitoring and licensing the state’s health care facilities – said it takes “appropriate action” to protect seniors, but acknowledged that despite hundreds of complaints since October 2023, it has sent one referral for prosecution to shut down unlicensed assisted living facilities (ALFs). Maryland Attorney General Anthony Brown’s office separately confirmed that it received one.

That one referral was in August 2024. OHCQ and the AG’s office said zero complaints were referred for prosecution in 2025.

This Spotlight on Maryland investigative series will expose how government failures have built an economy of exploitation – and who profits, who enables it, and who allows the state’s seniors to be ignored behind closed doors.

Here’s an overview of Spotlight on Maryland’s findings, which will be reported in depth in the coming weeks and months.

A crisis in plain sight

The investigation began when Spotlight on Maryland noticed a pattern: repeated 911 calls to the same Baltimore addresses for elderly residents in distress. Many of the calls involved unrelated seniors of different ages and genders living at the same locations – properties that were not listed as licensed assisted living facilities.

A trail of government records, lawsuits and nearly 500 hours of fieldwork — that took Spotlight on Maryland to even South Carolina — revealed a system that appears to be operating outside the law. Emergency responders frequently filed complaints with OHCQ detailing unlicensed assisted living facilities operating unchecked.

The complaints described strangers living together in cramped rowhouses, seniors left unwashed and unfed, and residents packed into bedrooms so crowded they violated city occupancy limits.

Maryland Legal Aid, a nonprofit law firm serving low-income residents, warned lawmakers in March 2023 that state protections for seniors and disabled adults were dangerously inadequate.

“It’s no secret that unlicensed ALFs engage in human and/or benefits trafficking, using coercion, deception, threats or other means to traffic a victim, moving them from one facility to another for the additional purpose of appropriating their benefits, such as Social Security Retirement, Food Stamps (SNAP), or other benefits,” the law firm said in its 2023 written testimony.

Those with low or no income are especially vulnerable to such exploitation because “they often have nowhere else to go,” Maryland Legal Aid said.

A licensed assisted living facility in Maryland costs about $4,000 per month, according to Maryland Legal Aid. Unlicensed operators charge far less – sometimes between $600 to $1,000 – creating an illicit market that preys on those least able to protect themselves, according to Spotlight on Maryland’s investigation.

There have also been federal warnings. An 81-page study from the U.S. Department of Health and Human Services in 2015, during the Obama administration, said “unlicensed care homes appear to be widespread in some areas within some states.”

“They are commonly run in single-family residences, but also were reported to operate inside buildings that had been schools or churches,” the HHS study said. “Although some … informants provided a few examples of unlicensed care homes where residents receive what they categorized as good care, it appears that abuse, neglect, and financial exploitation of these vulnerable residents is commonplace.”

The HHS report highlighted a handful of states, including Maryland, Georgia, Indiana, North Carolina, Pennsylvania, and Texas. In Maryland, federal researchers found that there may have been 78 unlicensed care homes serving more than 400 individuals in one county.

A separate federal report around the same time period estimated 370 to 400 beds in unlicensed assisted living facilities in Anne Arundel County.

Government documents show suffering

The suffering is laid bare in OHCQ complaints obtained by Spotlight on Maryland.

There are more than 115 unlicensed assisted living facilities operating across Baltimore, a Spotlight on Maryland investigation found. (Credit: WBFF)

In one case, Baltimore police discovered a 74-year-old man who had been missing for four days, his body covered in maggots, found beneath a bush outside a suspected unlicensed home in Lake Walker.

In West Baltimore’s Forest Park neighborhood, officers found a 77-year-old male inside an alleged unlicensed ALF, lying in a hospital bed, unresponsive and “covered in a copious amount of dried feces.”

[He] also [had] a large piece of what appeared to be an adult diaper in [his] mouth with feces present,” an emergency responder reported to OHCQ.

In yet another incident, a 60-year-old woman managed to call for help only after fighting to retrieve her cellphone from an alleged unlicensed ALF manager. Inside the ambulance, she told responders she could no longer urinate without severe burning and struggled to walk.

Spotlight on Maryland asked Rafael Lopez, secretary of the Maryland Department of Human Services, what his agency is doing to aid vulnerable adults living in unlicensed facilities. Lopez’s agency oversees Adult Protective Services.

“I’m not familiar with the specific question you’re asking,” Lopez said. “When any case comes to our attention of any kind of abuse of an adult, we act urgently and we make sure we treat that adult with the respect and dignity that they deserve.”

Despite Lopez saying his team would provide data on the number of contacts and referrals made from individuals living in unlicensed ALFs, his office did not supply that information and said the department does not categorize complaint data by setting.

The systemic cycling of elderly adults with nowhere to go

Each emergency visit to an area hospital triggers the same bureaucratic system: After treatment, hospitals scramble to find placement for what professionals call “complex cases.”

Some individuals – overwhelmingly elderly, Black, disabled, and poor – are cycled from emergency rooms to unlicensed homes, then back again. Many suffer from dementia, Alzheimer’s, terminal cancer, or substance use disorders.

Lawyers, health care workers, and family members described an unbroken loop in which hospitals discharge patients because they need the beds, and nobody checks where they end up.

In one case, Christina Talley said she called police for a welfare check after learning that her 69-year-old sister, who has Lewy body dementia, was left alone by home care professionals. Her sister – whom Talley asked not to name – had previously set her home on fire by accident because of her memory loss.

Christina Talley said she called police for a welfare check after learning that her 69-year-old sister, who has Lewy body dementia, was left alone by home care professionals. (Zackary Lang / Spotlight on Maryland)

Talley said her sister later spent about four months at a Johns Hopkins hospital as doctors worked to determine the best medication and treatment plan for her complex condition. Eventually, a meeting was held between hospital staff and family members to discuss her sister’s long-term care.

Talley said she felt she had no choice when the hospital informed her family that her sister needed to be moved.

The government “needs to advocate for the aging,” Talley said. “There has to be laws, and rules, and regulations – a deep dive into how the aging system is being run and put them [the seniors] first instead of the bottom line, the money.”

Talley said the ongoing cycle between hospitals, residential placement organizations, and both licensed and unlicensed assisted living facilities has taken a toll on her sister and the entire family – with no clear end in sight.

A spokesperson for Johns Hopkins hospitals acknowledged Spotlight on Maryland’s questions about Talley’s experience and allegations but did not respond before publication.

‘I take it one day at a time’

George “Bobby” Gilliam, 62, is one of many older Marylanders with nowhere else to go. Standing outside a Garrison Boulevard building in early October, he described his living situation to Spotlight on Maryland.

George “Bobby” Gilliam, 62, is one of many older Marylanders with few housing options. (Zackary Lang / Spotlight on Maryland)

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“I pay $765 a month for rent…I can stay here as long as I can pay my rent,” Gilliam said. “They give medication, they send you to the day program. Right now, I’m trying to get food stamps.”

Gilliam’s brother, Frank Clark, said their family has struggled for years to find him adequate care and support. Speaking from his car outside his elderly parents’ home in Sumter, South Carolina, Clark said both parents – now in their 80s and hospitalized – have been desperate to ensure Gilliam is safe. Clark said his brother has a history of drug addiction and is vulnerable to exploitation.

“You’ve been there. You’ve seen the area. It’s the worst place in the world you could put them type of people because they’re susceptible to everything around,” Clark said. “I know this is his second, maybe third go around with them. They had a smaller house the first time. I think they still got that same house, I’m not sure.”

Although a staff member said the building’s residents are fed, Gilliam said he was still waiting for government assistance to supplement what he had in his apartment – a bag of rice and some water.

At the end of the day, a long day, I pray, I just pray, and I sit back and I be quiet,” Gilliam said. “It gives me a peace of mind, and I go to a quiet place, a little quiet area, and I pray to God and Jesus Christ, and I take it one day at a time – that’s all I can do.”

His situation underscores a growing crisis in Maryland: Older residents with limited income or health challenges often end up in various housing settings with little oversight, but which fill a gap no one else will.

‘We take people 24 hours a day’

Gilliam lives in a building operated by Daquan Thomas, who identified himself to Spotlight on Maryland as founder of Aim to Inspire Care Forever Limited, a nonprofit running a multistory building on Garrison Boulevard in Walbrook Junction. He calls his business “supportive housing.”

“I would say one of our biggest supporters would be LifeBridge Health,” Thomas said. “They really don’t believe in, you know, putting people out on the streets, so, if anything, they’ll contact us. We take people 24 hours a day, seven days a week.”

LifeBridge Health confirmed to Spotlight on Maryland that it has a business relationship with Thomas’ organization, claiming it partners for “medical respite care.” When asked to define the partnership and what qualifies as an appropriate discharge to Thomas’s organization, LifeBridge Health’s spokesperson Sharon Boston responded, saying, “We have no further comment.”

Brian Mullen, a spokesperson for the University of Arizona Global Campus – the school that acquired and rebranded Ashford University in 2020 – said that Thomas, who claimed to hold a doctorate in health care administration from Ashford University, took only one course in 2010 and never graduated.

Mullen added that Thomas was enrolled in a bachelor’s program in human resources.

Daquan Thomas said that he is the founder of Aim to Inspire Care Forever Limited, a nonprofit running a multistory building on Garrison Boulevard in Walbrook Junction. He calls his business “supportive housing.” (Zackary Lang / Spotlight on Maryland)

Spotlight on Maryland emailed Thomas about the discrepancy. Thomas was also questioned about his active $1.7 million lawsuit against his nonprofit and Gilliam’s claims of verbal abuse.

“[S]hut your mouth find factual information you are working for my landlord and my attorneys will be in contact with your company,” Thomas said in an email. “My Ph. D [sic] is from a university you ask me which school I went to I advised you one of the many because your [sic] a snake in the grass working for the devil get a real story Gary as your time at your current company will end very soon.”

Court filings show multiple bankruptcy cases for Thomas spanning 15 years and a $1.7-million judgment for unpaid rent at his Garrison Boulevard property, where Thomas said he has also struggled to pay energy bills. Bankruptcy filings show that Thomas claimed to have earned income only from working in retail for the prescription eyeglass industry.

In July 2024, Thomas applied to be a nonprofit and last month told Spotlight on Maryland he has applied to receive state and local taxpayer funds.

“We’ve applied for multiple grants and federal funding,” Thomas said. “[W]e still haven’t gotten any type of, you know, help, unfortunately – but it is what it is. We’re still making it happen, you know, we have the hospitals that we work with who, you know, make private donations to the nonprofit.”

Thomas described the services Garrison Boulevard location offers.

“Typically, it just depends on the client,” Thomas said. “If the client needs assistance with medication management, if the client needs assistance with light housekeeping, if the client needs trips back and forth to appointments, anything of that nature.”

The property’s owner, 211 W Garrison, LLC, has filed for receivership, alleging Thomas is illegally running an assisted living facility. Despite the legal troubles, Thomas claimed to be serving individuals living in 38 units in the building and between 200 and 400 people – most poor, disabled, struggling with mental illness, or battling addiction – since he started operating Maryland facilities in 2018.

But as the legal battle continues, residents like Gilliam are living in a last resort where they are paying rent to an operator who is being sued for allegedly not paying his lease, potentially putting their housing at risk.

‘Nobody’s noticing’

Spotlight on Maryland requested interviews with LifeBridge Health and Johns Hopkins, both identified by multiple sources as hospitals that outsource some discharge placements to third-party operators. Neither institution agreed to an interview.

“[Assisted living] facilities need to be licensed and monitored,” said Arthur Drager, outside counsel for Johns Hopkins hospitals and other Maryland hospital systems. “It’s not a matter of only getting a license. Someone or some entity needs to oversee and stop in, unannounced, in facilities, to see what is actually going on.”

Ellen Jordan “EJ” Hammann, a partner with the Baltimore medical malpractice firm Brown and Barron, said that those inside licensed and unlicensed facilities caring for seniors are not the only ones keeping silent. Seniors often won’t — or can’t — advocate for themselves.

Our elderly population tends to be quiet, especially when they’re ill. They’re not making a lot of noise,” Hammann said. “What we have is a quiet generation slowly slipping away, and nobody’s noticing.

Ellen Jordan “EJ” Hammann, a lawyer at Brown and Barron, said seniors often won’t — or can’t — advocate for themselves. (Zackary Lang / Spotlight on Maryland)

Drager, the outside counsel for Johns Hopkins, said he “probably” has seen instances of seniors placed in an unlicensed ALF in his career after hospital discharge. Without naming the hospital, the elder care attorney for medical institutions said a guardianship client of his was shipped one day to an old farmhouse in Delaware.

When Drager arrived with hospital attorneys, he said he saw approximately half a dozen seniors sitting in a living room around a television set.

“I took this woman outside, with the attorney from the hospital,” Drager said. “She had bruises on her arms, she was frightened of the people who had the facility, and we let her know we were not going to leave without her.”

Hammann said lawyers who work on elder neglect and elder abuse talk about the absence of care. “And I think it is sometimes akin to warehousing. It’s like you’re renting a storage unit, you sign a contract, you put boxes in a storage unit, and you forget about them.”

Even as the crisis and unlicensed facilities multiply, state lawmakers are considering loosening regulations. One bill introduced during the 2025 session would expand Medicaid funding for long-term rentals, a step advocates say could blur the line between supportive housing and unlicensed care homes.

In written testimony, Johns Hopkins said of the proposed Maryland expansion: “There are real benefits to providing this service, we know first-hand.”

A law with no enforcement

Two years ago, the Maryland General Assembly – at the request of Attorney General Brown – made operating an unlicensed assisted living facility a felony. The law had overwhelming bipartisan support and the backing of advocates for older adults.

Maryland State Attorney General Anthony Brown’s office in 2023 pushed for legislative changes to make it a felony to operate an unassisted living facility.

“One thing has become clear…unlicensed assisted living facilities are hotbeds for the abuse and exploitation of vulnerable victims who cannot speak for or protect themselves,” said W. Zak Shirley and Lisa Hyle Marts, leaders in the Medicaid Fraud Control Unit in the attorney general’s office, in a March 30, 2023, memo. “By virtue of remaining unlicensed, these facilities operate in the shadows – enriching their unscrupulous owners/operators by taking advantage of people in desperate need of assistance.”

At the time, Baltimore City Mayor Brandon Scott’s office said the city’s health department knew of 80 unlicensed ALFs. That estimate has increased by nearly 50% in two years, based on counts now tracked by local and state agencies.

In a March 2023 letter to the state House Health and Government Operations Committee, the Mayor’s Office of Government Relations acknowledged “multiple complaints” about unlicensed assisted living facilities, citing financial, physical, and psychological abuse, resident neglect, inadequate food for residents, mismanagement of their medications, and theft of their financial benefits.

Nearly three years later, the city declined to answer Spotlight on Maryland’s questions about unlicensed assisted living facilities. A city spokesperson said the request for information would be “handled by the Office of Health Care Quality – within the Maryland Department of Health – as they are responsible for licensing and regulating assisted living facilities, residential service agencies, and nurse referral agencies.”

The Maryland Department of Health said it takes “appropriate actions” to combat unlicensed ALFs, including cease and desist letters, fines, and referrals to the attorney general for prosecution. A department spokesperson estimated receiving eight to 10 complaints per month about unlicensed facilities – consistent with a 2023 Health department letter showing about 120 allegations investigated annually.

Spotlight on Maryland has filed a public records request with OHCQ to learn more about the complaints and referral process.

OHCQ works closely with the Medicaid Fraud Control Unit (MFCU) within the Office of the Attorney General to investigate and prosecute these unlicensed programs,” said the 2023 letter from former Health Secretary Laura Herrera Scott.

Yet Brown’s office confirmed that not a single prosecution has been brought under the new law since it took effect in October 2023.

Brown’s office said it received one criminal referral in August 2024 for a suspected unlicensed assisted living facility in Anne Arundel County. Jennifer Donelan, the AG’s spokesperson, said the office “declined to prosecute due to insufficient evidence.”

Privately, government officials have met about what they call a growing unlicensed ALF crisis, according to senior government officials not authorized to speak to the media. The same leaders who championed the 2023 legislation have failed to enforce it, overwhelmed by the growing number of aging Marylanders in need and the lack of legitimate housing alternatives.

Have you experienced or have direct knowledge about unlicensed assisted living facilities operating in Maryland? Do you have a tip related to this story? Send news tips to gmcollins@sbgtv.com or contact Spotlight on Maryland’s hotline at (410) 467-4670.

Follow Gary Collins on X and Instagram. Spotlight on Maryland is a collaboration between FOX45 News, WJLA in Washington, D.C., and The Baltimore Sun.