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Levels of Care

Image of two elderly woman hugging and smiling.Assisted living facilities are designed for people who need assistance with daily activities such as personal care, medication management, mobility, meal preparation and household chores. However, these facilities are not appropriate for people who need daily nursing services, such as those provided in nursing homes.

In accordance with state regulations, assisted living facilities are licensed to provide care for individuals at one of three levels of care. Some facilities are licensed for Level One, while others are licensed for Level Two or Three. Providers who are licensed for Levels Two or Three can also admit residents who require lower levels of care.

  • Level One (low level of care): The resident needs occasional supervision, assistance or reminders to perform some daily activities, but is independent in other activities. He or she may require assistance or reminders to take medications, or may be able to take medications independently.
  • Level Two (moderate level of care): The resident requires more substantial support with some activities of daily living, while needing only minimal assistance with others. Assistance with medications may be provided.
  • Level Three (high level of care): The resident needs frequent and comprehensive assistance with activities of daily living. Staff administers medications or assists the resident to take them; staff monitors the resident for the effects of medications.

Note: If a resident requires more than Level Three care, the provider may request a resident-specific waiver from the state, if the provider can show that the facility can provide the needed services.

Assessment and Cost of Care

At the time of admission, the manager will assess the level of care that your older relative will require. If this level of care exceeds the level(s) for which the facility is licensed, you will need to find another facility that is licensed for that level. The resident's level of care is reassessed on a regular basis.

Your relative's level of care may affect the total cost of care. Be sure you understand how the fees may increase if your relative requires more care in the future.

When you consider an assisted living facility, think about how your relative's health status may change over time. If your relative has a progressive condition, such as Alzheimer's disease or Parkinson's disease, he or she may need more help in a year or two than is presently required. Consider choosing a facility that is licensed for Level Three, so the person may remain at the facility until the time when they need another care setting, such as a nursing home or a hospice program.