In short
Most assisted living communities offer a few levels of care and charge more as a resident needs more help, the National Institute on Aging says. The level is set by an assessment of daily tasks, medicines and supervision, and is usually reassessed after a change in health. Ask how each level is defined, priced and reviewed.
How care levels usually work
- An assessment at move-in looks at help with bathing, dressing, toileting, mobility, medicines and memory.
- The level sets the price. Many communities add a monthly care fee on top of rent; some use points, some use tiers.
- Reassessment follows a fall, a hospital stay or a noticeable change, and can move the resident up a level.
License types can limit care, too
States also license what a community may provide. Florida, for example, licenses assisted living facilities with a standard license and specialty licenses for limited nursing services, extended congregate care and limited mental health. A community without the right license may not be able to keep a resident whose needs grow.
Triggers that commonly move someone up a level
- Needing hands-on help with more daily tasks
- Needing two staff for transfers
- Incontinence care
- Memory loss that requires more supervision or redirection
- More complex medicine management
Questions to ask about care levels
Questions families ask
Do all assisted living communities have care levels?
Many do. NIA notes that typically a few levels of care are offered, and residents pay more for extra services. Others charge for each service separately.
Can assisted living raise the price when needs change?
Usually yes, after a reassessment. The contract should explain how and when, so read that section before signing.
What happens if my parent needs more care than assisted living can give?
The community may require a move to memory care or a nursing home. Ask what its limits are before move-in.
Is memory care a higher level of assisted living?
Often it is a separate unit with its own pricing. Ask whether it is a care level or a different program.