Understanding Our Levels of Care
Our adult family home care levels describe the support a resident may need in Bothell or Kirkland, from light assistance to more intensive care. They guide discussion and do not replace an individualized assessment.
Level I — Light Care / Independent
A resident at this level generally meets at least three of the following:
- Ambulatory
- Alert and oriented
- Continent
- No significant behavioral concerns
- Able to perform at least some activities of daily living independently
- May require medication reminders or assistance
Typical support: Light assistance, supervision, medication support, and help maintaining independence.
Level II — Moderate Care / Independent With Assistance
- Needs assistance when standing but is otherwise ambulatory
- May occasionally experience bladder incontinence while remaining continent of bowel
- May be mildly confused but responds well to direction
- Can participate in activities of daily living
- May require assistance with medications
Typical support: Moderate assistance while encouraging as much independence as possible.
Level III — Heavy Care / Dependent on Assistance
- Requires one-person assistance with transfers between bed, chair, and toilet
- Requires assistance with ambulation
- Experiences bladder and/or bowel incontinence
- May be confused and require significant direction
- Is often unable to perform activities of daily living independently
- Requires complete medication assistance
Typical support: Extensive hands-on assistance throughout daily activities and medication management.
Level IV-A — Heavy Care / Total Care
- Requires one-person assistance with transfers
- Uses a wheelchair
- Experiences incontinence
- Has dementia or cognitive impairment
- Requires significant help with activities of daily living
- Requires complete medication assistance or administration
- May be at increased fall risk
- May occasionally require nighttime care
Typical support: Comprehensive assistance with mobility, personal care, medication support, safety, and daily activities.
Level IV-B — Complex / Intensive Care
This level may include a resident receiving hospice or end-of-life care, including bedbound status, pain-management needs, repositioning as required by the care plan, medication administration as ordered, extended feeding assistance, bed baths, and extensive personal care.
It may also include residents requiring two-person assistance, mechanical-lift support, additional staffing, high fall or elopement risk, frequent nighttime care, complex medical conditions, or complex dementia and behavioral-health needs.
Typical support: Intensive, individualized care requiring greater staff involvement and coordination with appropriate healthcare professionals.