Understanding Levels of Care in an Adult Family Home
Care levels are a practical way to describe how much assistance a resident may need. They do not replace an individual assessment.
Level I — Light Care / Independent
A resident may be ambulatory, alert and oriented, continent, able to complete part of their own activities of daily living, and may need medication reminders or light assistance.
Level II — Moderate Care / Independent with Assistance
A resident may need help standing, occasional bladder incontinence support, mild redirection, assistance with activities of daily living, or medication assistance while still participating in their own care.
Level III — Heavy Care / Dependent on Assistance
A resident may require one-person transfers, significant ambulation support, bladder or bowel incontinence care, substantial direction, extensive help with activities of daily living, and complete medication assistance.
Level IV-A — Heavy Care / Total Care
A resident may use a wheelchair, require one-person transfers, have dementia or cognitive impairment, need significant help with daily living, complete medication assistance or administration, fall-risk support, and occasional nighttime care.
Level IV-B — Complex / Intensive Care
This level may include hospice or end-of-life care, bedbound residents, frequent repositioning, long feeding sessions, bed baths, intensive nighttime care, two-person assistance, mechanical-lift support, high fall or elopement risk, complex dementia, or other situations requiring increased staffing and coordination.
Why assessment matters
Two residents with the same diagnosis may need very different amounts of assistance. Care level should therefore be based on the resident’s actual functional needs, safety needs, care plan, staffing requirements, and the home’s ability to safely provide the needed support.
Have questions about a specific care situation?
Every resident is different. We can discuss care needs, current availability, and which of our three homes may be the best fit.