What Are the Levels of Care in Assisted Living

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Not every resident in assisted living needs the same type of care. Some just need a little help. Others need support all day, every day. That’s why understanding what the different levels of care are is so important.

If you’re starting or running an assisted living home, this guide will help you know exactly what to offer, what to look for, and how to support residents as their needs change.

Check out this video, too;

Why This Matters

Offering the right level of care helps you:

✅ Avoid burnout for your team
✅ Keep your residents safe and satisfied
✅ Stay compliant with state regulations
✅ Make sure your facility runs smoothly and profitably

Let’s break it down.

👶 Level 1: Supervisory Care

This is the lightest level of care. These residents can do most things on their own. They just need:

Medication reminders
Some light supervision
Maybe help with setting up doctor appointments

You’re mostly checking in on them and making sure they’re safe. You might have daily conversations, monitor their behavior, and just be there in case something happens.

This is perfect for residents who are still pretty independent.

🚶 Level 2: Personal Care

Now we’re stepping it up a bit.

These residents need some hands-on help with:

Bathing
Dressing
Toileting
Eating
Transferring (getting in and out of bed/chairs)

At this level, your staff will be helping multiple times a day. You’ll need caregivers who are trained and ready to offer support in a kind and respectful manner.

This is one of the most common levels of care in assisted living.

🛏️ Level 3: Directed Care

This is a higher level of care for residents who:

Can’t direct their own care
Might have memory issues
Need help with all ADLs (Activities of Daily Living)
Could be a safety risk if left alone

These residents might have dementia, Alzheimer’s, or other cognitive impairments. They need more supervision, more staff time, and more planning around their day.

It’s not quite a skilled nursing level yet, but it’s getting close. Your team should be trained to manage behaviors, communicate clearly, and keep residents calm and engaged.

⏳ When Residents Decline or Improve

Residents’ needs can change — fast.

Let’s talk about what to do when that happens.

If They Decline:

If a resident starts needing more care than you can legally or safely provide, you have three main options:

Bring in Hospice
Hospice can offer additional support to your team and the resident — especially at end-of-life. This lets the resident stay in a familiar setting without having to move.
Discharge to a Skilled Nursing Facility
If the resident still has months to live but needs 24/7 medical care, it might be time to move them. Skilled nursing is designed for people who need constant clinical attention.
Add Extra Services
Depending on your license, you might be able to bring in home health or other third-party providers to help with things like wound care, therapy, or injections.

If They Improve:

Yep, that happens too!

Some residents get better — physically or mentally — and they might not need the level of care you provide.

In that case, they might be a better fit for:

Independent living
Home with family
A less intensive care setting

If they’re bored or don’t need your services anymore, it’s okay to help them transition. That’s a win for them and you.

🎯 Quick Tips for Managing Levels of Care

Here’s how to stay on top of it all:

✅ Do regular assessments — at least annually

✅ Track changes in condition or behavior

✅ Communicate with families about what's happening

✅ Know your state’s licensing requirements

✅ Don’t be afraid to say, “This isn’t the right fit anymore”

Remember: It’s not about keeping every resident forever. It’s about giving them the right care at the right time.

Take Action Today!

🚀 Want to launch your assisted living business in the next 12 months?

✅ Step 1: Download the Business Plan Checklist to start planning.
✅ Step 2: Apply to the Assisted Living Investing Mastermind for expert coaching.
✅ Step 3: Follow this guide, take action, and bring your vision to life!

Got questions? Drop them in the comments below! ⬇️

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