Level of care assessment form 2025

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The form is used to determine the level of care and supervision required by a resident prior to the residents referral and admission into a licensed adult residential care home. Level of care is defined to mean a residents functional level.
In medicine, there are four levels of care: primary, secondary, tertiary, and quaternary. The levels of care refer to the complexity of the medical cases that healthcare providers treat and the skills and specialties of the providers. Primary care involves consulting with your primary care provider.
The five levels of assisted living include: Level 1: Independent living. Level 2: Assisted living. Level 3: In-home care. Level 4: Memory care. Level 5: Skilled nursing care.
The level of care assessment is usually required to be filed by individuals who are seeking long-term care services or support. This could include elderly individuals who need assistance with daily tasks, individuals with disabilities, or individuals with chronic illnesses who require specialized care.
Level 1: minimal help and care needed Residents in this category often dont need much supervision as they complete ADLs. But if a resident needs more help, they can ask to move into higher levels of care. The next level up is level two, where residents receive moderate hands-on care.
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