Lic 604a 2026

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  1. Click ‘Get Form’ to open the lic 604a in the editor.
  2. Begin by filling out the 'Facility Information' section. Enter the name, type, address, city, state, zip code, and telephone number of your facility.
  3. In the 'Basic Services' section, specify the name of the client/resident and their birthdate. Indicate whether they will be in a single or double room and list any special dietary needs.
  4. Complete the 'Optional Services' section by detailing any additional services offered along with their rates and payment schedules.
  5. Fill in the total monthly rate for both basic and optional services at the end of the form.
  6. Review all sections for accuracy before signing. Ensure that both you and the client/resident or authorized representative sign and date where indicated.

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To ensure each resident receives the right type and amount of care, most assisted living communities categorize residents according to one of three levels of care needs: basic or low-care, intermediate or medium-care, and advanced or high-care.
Level 3 care is for residents who need a great deal of help with most if not all activities of daily living (ADLs). At level 3, residents need continuous support and supervision throughout the day.
Level 6 care is a term sometimes used in long-term care settings to describe exceptionally high or complex needs, often associated with advanced memory care or medical dependency. It may involve 24-hour supervision, total assistance with daily tasks, and specialized care for conditions like advanced dementia.

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New Rules for Assisted Living Facilities Staffing Requirements. Resident Care Standards. Enhanced Safety Standards. Transparency and Communication. Resident Rights and Activities. End of the One-Size-Fits-All Policy. Upgraded Facilities. Emergency Preparedness and Response.
Level five: full assistance with daily living activities A senior receiving level-five care might have many caregivers for various complex medical conditions. Residents ability to socialize may be limited. Senior citizens receiving level five care may need more help to do so.
If a senior could jeopardize the safety and health of other residents, the senior may be denied admission to an assisted living facility. Some of the most common conditions for disqualification include seniors who have severe memory impairments, who need extensive medical care, or who are bedridden.

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