What does Level 5 care mean?

<a href="https://www.caring.com/resources/what-is-level-five-care-in-assisted-living" style="text-decoration:none">Level 5 care</a> is often care given to those with progressive cognitive conditions who can no longer perform self-care. Staff typically undergoes specialized training and assists these residents with all activities of daily living and offers them therapies and activities designed for individuals with memory loss.

What Is Level 4 Assisted Living?

Q: What is the highest level of care in assisted living?

Assisted living facilities offer multiple levels of care, which begin with Level 1. The highest care level varies by facility and may be Level 3, Level 4, or even Level 6. An evaluation of your loved one before they are officially admitted to an assisted living facility will ensure that their needs can be met by one of the available care levels.

Q: What is Level 3 care in an assisted living facility?

In a facility that offers a total of three levels of care, Level 3 would be the highest level and provide the greatest amount of support to residents. In such facilities, Level 3 care could include assistance with all activities of daily living, medical care, and 24-hour supervision. However, in facilities offering four care levels, this same level of assistance may be provided as part of their Level 4 care instead, while Level 3 care would provide somewhat less support.

Date Updated: December 2, 2025

Written by:

Pilar Martland

Pilar Martland double-majored as an undergraduate at UC Davis and earned bachelor’s degrees in English and science. Following graduation, she spent two years as an AmeriCorps member working in the public school systems of California and Washington. She then completed a master's degree in education and became the author of multiple children's books.

Pilar has spent the past several years focusing on raising her family while continuing to pursue work on a freelance basis as a writer, editor, researcher, and fact-checker. She strives to make a positive difference by spreading awareness and empowering others through research-backed, educational, and informative content.

Edited by:

Matt Whittle

Matt Whittle is a freelance writer and editor who has worked with higher education, health, and lifestyle content for eight years. His work has been featured in Forbes, Sleep.org, and Psychology.org. Matt has a Bachelor of Arts in English from Penn State University.

Matt brings experience taking complicated topics and simplifying them for readers of all ages. With Caring, he hopes to assist seniors in navigating the systems in place to receive the care they need and deserve. Matt is also a freelance composer — you may have heard his work in global online ad campaigns for various products.

SENIOR LIVINGAdvisor

Senior Living Advisor

Caring

Without national regulations and as state laws vary regarding care levels, assisted living facilities cater to different resident needs through various service packages. Level 4 assisted living is among the most intensive types of care in long-term settings. Communities commonly offer 3-6 levels of care, though many top out at four. Residents can often adjust their level of care as their needs change, with monthly fees adjusted to reflect enhanced services.

Key Takeaways

Expect Facility Variability: Care levels often vary by facility or state. A provider may offer as few as three or as many as six levels of care. However, the amount of assistance that a facility's staff provides always increases by level.
Determine Care Level Needed: Ensure your loved one receives an evaluation by staff to determine which level of care best aligns with their needs. This assessment typically occurs as one of the first steps in the process of getting someone into assisted living.
Consider Costs: The overall costs of care vary depending on location, level of care, and other factors. Level 4 will generally be more expensive than Level 1, Level 2, or Level 3 care at the same facility.

How Do Assisted Living Facilities Evaluate Residents' Care Levels?

Staff members at assisted living facilities evaluate each potential resident to create a personalized care plan tailored to their unique needs. They carry out the care plan by making direct observations, seeking caregiver input, and requesting information from the senior's health care providers.

Healthcare providers must generally disclose essential information for staff, including whether the resident has any conditions requiring treatment or management or is at risk for certain injuries.

The final care plan takes any medical conditions, cognitive impairments, behavioral challenges, and communication limitations into consideration. It also notes seniors' mobility levels, the number of activities of daily living (ADLs) they can perform independently, and whether they can self-administer medication. Assisted living communities regularly review personalized care plans so they remain current as residents' needs change.

Common Level 4 Services

Level 4 assisted living is the highest level of care in many facilities. It includes a significant amount of services and support:

Daily Activities: At this level, residents need help with most or all ADLs, including eating, bathing, dressing, and toileting.
Mobility Assistance: Health complications may make it more difficult for residents receiving Level 4 care to move easily.
Transportation: Communities often provide transportation services to residents receiving this level of care so they can safely attend appointments or participate in recreational activities.

Ability-Appropriate Activities: Communities offer ability-appropriate, small-group, and one-on-one activities to Level 4 care residents.
Some Additional Services: Level 4 residents often need light medical services, rehabilitation therapies, or medication administration, as communities' licenses allow.

In facilities that offer four levels of care, individuals who require more intensive support may need to move to a clinical-focused nursing home or specialized memory care neighborhoods within these types of assisted living communities.

What Comes After Level 4 Assisted Living?

Some facilities may only have four care levels. Other facilities may have more. In facilities with additional levels, levels beyond Level 4 may include memory care for residents with cognitive decline and care that includes medical assistance for residents with significant and complex medical conditions.

Bottom Line

Care levels vary by assisted living facility, and their number distinctions differ with location and provider. Among those that offer four or more levels, Level 4 typically includes assistance with mobility and most, if not all, ADLs. For more information and resources related to assisted living, visit our assisted living hub.

Frequently Asked Questions

What is the highest level of care in assisted living?

What is Level 3 care in an assisted living facility?

What does Level 5 care mean?

Sources

A guide to levels of care in assisted living. (2024). New Perspective
Huddelston, Cameron. (2025). How to assess when an older adult requires caregiving assistance. AARP
The levels of assisted living in Maryland: A comprehensive guide. (2024). Brookeville House
Unpacking assisted living: The 5 levels of care in assisted living. (2024). Village Walk Senior Living
What are the 6 levels of care in assisted living? (2025). Bridge Senior Living

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