What Is Level 4 Assisted Living?

Author: Sarah Williams

Reviewed By: Brindusa Vanta

Level 4 assisted living is among the highest support levels in this type of long-term care setting. Without state regulations regarding care levels, assisted living facilities can set their service packages to cater to varying needs. Communities commonly offer between three and six levels, although four may be the highest in some. Residents change levels as their needs increase, with monthly fees adjusted to reflect enhanced care.  

Lower vs. Higher Care Levels

Seniors requiring minimal day-to-day help enter assisted living communities at lower care levels. They typically need a little support with basic activities, such as fastening clothes, but live mostly independently. Such residents benefit from enrichment activities and may prefer to prepare meals in their private accommodations.

In contrast, higher care levels provide greater hands-on help with activities of daily living. Seniors may have reduced mobility, impaired cognitive skills or medical needs. Some communities offer intermittent skilled nursing and medication management alongside personal care and ability-appropriate leisure programming.

Common Level 4 Services

Communities perform detailed assessments for new residents to ensure they receive necessary support services. They also regularly review personalized care plans. Although plans vary for each individual, level 4 services include help with activities of daily living, including bathing and toileting. Residents may need assistance transferring to and from bed, eating and moving throughout the community. Staff members often also provide escort services.At this level, communities offer ability-appropriate small-group and one-on-one activities. Level 4 residents often need light medical services, rehabilitation therapies or medication administration, where 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 neighborhood.