Choosing a home often starts with a question: how much help will my loved one need? A care level describes the amount of support a person requires. It is different from choosing a private or shared bedroom.
Use this guide to prepare questions. A professional assessment and a conversation with the home are needed to determine suitability.
Maryland’s three levels of care
Maryland’s Office of Health Care Quality describes three categories of assisted living support. These describe care needs, not a rating of a home’s quality. Read Maryland’s consumer guidance.
Low level of care
Occasional assistance with personal or health-related needs. A person may need some help with everyday activities while managing other parts of the day independently.
Moderate level of care
Substantial assistance in one or more personal or health-related areas. The amount of help needed is greater than occasional support.
High level of care
Extensive, frequent assistance across several personal or health-related areas. Families should discuss the specific support needed and whether a home can safely provide it.
Ask Zion about its current licensed care level, staffing, and admission criteria. This guide does not establish that Zion provides every service described.
How is a level of care determined?
An assessment looks at everyday functioning and the help needed, rather than a diagnosis alone. A nurse or another qualified health professional may review daily activities and medication needs. Assessments are revisited as circumstances change. See A Place for Mom’s overview of care assessments.
For a useful conversation, describe a typical day. For example, is a reminder enough, or does someone need hands-on help? Is help needed occasionally, at every meal, or overnight? These examples help explain the support you are seeking; they are not a scoring tool.
- Personal routines: bathing, dressing, toileting, eating, and getting around.
- Medication routines: what help is needed to follow the prescribed schedule.
- Safety and supervision: concerns you want the assessor to understand.
- Preferences: familiar routines, interests, and what your loved one wants to continue doing independently.
What should families bring to a visit?
Bring your questions and a clear description of the help currently being provided. Ask the team how to share health records securely; please do not put medical details in the website inquiry form.
- Who completes the assessment, and how will the results be explained?
- Can the home meet these needs during both daytime and overnight hours?
- Which services are included in the written care plan?
- What support would require a different care setting?
- How are families involved when the plan changes?
Request the home’s completed Maryland Assisted Living Program Uniform Disclosure Statement to compare staffing, services, and fees.
What happens when care needs change?
Ask how the home notices changes, arranges reassessment, and updates the care plan with the family. Maryland’s Board of Nursing describes service planning as a collaborative effort between the assisted living manager and the RN case manager/delegating nurse. Read the Board’s service-plan guidance.
A bedroom preference does not determine a care level. Discuss the assessment and room choice separately, and ask for a written explanation of the proposed services before making a decision.
YOUR NEXT STEP
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