Tier Levels

General Guidelines for Resident

Transitions	Transitions Plus	Tier 1 Care	Tier 2 Care	Tier 3 Care
Domestic services: 3 meals/day + snack weekly laundry weekly housekeeping	Domestic services: 3 meals/day + snack weekly laundry weekly housekeeping	Domestic services: 3 meals/day + snack, weekly laundry, weekly housekeeping	Domestic services: 3 meals/day + snack weekly laundry, weekly housekeeping, bathroom cleaning	Domestic Services: 3 Meals per day + nightly snack, weekly, laundry, weekly housekeeping, additional bathroom cleaning
Independent in personal care	Independent in personal care	Cueing for personal care, 1 bath/shower per week. Identifies when attention is needed and is able to self-manage incontinence care	Assistance with personal care, ie. dressing, 2-3 baths/showers per week, assisted incontinence care with resident participating in care or willing to have staff assist, and identifies when attention is needed. Transportation to and from meals.	Assistance with personal care, i.e. dressing 2-3 baths/showers per week, frequent incontinence care with resident participating in care and willing to have staff assist, and identifies when attention is needed. Transportation to and from meals.
Assistance with medication refills and delivery	Assistance with medication refills and delivery, and/or oral administration of simple medications.	Assistance and/or administration of simple medications – oral administration, eye drops and Inhalers.	Administration of complex medication regimens ie: insulin, medications that require close monitoring ie:.Coumadin, psychoactive meds, crushing meds, Subcutaneous injections. Residents with medication changes greater than monthly.	Administration of complex medication regimens i.e.; insulin medications that require close monitoring i.e.; Coumadin psychoactive meds, crushing meds, subcutaneous injections. Residents with medication changes greater than monthly.
Scheduled community activities and events	Scheduled community activities and events	Daily reminders for community activities, coordination of medical care	Daily reminders for community activities, scheduling/coordination of medical care, cueing for daily personal care and functional needs, Assistance to/from activities	Daily reminders for community activities, scheduling/coordination of medical care, cueing for daily personal care and functional needs. Assistance to/from activities.
Medical support (emergencies)	Medical support (emergencies)	Routine medical support and care, ie: teds, braces, weekly glucometer checks and vital signs. Infrequent falls: less than monthly	Non-routine medical support and care, ie: frequent vital signs, daily to weekly glucometer checks ordered by licensed Health Care professional, falls greater , falls greater than monthly, NMT treatments, frequent weighs, Hospice Care.	Tier 2 plus: frequent falls that require closer supervision at a 5:1 ratio. Any type of care that requires additional support care, behavioral changes and assessments that require close supervision. Frequent monitoring of health status needs.

Each resident will be assessed individually and each tier level will be determined by the individual needs of each resident. The Assisted Living Director and Nurse Coordinator determine the level of care needed. The monthly service fee varies based on level of care; one price includes everything described above.

** This tier level available for current Silver Maples residents only.