New Orleans Senior AdvisorWhat is the difference between a Level 3 and a Level 4 ARCP?
Both serve 17 or more residents in apartments, but only a Level 4 ARCP may provide intermittent nursing services, must employ or contract with an RN nursing director on call 24 hours a day, and may have staff give IV therapy on a time-limited basis under RN or physician supervision (LAC 48:I.6843, 6845, 6865).
A Level 3 provider can help with bathing, dressing, meals and medications, but any nursing a resident needs comes from an outside home health agency or hospice. No ARCP of any level may keep a resident whose condition requires continuous monitoring by licensed staff.
How many Level 4 ARCPs are there around New Orleans?
Very few: LDH's October 2026 Licensed Providers Report lists 63 adult residential care providers in the six parishes: 15 at Level 1, 19 at Level 2, 23 at Level 3 and 1 at Level 4, with 5 whose level LDH's records do not state; 37 of them are in Jefferson Parish.
In the six parishes, LDH's records show Level 4 status on a continuing care retirement campus that also has a nursing home. If a parent's needs are mostly stable but include, for example, regular injections or nursing assessments, a Level 3 building working with a home health agency can often meet them.
When does a parent need Level 4 instead of Level 3?
Level 4 makes sense when a parent needs regular but intermittent nursing that would otherwise mean frequent home health visits, such as ongoing wound care, injections or catheter care, and the family wants the provider itself responsible for it.
The difference is accountability. In a Level 3 ARCP, the resident or family contracts with a third-party provider for services beyond the ARCP's scope, and the ARCP's job is to coordinate and notice if care is not delivered. In a Level 4, the nursing director prepares the health care part of the service plan with the resident's physician.
How do Level 3 and Level 4 costs compare?
No published figure separates them, but Level 4 providers carry the cost of nursing staff, so expect higher care-level charges, while a Level 3 resident's nursing is billed separately by the outside agency, usually to Medicare when it is skilled home health.
That can make a Level 3 building cheaper for a resident whose nursing needs are Medicare-covered and short-term, and a Level 4 more economical for someone with ongoing nursing that Medicare will not cover.
How do I confirm a provider's level?
Check LDH's location directory entry, which states the level and capacity, and the Licensed Providers Report, where many licensed names include the level; then ask the provider to show its current license.
Our facility pages reproduce both. If the level a building describes on a tour differs from LDH's record, ask why before signing.
At a glance
| A Level 3 ARCP | A Level 4 ARCP | |
|---|---|---|
| Nursing | Brought in from home health or hospice | Provided intermittently by the ARCP |
| RN | Not required | RN nursing director on call 24 hours |
| IV therapy | Not by staff | Time-limited, under RN or physician supervision |
| Availability | Common | Rare |
Sources include LAC 48:I.Chapter 68 (adult residential care providers), the Louisiana Department of Health's Health Standards Section and Office of Aging and Adult Services pages, the Governor's Office of Elderly Affairs, CareScout and VA rate tables as cited above; see our editorial standards.
