Levels of Hospice Care

Hospice is comfort care brought to every patient, whether in a private home, a nursing home, assisted living community or hospice house.

The Centers for Medicare and Medicaid Services has defined four kinds, or “levels,” of hospice care. One patient may experience all four levels, perhaps in just a week or ten days of hospice services. Another patient may experience one level of care throughout the duration of his or her hospice care. Each level of care meets specific needs, and every hospice patient is unique.

Every Medicare-certified hospice provider must provide these four levels of care:

Routine hospice care is the most common level of hospice care. With this type of care, an individual has elected to receive hospice care at their residence, which can include a private residence, assisted living facility or nursing facility.

General inpatient care is provided for pain control or other acute symptom management that cannot feasibly be provided in any other setting and begins when other efforts to manage symptoms have been ineffective. General Inpatient Care can be provided in a Medicare certified hospital, hospice inpatient facility or nursing facility that has a registered nurse available 24 hours a day to provide direct patient care.

Continuous home care is care provided for between eight and 24 hours a day to manage pain and other acute medical symptoms. Continuous home care services must be predominantly nursing care, supplemented with caregiver and hospice aide services and are intended to maintain the patient at home during a pain or symptom crisis.

Respite care is available to provide temporary relief to the patient’s primary caregiver. Respite care can be provided in a hospital, hospice facility or a long-term care facility that has sufficient 24-hour nursing personnel present on all shifts to guarantee that the patient’s needs are met. Respite care is provided for a maximum of five consecutive days.