Levels of Care in Hospice

A patient can be admitted to hospice on any level of care deemed necessary by the hospice physician. As a patient’s needs change, they may be transferred between levels of care. With four levels of care in place, no patient should ever be left alone in a crisis.

Routine Home Care

Routine home care is the most utilized level of care under the hospice benefit. Once a patient has been deemed hospice-appropriate by the hospice Medical Director, our staff visits the patient wherever they live.

Continuous Care

If a patient develops physical or emotional symptoms that aren’t easily managed with routine care, continuous care may be an option, as directed by the hospice physician. Continuous care provides more intense care in the patient’s home environment. Under this level of care, a nurse and/or a hospice aide remains in the patient’s home environment for a minimum of 8 hours in a 24-hour period to administer medications, treatments, and support until the symptoms are under control. Some examples of symptoms requiring continuous care are unrelieved pain, severe nausea and vomiting, severe shortness of breath, and anxiety or panic attacks. Continuous care is considered a short-term level of care and is reevaluated every shift.

General Inpatient Care

Some patients may have symptoms so severe that they cannot be adequately controlled in the home. Symptoms requiring inpatient care are the same as those requiring continuous care, but the setting of care is different. With inpatient care, hospice services can be provided in a skilled nursing facility, where nurses are available around the clock to administer medications, treatments, and emotional support to make the patient more comfortable.

Compared to continuous care, this inpatient care is considered short-term and is discontinued once a patient’s symptoms are under control and are comfortable.

Respite Care

This level of care is used to support the family or caregiver of the patient in order to provide respite from primary caregiver duties. If the family or caregiver is having a difficult time with the demands of caregiving, respite care may be an option.

If a patient’s family is the primary source of care and cannot meet the patient’s needs due to caregiver stress or other extenuating circumstances, a patient may temporarily be admitted to an inpatient environment, such as a skilled nursing facility, to give the family a needed break or respite.

Once the period for respite care expires, the patient may privately pay for additional respite days or return to routine care in their home setting.