The Four Levels of Hospice Care - An Overview from Transitions Hospice

At Transitions Hospice, true to our Commandments, we believe that hospice should never be a “one size fits all” approach. That’s why we are proud to provide multiple levels of care, as recognized by Medicare. For most patients over the age of 65, hospice care is paid for by the Medical Hospice Benefit. Medicare identifies four distinctive levels of hospice care: routine home care, continuous home care, general inpatient care, and respite care. Individuals utilizing hospice may utilize all four levels throughout their hospice experience, or only one, depending on their needs and desires.

Routine Home Care is the most basic level of hospice care. In this stage, care teams serve the patients wherever they reside. The team includes registered nurses, advanced practice nurses, certified nurse’s aides, social workers, volunteers, physicians, dietitians, and chaplains, and offers a comprehensive plan of care that is tailored to each patient’s unique needs. Medications and medical equipment are brought directly to the patient or caregiver, and our care team develops a plan of care and visits frequently to meet the patient’s needs.

When an individual is experiencing symptoms that cause severe pain and require frequent interventions, such as medication administration, the patient will qualify for Continuous hospice care. In this level of care, a nurse or certified nursing aide (CNA) will remain at the bedside for as long as the patient qualifies for continuous care. The goal of continuous care is to get a patient’s symptoms under control to a point where they are manageable with routine hospice care. Continuous care is important because it allows the patient to remain at home through a difficult time instead of being uprooted into a hospital. Some examples of acute conditions that may require continuous hospice care include: uncontrolled pain, trouble breathing, extreme nausea, changes in consciousness, and seizures.

When symptoms require an advanced level of care that is beyond routine hospice or continuous care, a patient will enter the “inpatient” level of hospice. This often occurs when the patient needs 24-hour pain control or acute or complex symptom management that cannot be provided at home. In its entirety, the goal of inpatient care is to control severe pain and symptoms so that the patient can return home to familiar surroundings and continue with routine hospice care. This level of care can be provided within a skilled nursing facility or any facility contracted to operate an inpatient unit.

Finally, the fourth level of hospice care is respite care, where a home hospice patient is admitted into a facility for a short period of time. The goal of this care is to provide a short-term break for family caregivers who are assisting a loved one with an advanced illness. These services can be offered at any hospital, hospice facility, or skilled nursing facility that is able to provide 24-hour care. It is essential that those taking care of loved ones are able to take breaks and avoid “caregiver burnout”. These “breaks” can last up to 5 days and plans for respite care are developed directly with family members of the patient.

We are proud to be able to provide all levels of care within Transitions Hospice, and hope to help you and your loved ones determine the best course of care for all of your end-of-life needs. For more information about Transitions Hospice, please call 877-726-6494 or visit www.transitionshospice.com.

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