Levels of Hospice Care
- Routine Hospice Care. Most often in a person’s place of residence; routine care is provided in private homes, skilled nursing facilities, independent-living facilities, assisted-living facilities, and group homes. Care visits are scheduled with additional as-needed visits from team members. The plan of care includes medications, equipment and treatments related to the diagnosis, and individuals, family members and friend caregivers have access to an on-call hospice nurse 24 hours a day. The Medicare classification for this level of care is “Routine Care.”
- Respite Hospice Care. Available in a dedicated hospice residence or a contracted nursing facility, respite care provides support for family members and friend caregivers for up to 5 days to relieve them of the tremendous responsibility of caregiving. This break allows them to rest and practice self-care, or help them recover from fatigue. Patients receive the same level of care as they would receive at home with visits from the interdisciplinary team of hospice nurses, hospice aides, social workers, chaplains and volunteers. Respite care can also be available via private pay in special circumstances such as a caregiver being out of town. The Medicare classification for this level of care is “Respite Care.”
- Continuous Care. This is care for individuals with acute symptoms or needs and is available in dedicated hospice residences, contracted hospitals, contracted nursing facilities, and in special circumstances (with physician approval if only for brief periods of crisis) in a private home. A daily evaluation determines the necessity of this intensive care, and once acute symptoms have been alleviated or effectively managed, patients in a facility may be able to transfer back home or to another care setting. The Medicare classifications for this level of care is “General Inpatient Care” (GIP) or “Continuous Care” if in a home.
- Hospice Care in a Dedicated Hospice Facility. Even when a patient is not in need of intensive care or respite for caregivers, they can elect a hospice residence at their own expense (for room and board) as medical coverage covers the cost of medical care, but seldom covers the cost of room and board. Residential hospices can provide a peaceful, homelike environment with around the clock care by a compassionate hospice team, 24/7 visiting hours and flexibility such as being able to bring family pets for a visit. The Medicare classifications for this level of care is “Residential Hospice Care.”