Levels of care describe to meet the changing clinical needs of the patient. The patient’s hospice nurse assesses patient status at the time of admission. Assessment and documentation by the hospice staff identifies the appropriate level of care.

Routine Care: Hospice care is provided in the home. Home may be within a long-term care facility. Patient symptoms are controlled. Non-skilled services are provided by family or paid caregivers.

Respite Care:Care is provided in approved hospitals, SNFs and/or hospice inpatient units when the patient requires pain control or acute symptom management that cannot feasibly be provided in other settings.

General Inpatient Care: - Care is provided in approved hospitals, Skilled nursing facilities and/or hospice inpatient units when the patient requires pain control or acute symptom management that cannot feasibly be provided in other settings.

Continuous Care: Care is offered only during periods of crisis to maintain patient at home. This level of care is appropriate when symptoms are not well controlled and the patient requires predominately nursing care to achieve palliation of symptoms. A patient who is imminently dying does not necessarily qualify for this level of care.

Sources:
CMS Hospice Manual, Chapter 9 - Section 40.2
Palmetto GBA Hospice Manual Section 3.5.4