Hospice
Levels of Care
Medicare in the United States categorizes hospice care into four distinct levels to address the varying needs of patients and families. Each level has a specific focus and is designed to offer a particular type of support.
Below is a detailed description of the four levels of support.
Routine Home Care
This is the most common level of hospice care and can be provided in a variety of settings, including the patient's home, a family member's home, or a long-term care facility. The focus is on managing symptoms and providing emotional and spiritual support. Routine home care include regular visits from the hospice care team, which may include nurses, social workers, chaplains, home health aides, and volunteers.
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Medicare provides a flat daily rate for each day the patient is under routine home care regardless of the number or length of visits by the hospice team on that particular day.
Continuous Home Care
This level is for situations where the patient is experiencing a medical crisis and needs close, continuous care to manage acute medical symptoms. This care is provided at home and generally involves a nurse or healthcare aide staying with the patient for a significant number of hours, often around-the-clock.
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Medicare pays a higher daily rate for continuous home care, reflecting the increased level of services provided. The rate is often calculated on a an hourly basis.
General Inpatient Care
This level is intended for short-term care to manage symptoms that cannot be handled in other settings. This often includes intense pain or severe nausea and vomiting. Patients are typically admitted to a hospice facility, hosptial, or sometimes a skilled nursing facility for intensive medical care.
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Medicare offers a higher daily payment rate for general inpatient care to cover the added costs of an inpatient facility and increased medical oversight.
Respite Care
Respite care offers a break for caregivers by providing short-term relief. During a respite care stay, which is usually limited to a maximum of five days, the patient is moved to a hospice felicity, hospital, or skilled nursing facility. The goal is to allow family members or other caregivers some time off from their caregiving responsibilities.
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Medicare covers the cost of respite care at a daily rate, which covers the facility's charge for room and board as well as any hospice services provided.
