Hospice patients may require differing intensities of care during the course of their disease. While hospice patients may be admitted at any level of care, changes in their health status may require a change in their level of care.
The Medicare Hospice Benefit affords patients four levels of care to meet their clinical needs:
Routine Hospice Care (RHC):
This is the most common level of hospice care. With this type of care, an individual has elected to receive hospice care at their residence. As mentioned above, this includes nursing and residential facilities.
Continuous Home Care (CHC):
This type of care is provided to the patient between 8 and 24 hours a day to manage pain and other acute medical symptoms. Continuous Home Care services must be predominately nursing care, supplemented with caregiver and hospice aide services and are intended to maintain the terminally ill patient at home during a pain or symptom crisis.
Inpatient Respite Care (IRC):
Respite care is to provide temporary relief to the patient’s primary caregiver. This type of care can be provided in a hospital, hospice facility, or a nursing facility that has sufficient 24 hour nursing personnel present.
General Inpatient Care (GIP):
General inpatient care is provided for pain control or other acute symptom management that cannot feasibly be provided in any other setting. GIP begins when other efforts to manage symptoms are not sufficient. This type of care is provided in a Medicare certified hospital, hospice inpatient facility, or nursing facility that has a registered nurse available 24 hours a day to provide direct patient care.
Location of Care
The majority of hospice care is provided in the place the patient calls home. In addition to private residences, this includes nursing and residential facilities as well. Hospice care may also be provided in freestanding hospice facilities and hospitals.
