The Four Levels of Hospice Care


Routine Care

Routine care is the most common level of hospice care and most patients start on this level of care. Routine care is provided in the patient’s place of residence – a private home, an assisted living community, skilled nursing facility, etc. Under routine care, the patient receives regular visits from the members of your care team, based upon their specific needs. Generally, nurses will visit about two to three times per week to monitor the patient’s overall condition. As the hospice patient’s needs change, team members adjust their visits to accommodate these changes and ensure optimal care.


Continuous Care

Continuous Care is the highest level of hospice care that a patient can receive in a home or residential care facility. Continuous care is provided during periods of crisis in which a patient is experiencing symptoms that are unmanageable by routine care. Such symptoms will require continuous nursing intervention (up to 24 hours per day) to achieve palliation and comfort. During continuous care, nurses will remain bedside with the patient for at least 8 hours and up to 24 hours a day, until symptoms are managed and comfort is ensured.


Respite Care

Respite Care is provided to patients for the purpose of allowing family members and caregivers a short (five-day) break from the duties of caregiving. During respite care, patients are transferred to a contracted skilled nursing facility that will manage the care of the patient in conjunction with the hospice. Respite Care is only provided on an occasional basis, for a maximum of five days in every certification period.


General Inpatient Care

General Inpatient Care (or GIP) care takes place if a patient experiences acute symptoms that cannot be safely managed in their home or another residential setting. GIP care is provided in a skilled nursing facility or a hospice inpatient unit where there is a Registered Nurse available to manage these symptoms24 hours a day. Once symptoms are under control, the patient will return to their home usually under the routine level of care.

Final Note on Levels of Hospice

These are the overall hospice level of care definitions. More information can be provided via phone or email, which can be found at the bottom  of our webpage. The routine care level remains, and most likely, will always remain the most common method of care, the continuous care will most likely always remain an extension of routine care, and the hospice inpatient level of care criteria and respite care criteria will always work best dependent on the selective instance of care needed, patient outlook, and family and physician deliberation.


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