Skip to main content

Levels of Hospice Care Explained

Understanding the four levels of hospice care: routine, continuous, inpatient, and respite care, and when each level is used.

Written and reviewed by a board-certified hospice & palliative medicine physician

Last reviewed:

9 min read

Medicare requires that all certified hospice providers offer four distinct levels of care. Understanding these levels helps you know what to expect and when different types of care might be needed. Most patients receive routine home care, but other levels are available when circumstances require more intensive support.

1

Routine Home Care

This is the most common level of hospice care, provided wherever the patient calls home—whether that's a private residence, nursing home, or assisted living facility. Your hospice team makes scheduled visits based on the patient's needs.

What This Includes:

  • Regular visits from nurses, aides, social workers, and other team members
  • 24/7 phone support for questions and concerns
  • All medications, equipment, and supplies related to the terminal illness

When It's Used: This is the standard level of care for most hospice patients. It's provided when symptoms are manageable.

2

Continuous Home Care

This level provides intensive nursing care at home during a medical crisis. A nurse or aide stays in the home for extended periods (at least 8 hours, often 24 hours) to manage acute symptoms and stabilize the patient.

What This Includes:

  • Extended nursing care in the home (8-24 hours)
  • Intensive symptom management during a crisis
  • Support to help avoid hospitalization
  • Care until the crisis is resolved or patient is stabilized

When It's Used: During a medical crisis when symptoms are out of control and the patient needs intensive nursing care to avoid hospitalization. Examples include severe pain, breathing difficulties, or other acute symptoms that can't be managed with routine visits.

3

General Inpatient Care (GIP)

This level provides short-term inpatient care in a hospice facility, hospital, or skilled nursing facility when symptoms are too severe to manage at home. The goal is to stabilize symptoms so the patient can return home.

What This Includes:

  • 24/7 nursing care in an inpatient facility
  • Intensive symptom management and medical care
  • Access to medical equipment and medications
  • Care until symptoms are controlled and patient can return home

When It's Used: When symptoms are too severe to manage at home, even with continuous care. This might include severe pain, breathing difficulties, nausea/vomiting, or other symptoms requiring intensive medical intervention.

4

Respite Care

This level provides short-term care in an inpatient facility to give family caregivers a break. Short-term inpatient care (up to 5 days per certification period), allowing caregivers to rest, attend to other responsibilities, or simply recharge.

What This Includes:

  • Short-term inpatient care (up to 5 days per certification period)
  • Full hospice services while in the facility
  • Time for family caregivers to rest and recharge

When It's Used: When family caregivers need a break. This is available to prevent caregiver burnout and ensure families can continue providing care.

More to Explore

Explore related hospice topics and practical family guidance.

Hospice Care Near You

Explore hospice providers and care options for families across Texas.

Browse all Texas hospices