Understanding Hospice Care
Managing Medications in Hospice
Understand how medications work in hospice care, pain management strategies, and the family's role in medication administration.
Read guide →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.
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.
When It's Used: This is the standard level of care for most hospice patients. It's provided when symptoms are manageable.
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.
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.
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.
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.
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.
When It's Used: When family caregivers need a break. This is available to prevent caregiver burnout and ensure families can continue providing care.
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