The Four Levels of Hospice Care
Levels of Care
Hospice is comfort care brought to every patient, whether in a private home, a nursing home, assisted living community or hospice house.
The Centers for Medicare and Medicaid Services has defined four kinds, or “levels,” of hospice care. One patient may experience all four levels, perhaps in just a week or ten days of hospice services. Another patient may experience one level of care throughout the duration of his or her hospice care. Each level of care meets specific needs, and every hospice patient is unique.
Every Medicare-certified hospice provider must provide these four levels of care:
Routine Home Care
Almost 95 percent of the time, hospice is provided in the home by team members including a physician, registered nurse, hospice aid, social worker, chaplain, volunteer and bereavement specialist, who come for scheduled visits depending on the needs of the patient and family.
Read more: There’s No Place Like Home for Hospice
Because hospitals are not ideally suited to providing comfort care, hospice patients are best cared for at home, even when symptoms are severe. Shifts of continuous care at the bedside keep the patient comfortably at home for up to 24 hours a day. VITAS calls this service Intensive Comfort Care®.
Read more: What is Continuous Care?
When symptoms cannot be managed at home, hospices must have beds in a hospital or other facility, sometimes in a wing or floor called an inpatient hospice unit, where patients are cared for around the clock for a temporary time, typically 3–5 days, until they can return to routine home care.
Read more: What to Expect From Inpatient Care
When a family caregiver needs a break, the hospice patient can be cared for in an inpatient bed for from 1 to 5 days, no matter what level of care they need.
Read more: Respite Care Brings Relief for Caregiver Burnout