Routine home care is the basic level of care under the hospice benefit and is provided at the patient’s place of residence (Home, Assisted Living Facility, or Nursing Home). The amount and frequency of treatments are determined in the patient’s plan of care.

Routine home care services include:

• Nursing and Physician services
• Medical social services
• Home Health Aide services
• Counseling services (pastoral, spiritual, bereavement, dietary, and others as necessary)
• Medications related to the terminal illness
• Durable Medical Equipment
• Medical supplies related to the terminal illness
• Lab/Diagnostic related to the terminal illness
• Physical therapy
• Occupational therapy
• Speech-language pathology services

General Inpatient Care (GIP) is a higher level of care ordered by the patient’s physician when pain or other symptoms cannot be relieved at the patient’s place of residence. GIP consists of intensive around the clock medical, nursing, and psychosocial care to make the patient more comfortable. This level of care is intended to be short-term to manage symptoms so the patient can return to their previous residence with Hospice care. While receiving GIP care, all charges, including room and board charges, are covered by Medicare, Medicaid, and many private health insurance plans. 

Continuous home care is ordered by the patient’s physician and is provided during times of crisis. Continuous care is a higher level of care and is needed for at least eight hours in a 24-hour period to achieve palliation or management of acute medical symptoms. A nurse must provide fifty percent of the required care. The continuous home care staff will care for the patient and provide teaching to the patient’s family until the symptoms are under control. Once symptoms are managed, their level of care will be changed to Routine Home Care. 

Continuous home care symptom examples would be:

• Unrelieved pain
• Severe nausea and vomiting
• Severe shortness of breath
• Severe Anxiety or panic attacks
• A breakdown in the primary caregiver support system

Respite Care is short-term, temporary care of up to five days, provided in an approved facility. Once the respite period ends, the patient will be discharged back to their routine home care setting.

If a patient’s family is the primary source of care and cannot meet their loved one’s needs due to caregiver stress or other extenuating circumstances, a patient may temporarily be admitted to an inpatient respite environment to give the family a needed break or respite.