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To help support both patients and family caregivers at the end-of-life, Medicare provides four levels of care under the hospice benefit. They are: routine home care, continuous home care, general inpatient care (GIP), and respite care.

This guide should help you better understand the differences between each of these types of care.
  1. Routine Home Care. This is the type of hospice care familiar to most people. The full complement of hospice services ranging from nursing care to companion volunteers and spiritual care are delivered to the patient in their own home. Home is whatever setting the patient considers it to be. In the eyes of Medicare, home can be the patient’s private home, an assisted living community, a nursing home or the home of a friend or loved one.

  2. Continuous Home Care. If a hospice patient develops an acute condition that needs around-the-clock support from nursing staff to try to manage pain or control symptoms, they can be moved to this advanced level of care. Hospice services will be provided by a nurse and/or aide for up to 24 hours a day. Care is still delivered in whatever setting the patient calls home. No physical change in location is required.

  3. General Inpatient Care (GIP). Should a patient’s care become so acute it cannot be managed in their home setting, they may be moved to an inpatient care center on a short-term basis. That might be a hospital, an inpatient hospice or a long-term care community. Once the patient’s pain and symptoms are under control again, they can return home.

  4. Respite Care. The respite level of care benefit under hospice is designed to give family caregivers a break from the demands of caring for a loved one at end-of-life. The hospice patient can be moved to a hospital, inpatient hospice or long-term care community for up to five days. And more than one respite period is allowable if necessary.

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