{"ref":"CA-HSP-LOC-01","title":"Levels of Care: Routine Home Care, Continuous Home Care, Respite and General Inpatient Care","category":"Hospice care","summary":"Defines the four levels of hospice care (routine home care, continuous home care, inpatient respite care and general inpatient care), when each may be used, who decides and how a change in level is ordered, documented and reviewed, and how the Agency arranges short inpatient stays under California's inpatient care arrangements requirement.","inShort":["There are four levels of care: routine home care, continuous home care, inpatient respite and general inpatient care.","Continuous home care is only for a short crisis, to keep the patient at home, and must be mostly nursing care.","Respite is for the caregiver's rest, for no more than five days in a row.","Any change in level needs a physician's order and the patient's or family's agreement.","Record start and end times and review continuous and inpatient care at least every 24 hours."],"primaryCitation":"42 CFR §418.302","citations":["Cal. Health & Safety Code §1746(d)(3), (f)","Cal. Health & Safety Code §1749(d)(6)","22 CCR §74868(g)","22 CCR §74820(a)"],"federalCitations":["42 CFR §418.302","42 CFR §418.204","42 CFR §418.108","42 CFR §418.202(e)","42 CFR §418.400(b)"],"surveyorAsks":["Who decides that a patient needs continuous home care or general inpatient care, and how is that documented?","Show me the record of a period of continuous home care. How many hours were provided, and by whom?"],"forms":[{"ref":"CA-HSP-LOC-01-A","title":"Level of Care Change and Crisis Care Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.302; Health & Safety Code §1746(d)(3))","5. The Four Levels","6. Starting a Higher Level of Care","7. Review and Return to Routine Home Care","8. Documentation and Monitoring","9. Responsibilities","10. Records and Compliance Monitoring","11. Staff Training","12. References","13. Related Policies and Forms","14. Approval","15. Revision History"],"version":"1.0","sample":false,"pack":"ca-hospice","state":"California","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}