{"ref":"DC-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), sets the clinical criteria, orders, settings and documentation for each, the limits on respite and inpatient days, and the extra DC Medicaid rules, so that every patient gets the level of care his or her needs call for, and only that level is billed.","inShort":["The level of care depends only on the patient’s needs, never on payment.","Continuous home care is only for a crisis of acute symptoms; nursing must be more than half the hours.","Record continuous care hour by hour, and stop it as soon as the crisis is under control.","General inpatient care is for pain or symptoms that cannot be managed at home; visit the patient every day.","Respite care gives caregivers a short rest; plan no more than five days in a row."],"primaryCitation":"42 CFR §418.302","citations":["29 DCMR §939.20(e)","29 DCMR §939.26","29 DCMR §939.34(a)","29 DCMR §940.21","29 DCMR §940.22"],"federalCitations":["42 CFR §418.302(b), (e)","42 CFR §418.204","42 CFR §418.108","42 CFR §418.110(b), (f)","42 CFR §418.112(c)","42 CFR §418.400(b)"],"surveyorAsks":["Show me a patient who received continuous home care. Where is the crisis documented, and how many hours were nursing?","What criteria do you use to start and stop general inpatient care? Show me the daily documentation."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.108)","5. Routine Home Care","6. Continuous Home Care","7. General Inpatient Care","8. Inpatient Respite Care","9. Changing the Level of Care","10. The Inpatient Limit","11. DC Medicaid Beneficiaries Under 21 (If the Agency Is Enrolled)","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"dc-hospice","state":"Washington, DC","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}}