{"ref":"NC-HSP-LOC-01","title":"Levels of Care: Routine Home Care, Continuous Home Care, Respite and General Inpatient Care","category":"Hospice care","summary":"Describes the four levels of hospice care (routine home care, continuous home care during brief periods of crisis, inpatient respite care and general inpatient care for symptoms that cannot be managed elsewhere), who decides the level, the physician order and documentation each level needs, the settings and limits that apply, and how the Agency keeps care continuous when the level changes.","inShort":["Most days are routine home care. The level changes only on need, with a physician order.","Continuous home care is for a short crisis at home and must be mostly nursing care. Record start and stop times.","Respite gives the family a break in a contracted facility. It is occasional, and only five days in a row are covered.","General inpatient care is for pain or symptoms that cannot be managed at home.","Reassess every day during continuous or inpatient care and change the level back as soon as the need ends.","Send the current plan of care to the inpatient facility."],"primaryCitation":"42 CFR §418.302","citations":["10A NCAC 13K .0102(27)","10A NCAC 13K .0501(5)","G.S. 131E-201(3)","NC Medicaid Clinical Coverage Policy 3D, section 4.2.1"],"federalCitations":["42 CFR §418.302(b), (e), (f)","42 CFR §418.204(a), (b)","42 CFR §418.108(a), (b), (d)","42 CFR §418.100(c)(2)","42 CFR §418.400(b)"],"surveyorAsks":["How does the team decide that a patient needs continuous home care or general inpatient care?","Show me the documentation for a continuous home care day: hours, who gave the care and why."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.302)","5. The Four Levels","6. Deciding and Changing the Level of Care","7. Continuous Home Care","8. Inpatient Respite Care","9. General Inpatient Care","10. Inpatient Care Arrangements and Limits","11. Documentation for Every Day of Care","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":"nc-hospice","state":"North Carolina","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}}