{"ref":"TX-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, inpatient respite care and general inpatient care), when each may be used, who decides, how a change in level of care is ordered and documented, where inpatient care may be provided, and the limits on respite and inpatient days.","inShort":["There are four levels of care: routine home care, continuous home care, respite and general inpatient care.","A hospice physician orders every change in level of care. Write down why.","Continuous home care is only for a crisis, must be mostly nursing, and needs at least 8 hours in a day. Record your start and end times.","Respite gives the caregiver a break, usually for no more than five days in a row.","General inpatient care is for pain or symptoms that cannot be managed anywhere else. Check on the patient every day."],"primaryCitation":"42 CFR §418.302","citations":["26 TAC §558.863","26 TAC §558.850(b), (e)(6)"],"federalCitations":["42 CFR §418.302","42 CFR §418.204","42 CFR §418.108","42 CFR §418.202(e)","42 CFR §418.400(b)"],"surveyorAsks":["This patient received continuous home care. Show me the period of crisis, that care was predominantly nursing, and the hours provided.","Why was this patient moved to general inpatient care, and why could the symptoms not be managed in another setting?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.302; §418.204; 26 TAC §558.863)","5. The Four Levels of Care","6. Routine Home Care","7. Continuous Home Care","8. Inpatient Respite Care","9. General Inpatient Care","10. Changing the Level of Care","11. Where Inpatient Care Is Provided","12. Inpatient Days Limit","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"tx-hospice","state":"Texas","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 Hospice","legalName":"Sample Hospice, LLC","logo":null}}