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Levels of Care: Routine Home Care, Continuous Home Care, Respite and General Inpatient Care

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.

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About this policy
Policy number
CA-HSP-LOC-01
Version
1.0
Main rule
42 CFR §418.302
Library
California hospice · 60 policies
Category
Hospice care
Sections
16

In short

  • 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.

What's inside

16 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • 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

An inspector may ask

  • 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?

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