Levels of Care: Routine, Continuous Home Care, Respite and General Inpatient
Defines the four levels of hospice care (routine home care, continuous home care, inpatient respite care and general inpatient care), the clinical criteria and documentation for each, where inpatient care may be given, the Medicare and Pennsylvania Medical Assistance limits on respite and inpatient days, and how the IDG and a hospice physician decide and review each change in level of care.
About this policy
- Policy number
- PA-HSP-LOC-01
- Version
- 1.0
- Main rule
- 42 CFR §418.302
- Library
- Pennsylvania hospice · 60 policies
- Category
- Hospice care
- Sections
- 20
In short
- There are four levels of care: routine home care, continuous home care, inpatient respite and general inpatient care. Each needs a physician order and a plan of care update.
- Continuous home care is only for a short crisis to keep the patient at home. It must be mostly nursing care, and you record care hour by hour.
- Respite gives the family a break in an approved facility. Medicare pays up to 5 days in a row; Medical Assistance allows 5 days in a 60-day period.
- General inpatient care is for pain or symptoms that cannot be managed anywhere else. Review it every day and record why it is still needed.
- Our inpatient and respite facilities are: Sample General Hospital and Sample Nursing and Rehabilitation Center.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §418.302; §418.204)
- 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
An inspector may ask
- This patient received continuous home care. What was the period of crisis, and was the care predominantly nursing?
- Why was this patient on general inpatient care, and why could the symptoms not be managed in another setting?
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