The Four Levels of Hospice Care

Medicare-Certified Four Levels of Hospice Care

Medicare establishes and covers four distinct levels of hospice care to ensure patients receive the right support as their needs change. These levels are part of the Medicare Hospice Benefit and are designed to prioritize comfort, symptom management, and quality of life rather than curative treatment.

Medicare covers hospice care for eligible patients when a physician certifies a life-limiting illness and a focus on comfort-based care. Hospice teams regularly reassess care needs and adjust the level of care as symptoms and circumstances change.

1. Routine Home Care. Routine Home Care is the most common level of hospice care. It is provided wherever the patient calls home, including a private residence, assisted living facility, or nursing facility.
   
   This level of care focuses on:
   • Managing pain and symptoms
   • Providing regular visits from the hospice team
   • Supporting daily comfort and quality of life
   • Educating and supporting family caregivers
     
     Care is coordinated by a physician and includes scheduled visits from nurses, aides, social workers, chaplains, and other team members based on individual needs.
     
2. Continuous Home Care. Continuous Home Care is short-term, intensive care provided during a medical crisis when symptoms cannot be managed with routine visits alone.
   
   This level of care may include:

• Extended nursing care in the home
• Support during severe pain, breathing difficulty, or anxiety
• Stabilization of symptoms to avoid hospitalization

Once symptoms are brought under control, care typically transitions back to Routine Home Care. The goal is always to provide comfort while keeping the patient in familiar surroundings whenever possible.

3. Inpatient Hospice Care

Inpatient Hospice Care is provided when symptoms cannot be adequately managed at home, even with increased support.

This level of care may be needed for:

• Complex pain or symptom management
• Short-term medical stabilization
• Close monitoring by hospice clinicians

Inpatient care is intended to be temporary. When symptoms are controlled, patients often return home or to their prior place of residence with hospice support.

4. Respite Care

Respite Care is designed to support family caregivers by providing a short-term break from caregiving responsibilities.

This level of care:

• Allows caregivers time to rest and recharge
• Provides care for the patient in an inpatient setting
• Is typically available for up to five consecutive days

Respite care helps families continue providing care at home with renewed strength and peace of mind.

How Hospice Determines the Right Level of Care

Your hospice team continually evaluates the patient’s condition, symptoms, and support needs. Levels of care can change as conditions change, ensuring patients receive appropriate, compassionate care at every stage.

Hospice care is always focused on:

• Comfort and symptom relief
• Emotional and spiritual support
• Guidance for families and caregivers
• Respect for personal goals and wishes

How Foundations Hospice Support Families in All Levels of Hospice Care

No matter which level of hospice care is appropriate, support remains consistent, compassionate, and centered on what matters most to you and your family. Care is adjusted as needs change, but the goal never changes: comfort, dignity, and guidance through every stage.

Across all four levels of hospice care, you can expect:

• A dedicated care team led by a hospice physician and nurse who oversee comfort and symptom management
• Regular nursing visits with 24-hour on-call support for questions or urgent concerns
• Personal care assistance to help with bathing, grooming, and comfort needs
• Emotional and spiritual support for patients and loved ones
• Clear communication and education so families understand what to expect and how to help
• Ongoing coordination with caregivers, facilities, and physicians to reduce stress and confusion

Care does not reset or start over when a level changes. The same team continues walking alongside you, adjusting services to match the moment. Whether care is provided at home, during a short-term inpatient stay, or through respite support, you are never navigating these decisions alone.

Hospice is designed to be flexible because serious illness is not predictable. Support is built to follow you, respond to changes quickly, and help families feel confident that their loved one’s comfort and dignity remain the priority at every level of care.