Also Known As:
Four levels of hospice care, hospice care levels, Medicare hospice levels. See: our full guide.
Type:
Care classification system within the Medicare Hospice Benefit
Primary Purpose:
To match the patient’s current needs with the appropriate intensity of hospice care, scaling up or down as the situation changes.
When It Applies:
Throughout the hospice stay. Patients move between levels as their condition changes.
Who Is Involved:
The full hospice team. Different roles take the lead at different levels, the aide and nurse at routine care; the medical director and nursing staff at continuous and inpatient care.
Where It Occurs:
Routine and continuous care happen at the patient’s residence. General inpatient and respite care happen in a facility.
Duration:
Routine care continues throughout the stay. Continuous and inpatient levels are short-term and crisis-driven. Respite is limited to five days at a time.
Coverage:
All four levels are covered by the Medicare Hospice Benefit, Medicaid, and most private insurance.
Key Focus:
Matching care intensity to the patient’s current symptoms and family needs.
Common Misunderstanding:
Many families don’t realize there are four levels and assume hospice means one level of care. The ability to escalate to continuous, inpatient, or respite care without changing providers is one of the most powerful features of the Medicare benefit.
The Four Levels at a Glance
- Routine Home Care, the most common level. Regular team visits to manage symptoms and personal care at home.
- Continuous Home Care, around-the-clock nursing at home during a symptom crisis.
- General Inpatient Care (GIP), short-term hospice care in a facility when symptoms can’t be controlled at home.
- Respite Care, short-term facility stay (up to 5 days) so family caregivers can rest.
Why Having All Four Matters
Some hospices deliver only routine home care, contracting out the other three levels when they’re needed. Lifted provides all four levels in-house, which means the same team supports your loved one through every transition, no new agency, no new paperwork, no learning a new set of nurses in the middle of a crisis.
Read our full guide to the four levels of hospice care.
How Patients Move Between Levels
The plan of care is built around routine home care. When something changes, uncontrolled pain at home, an exhausted family caregiver, a symptom crisis, the team escalates to the appropriate level:
- Pain or breathing crisis at home → continuous home care
- Crisis exceeds what home can safely manage → general inpatient care
- Caregiver needs a break → respite care
- Crisis resolves → back to routine home care
Contact the team any time you suspect a level change is appropriate.