There are four levels of hospice care, defined by Medicare, that are paid for by Medicare, Medicaid, and most other insurance plans (click on the Paying for Hospice Care link). They allow the hospice program to keep the patient in the setting that best meets the needs of the patient. Some or all of these care options may be used during a patient's hospice care.

The four levels of care are:

Routine Care
The patient continues to live at home and receive hospice services there. The family and patient are able to handle the needs and care of the patient with assistance from the hospice team.

Continuous Care
Skilled nursing services are provided in the patient's home to help manage a patient crisis.

Inpatient Care
This care is provided in a facility (hospital, hospice residence or nursing home) for symptoms or crises that cannot be managed in the patient's home. This level of care is provided for a limited period of time, as determined by the physician and hospice.

Respite Care
This service is provided in a facility and is designed to give caregivers a rest from handling the care of the patient. Respite care is limited to five days and nights at a time. This service is often used to provide a break so that caregivers can participate in other family activities, such as holiday celebrations, or just to relieve a tired caregiver for a few days.

The hospice or the attending physician determines what levels of care are needed, and all types of care must be approved by the hospice before the patient may use them. Not all patients use or need all levels of care, yet all are available if they are needed