Levels Of Care Offered

The Centers for Medicare and Medicaid Services has defined four types, or “levels”, of hospice care.

Hospice care encompasses four distinct levels tailored to address various needs during patients' end-of-life experiences. Routine Home Care, Continuous Home Care, General Inpatient Care, and Respite Care. These four levels collectively ensure comprehensive and personalized care, reflecting the diverse needs and preferences of individuals during their end-of-life journey. As an ACHC accredited hospice, LDV Hospice is committed to upholding the highest standards of care and service while providing all four levels of care to our patients and their families. LDV Hospice currently uses contracted facilities for inpatient treatments.

Routine Home Care [Basic Care]

This is the most common level of care, in which palliative care and symptom management can be provided and maintained in the home or primary residence; whether it be a house, skilled nursing facility, or assisted living facility. It is focused on providing physical, spiritual, and emotional support to both our patients and their families. This can include, but is not limited to:

Nursing visits
Social worker visits
Physician visits
Medications to manage symptoms
Medical equipment and supplies (DME)
Physical and/or occupational
Speech therapy
Emotional and spiritual support for the patient and their family.

Continuous Care [In-Home Symptom Management]

This level of care is for short term management of out-of-control symptoms such as pain or agitation, facilitated by increased nursing care in a 24 hour period, usually provided in the home or primary residence. Continuous Care is provided to patients during a crisis period as necessary to maintain the patient in the home. Nurses and Certified Nurse Assistants monitor acute symptoms that require more intensive and continuous nursing care than is generally provided under routine home care. The goals for continuous care are to help patients live as fully as possible within their condition and prepare them for death. This usually requires a daily commitment from family members and caregivers, who need to be well informed about their loved one’s condition to provide proper care.

General Inpatient Care [Facility Symptom Management]

This is the crisis-like level of care for short term management of symptoms that cannot be controlled in the home. This level is provided in a contracted Medicaid/Medicare certified facility with 24 hour nursing services. General Inpatient Care (GIP) is provided to patients who have symptoms or pain that are unable to be managed in an outpatient setting. GIP requires that a registered nurse be available 24 hours a day to tend to the patient’s needs. GIP is not intended to be custodial or residential. Once a beneficiary's symptoms are stabilized, or pain is managed, the patient must return to a routine level of care.

Respite Care [Caregiver Rest]

A temporary level of care provided in a contracted Medicaid/Medicare certified facility, to allow the patient's primary caregiver(s) time off to be able to rest. This level of care is tied to caregiver needs, not patient symptoms. Caregivers who take time for themselves return better able to resume and perform their caregiver responsibilities. Elements of hospice respite care include the following: