4 Levels of Hospice Care Explained

Hospice care adapts to what you need today. Medicare defines four levels of hospice care that can be provided at home or in a facility. At Acacia Health, we match the level to your goals, manage symptoms quickly, and keep you and your family informed with clear, honest guidance.

Level 1: Routine Home Care

Routine Home Care is the most common level of hospice. You receive scheduled visits where you live, with a plan focused on comfort, safety, and time together.

What Routine Home Care Includes

• Skilled nursing visits for pain and symptom management
• 24 hour clinical phone support for urgent questions
• Social work support for counseling, resources, and planning
• Chaplain services based on your preferences and beliefs
• Certified home health aide visits for personal care such as bathing and grooming
• Medications related to the hospice diagnosis
• Durable medical equipment and supplies with fast delivery
• Education for caregivers so care at home feels safe and manageable

When It Helps Most
Routine Home Care works well when symptoms are controlled with scheduled visits and coaching for caregivers.

Level 2: Continuous Home Care

Continuous Home Care provides short term, around the clock nursing support at home when symptoms become intense. The goal is to stabilize you without a hospital trip whenever possible. If an urgent need arises, contact us so we can coordinate the next level of support.

What Continuous Home Care Includes

• Extended nursing presence in the home for crisis situations
• Rapid medication adjustments for pain, breathlessness, nausea, anxiety, or agitation
• Continuous monitoring and coordination with the hospice physician
• Education and reassurance for family during the crisis period

When It Helps Most
Choose this level when symptoms escalate quickly and you need continuous attention to stay comfortable at home.

Level 3: Inpatient Respite Care

Inpatient Respite Care offers a brief break for family caregivers. You receive inpatient care for up to five days while your loved ones rest and recharge.

What Inpatient Respite Care Includes

• Admission to a contracted facility for short term stay
• Nursing, aide support, and symptom management in a safe setting
• Continued coordination with your hospice team
• A planned return home once respite ends

When It Helps Most
Respite is helpful after a demanding period of caregiving or when families need temporary support.

Level 4: General Inpatient Care

General Inpatient Care provides short term, intensive symptom management in a hospital or inpatient facility when comfort cannot be achieved at home. Learn more about our approach to Hospice Care and how we coordinate with facility teams.

What General Inpatient Care Includes

• 24 hour nursing with rapid access to medications and treatments
• Frequent assessment by hospice clinicians and the facility team
• Daily coordination with the hospice physician and your attending doctor
• A plan to step down to Routine Home Care or Respite when symptoms stabilize

When It Helps Most
This level is appropriate for complex pain or symptom crises that require continuous clinical attention in an inpatient setting.

How We Match The Right Level To Your Needs

At Acacia, we lead with a patient first mindset. We listen to what matters most, we act with honesty and transparency, and we make things happen so relief does not wait.

Our Approach

• Clear assessment. Your nurse reviews current symptoms, medications, and goals.
• Team coordination. We align with your physician and our hospice medical director.
• Right level, right time. We adjust the level of care as conditions change.
• Education and support. We teach caregivers what to expect and how to reach us any time.
• Results oriented. We focus on comfort, safety, and preventing avoidable hospital trips when possible.

Where Care Is Provided

You can receive hospice services where you live, including a private home, assisted living, or a skilled nursing facility. Continuous Home Care, Inpatient Respite Care, and General Inpatient Care are arranged at contracted sites when needed. View our Service Locations for local coverage.

What Hospice Covers

Medicare, Medi Cal, and many private plans typically cover the four levels of care. Coverage often includes:

• Nursing, social work, chaplain, home health aide, and bereavement support
• Medications related to the hospice diagnosis
• Durable medical equipment and supplies
• Continuous Home Care, Respite, or General Inpatient Care when criteria are met

We verify benefits, explain coverage clearly, and communicate any items that are not covered before they occur.

Service Areas

We provide hospice care across Orange County, Riverside County, San Bernardino County, and Los Angeles County, including Irvine, Anaheim, Santa Ana, Riverside, San Bernardino, Los Angeles, and nearby areas.

FAQs

• Do patients move between levels of care?
  Yes. Care levels adjust as needs change. Your team monitors symptoms and recommends the most appropriate level.
• Is there a cost difference between levels of care?
  Hospice care for eligible patients is generally covered by Medicare, Medi-Cal, and most private plans across all four levels. We confirm your benefits and review details with you.
• How quickly can continuous or inpatient care start during a crisis?
  We responded promptly. Call us at any time. A nurse is available 24 hours a day to assess needs and coordinate the next level of support.
• Can we request respite care even if symptoms are stable?
  Yes. Respite is designed to support caregivers. It can be arranged when you need a short break.
• Do we have to change doctors?
  You can keep your primary physician involved. Our hospice medical director collaborates with your doctor to support the plan of care.