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Level Three Hospice: General Inpatient Care

The third of four levels of hospice care is called General Inpatient Care.  This level is unique in that a terminally ill patient can access this Medicare Hospice Benefit even though not previously enrolled in any hospice program. 

In the first level of hospice care called Routine Home Care, a terminally ill patient is cared for by a friend or family member designated as their caregiver.  If a medical emergency arises during Routine Home Care that requires aggressive attention such as pain levels soaring out of control, the caregiver contacts the hospice medical team. 

If the emergency meets the criteria set forth by Medicare, the patient enters the second level of hospice care called Continual Home Care or Crisis Care.  24-hour in-home skilled nursing care is initiated for up to five consecutive days. Once the emergency is resolved the hospice patient resumes Routine Home Care.  

A hospice patient must be enrolled in level one to be considered for level two.  Both of these levels of hospice care take place in the patient’s own residence where dignity and privacy remain predominant.

As the terminal illness progresses, any number of serious medical conditions can arise requiring a short-term admittance of the patient to a hospice facility.  This is called General Inpatient Care which is the third level of hospice care and usually lasts for up to five days.  In this facility the patient will receive constant monitoring and aggressive acute symptom management.   

Once the symptoms are under control the patient returns to their place of residence and continues Routine Home Care.

 Some of the serious medical conditions are:

            Advanced open wounds

            Ongoing nausea and vomiting

            Respiratory distress

            Seizures

            Excessive bleeding

            Manifesting serious delirium behavior

            Severe pain requiring epidural or other complex delivery of analgesics

            Other uncontrollable terminal complications

If a terminally ill patient is not enrolled in a hospice program and is hospitalized for a condition that requires constant monitoring and care such as pneumonia, they can choose to enroll in hospice and take advantage of the Medicare Hospice Benefit of General Inpatient Care.  They must first be discharged from the hospital as a pneumonia patient and then readmitted as a hospice patient and moved to the hospice unit in the hospital. 

When a hospital does not have a special unit devoted to hospice patients, Medicare allows the hospital to provide General Inpatient Care as long as it offers the terminally ill patient the following accommodations:

            A room that is home-like to give the patient privacy and dignity

            Access to spiritual and psychosocial counsel and assistance

            24hr skilled nursing care with an RN available on all shifts

            No restrictions on visiting hours for family and friends

After the medical condition is under control the new hospice patient is discharged to Routine Home Care or Continuous Home Care as their situation dictates.

https://www.giftedheartshospice.com/blog-detail/level-four-hospice-respite-care.phps

Gifted Hearts Hospice and Palliative Care in Seguin, TX, is a fully staffed facility available to patients who call South Central Texas their home.  It is nestled in the beautiful New Braunfels area as the best hospice near San Antonio, Texas.  It offers palliative care for patients of any age in any stage of illness.  It also offers all four levels of hospice care and maintains its motto: “Live until you Leave.”