The 4 Levels of Hospice Care

When families first explore hospice care, many are surprised to learn there isn’t just one type of care. In fact, hospice includes four distinct levels—from routine daily visits to urgent, around-the-clock support—so that care can adjust as your loved one’s needs change. At ViaQuest Hospice, we guide families through each stage, ensuring care is always compassionate, appropriate, and available when it’s needed most.

Understanding these four levels helps families know what to expect and feel confident that appropriate care is always available, whether your loved one needs gentle daily assistance or immediate symptom relief.

What Are the 4 Levels of Hospice Care?

According to Medicare guidelines, hospice care includes four specific levels, each tailored to different situations and needs. At ViaQuest Hospice, we seamlessly transition between these levels to ensure your loved one always receives exactly the right amount of care.

Hospice Level 1: Routine Home Care (Most Common)

What it includes: This is the foundation of hospice care, where your loved one receives regular visits from our interdisciplinary team in the comfort of their chosen environment—whether that’s home, an assisted living facility, or nursing home.

Typical services:

  • Scheduled visits from hospice nurses, aides, social workers, and chaplains
  • 24/7 on-call nursing support via phone
  • Medical equipment and supplies delivered to your location
  • Medication management for comfort and symptom control
  • Family education and caregiver support

When it’s used: For patients who are stable and can be cared for safely in their residence with periodic professional visits and family caregiver support.

Did you know that 95% of all hospice care days fall under routine home care according to the National Hospice and Palliative Care Organization? This makes it the most common type of hospice service and the one most families rely on.

Hospice Level 2: Continuous Home Care (Crisis Support Explained)

What it includes: When patients experience acute symptoms that can’t be managed with routine visits alone, we provide intensive nursing care in the home for 8-24 hours at a time.

Typical situations:

  • Severe pain that requires frequent medication adjustments
  • Acute shortness of breath or respiratory distress
  • Uncontrolled nausea or other symptoms causing significant discomfort
  • Family caregiver crisis where additional support prevents hospitalization

When it’s used: During periods of symptom crisis that can be managed at home with intensive nursing attention but don’t require hospital-level care.

For families, this level often feels like a safety net—bringing immediate expert care right into the home during the most stressful times. This level allows families to avoid unnecessary hospital trips while ensuring professional care is immediately available during challenging periods.

Hospice Level 3: Respite Care for Family Caregivers

What it includes: Short-term care in a Medicare-approved facility (up to five consecutive days) to give primary family caregivers a necessary break while ensuring their loved one receives continuous hospice care.

Imagine being able to take a breath, attend a family wedding, or recover from an illness yourself—while knowing your loved one is safe and supported in a hospice setting. That’s the power of respite care.

Benefits for families:

  • Primary caregivers can rest, attend to personal needs, or handle other responsibilities
  • Patients receive 24/7 professional care in a supportive environment
  • Opportunity for caregivers to recharge emotionally and physically
  • Peace of mind knowing their loved one is safe and comfortable

When it’s used: When family caregivers are experiencing burnout, need to travel, or require time to recover from their own health issues.

The Centers for Medicare & Medicaid Services recognizes that caregiver support is essential to successful hospice care, making respite care a covered benefit.

Hospice Level 4: General Inpatient Care (Acute Symptom Management)

What it includes: Hospital-level care focused on aggressive symptom management that cannot be achieved in any other setting.

While care happens in an inpatient setting, the focus remains on comfort—not cure. Every effort centers on reducing pain and easing symptoms, never extending discomfort.

Typical scenarios:

  • Pain or symptoms too severe for home management, even with continuous care
  • Complex medication needs requiring hospital-level monitoring
  • Situations where the home environment cannot safely support the patient’s needs

Where it’s provided:

  • Dedicated hospice inpatient units
  • Hospital beds contracted with hospice programs
  • Specialized skilled nursing facility beds

Important distinction: This is still hospice care focused on comfort, not curative hospital treatment. The goal remains quality of life and symptom relief.

How Transitions Between Levels Work

The reality is, most patients don’t stay at a single level the entire time. Their needs shift—and hospice adjusts right alongside them.

One of the greatest benefits of hospice care is its flexibility. At ViaQuest Hospice, we continuously assess each patient’s needs and adjust the level of care accordingly—often multiple times throughout their hospice journey.

Seamless transitions mean:

  • No gaps in care when needs change
  • Same hospice team coordinates all levels
  • Families don’t need to find new providers
  • All levels are covered by hospice benefits

Understanding Your Coverage

All four levels of hospice care are fully covered by Medicare, Medicaid, and most private insurance plans when provided by a Medicare-certified hospice like ViaQuest. At ViaQuest Hospice, this means families across Ohio, Indiana, and Pennsylvania can access care without the burden of unexpected costs.

Hospice Care Across Ohio, Indiana, and Pennsylvania

At ViaQuest Hospice, we provide all four levels of care to families throughout Ohio, Indiana, and Pennsylvania. Our experienced team ensures the right level of care is available when and where your family needs it most.

Whether your loved one needs routine support at home or intensive symptom management, we’re here to provide compassionate care tailored to their unique situation.

Ready to Learn More?

Choosing a hospice provider is a big decision—but you don’t have to make it alone. Call us at 855.289.1722 to talk with a ViaQuest Hospice specialist. We’ll walk you through each of the four hospice levels and help you decide what’s best for your loved one.

You can also download our Complete Hospice Care Guide for a step-by-step resource you can keep and share with your family. Remember, understanding your options helps you make the best decisions for your family’s unique situation.

Read more related articles

Insights on End-of-Life Care, Grief Support, and Family Wellbeing


The Compassion Chronicle

Join our community for compassionate advice, inspiration, and resources to help you and your loved ones find peace through the journey.
Gifts in Kind

Your in-kind donations provide direct comfort to our patients and support to their families. We gratefully accept items such as comfort blankets, pillows, medical equipment, books, puzzles, and other items that bring joy and comfort during difficult times. Contact us to learn about our current needs and donation guidelines.

Mail a Check

Prefer to give by check? Mail your donation directly to our foundation office. Your contribution will be processed securely and put to immediate use supporting our patients and families. Every check, regardless of size, represents your commitment to compassionate end-of-life care in our community.

Mail donations to:
ViaQuest Foundation
525 Metro Place N, Dublin OH 43017

Kroger Community Rewards Program

Support ViaQuest Hospice every time you shop at Kroger with no additional cost to you. Simply link your Kroger Plus Card to our organization, and a percentage of your eligible purchases will be donated to support our hospice services. It’s an easy way to make a difference while taking care of your everyday needs.

PayPal Donation

Make an immediate impact with a secure online donation through PayPal. Your contribution directly supports our mission to provide compassionate hospice care to families in their time of greatest need. Every dollar helps us deliver comfort, dignity, and peace during life’s most precious moments.

Non-Discrimination Notice

Notice of Privacy Practices

General Inpatient Care (GIP)

 Covered by Medicare, Medicaid, and many private insurance plans, this level involves moving you to a contracted hospital, hospice house, inpatient unit, or specialized nursing facility bed. This is used for acute symptom management that cannot be effectively achieved in your home setting, with treatment strictly focused on symptoms related to your hospice diagnosis, demonstrating our determination in ensuring optimal comfort and peaceful transitions.

Inpatient Respite Care (IRC)

Provided at a contracted nursing facility for up to five days, Inpatient Respite Care offers temporary relief for your primary caregiver—giving them the rest they need while ensuring you receive continuous expert hospice care. This level of care offers pure relief and peace of mind for families.

Continuous Home Care (CHC)

When a patient experiences a period of crisis with severe symptoms (such as uncontrolled pain or acute shortness of breath), Continuous Home Care can be provided. This involves a higher level of skilled nursing care delivered continuously in the home for a short period (typically 8-24 hours per day) until the crisis is resolved, showcasing our team’s resolute commitment and dedication to restoring comfort and stability.

Routine Home Care (RHC)

This is the most common level of hospice care, provided in the patient’s chosen residence—your own home, a nursing facility, an assisted living facility, or a hospice house. It includes intermittent visits from our hospice team (nurses, aides, social workers, chaplains, volunteers) to provide symptom management, personal care, emotional support, and education for caregivers, delivered with gentle guidance and a focus on maximizing daily comfort and quality of life in familiar surroundings.