When symptoms become hard to manage, you need the right level of hospice care at the right time. This guide explains how continuous home care and general inpatient hospice support you in North Texas. You will learn when each level is used, how they differ, how Medicare views coverage, and how to take the next step in Dallas County, Collin County, and Tarrant County.
Understanding The Four Levels of Hospice Care
Levels of care exist so you receive just enough support without losing the comfort of home when that is possible. The four levels are:
- Routine Home Care: Ongoing visits at home or in a facility with nursing, CNA, social work, and chaplain support.
- Continuous Home Care: Short-term, time-limited nursing in the home during a crisis.
- General Inpatient Hospice: Short-term inpatient care for complex symptoms that require 24-hour nursing oversight.
- Respite Care: Up to five days of inpatient support to give caregivers a rest.
What Is Continuous Home Care
Continuous home care is designed for a brief crisis that can be stabilized at home. A nurse stays for extended periods during the day or night, often in blocks of time, to manage symptoms that have suddenly escalated.
When it helps most
- Severe pain that is not controlled with the current plan.
- Breathing distress, agitation, or sudden anxiety.
- Complex medication changes that must be monitored closely.
What you can expect
- A nurse at the bedside for extended hours, teaching and adjusting medications in real time.
- Close coordination with your hospice physician or nurse practitioner.
- A plan to step back to routine home care once symptoms settle.
What Is General Inpatient Hospice
General inpatient hospice is short-term care in an inpatient setting, such as a contracted hospital unit or hospice inpatient center. This level is used when symptoms require continuous nursing assessment and rapid interventions that are not realistic at home.
When it helps most
- Refractory pain despite aggressive home management.
- Uncontrolled nausea or vomiting that prevents oral medications.
- Severe restlessness or delirium that places the person at risk.
- Complex breathing issues that require frequent interventions.
What you can expect
- 24-hour nursing, frequent assessments, and rapid medication adjustments.
- A quiet, family-focused environment with privacy and space for loved ones.
- A plan to return home when symptoms are stable, or to continue inpatient care if needed.
How to Choose the Right Level Today
Use this simple checklist. If you answer yes to two or more, call your hospice right away.
- Are symptoms changing every few hours despite recent medication adjustments
- Are you considering an ER visit due to pain, breathing, or agitation
- Are you afraid to be alone with your loved one because of sudden changes
- Are oral medications ineffective or not tolerated
Transitions Between Levels of Care
Moving between levels is normal. You might start with continuous home care for 24 to 48 hours, then step down to routine home care once symptoms settle. If control is not achieved at home, you may transition to general inpatient hospice for intensive stabilization. The goal is comfort with the least disruption to your daily life.
Medicare Coverage
Medicare, Medicaid, and many private plans recognize all four hospice levels. Medications related to the terminal diagnosis, medical equipment, supplies, and professional services are typically covered. Inpatient room and board is covered during general inpatient hospice or respite when criteria are met. For details, review the Medicare Hospice Benefit (opens in a new tab), then ask your hospice team to explain any potential out-of-pocket costs before you begin.
Start the Right Level of Care in Dallas County, Collin County, or Tarrant County
You deserve calm, clear guidance. If symptoms are escalating, you do not have to decide alone. A quick conversation can help you understand whether continuous home care or general inpatient hospice is the safest next step for your loved one in North Texas; call (469) 625-0705 to speak with our care team now, or contact us if you prefer to send a message.
