Continuous care is one of four types of hospice care that is required to be offered in all hospice programs.  This is in addition to routine home care, general inpatient, and respite care.  Continuous care is 8 – 24 hours of care provided in a 24-hour period that addresses a crisis situation, any symptom that can be documented as needing around the clock care, such as pain control, or, imminent death with certain complications.  These hours do not need to be consecutive.

The patient must require and be provided skilled care 51% of hours provided. The skilled care may be any combination of the continuous care LVN, and the visiting RN or case manager.  Once again, these hours need not be consecutive; they just need to be from midnight to midnight.

Who qualifies for Continuous Care?

A patient who is experiencing a crisis situation, any symptom that can be documented as requiring around the clock care, or imminent death with certain complications.

Medicare regulations simply state that continuous care must be offered in a time of distress, symptom control, or imminent death with complications that requires skilled nursing.  Medicare also states that the hospice must provide continuous care for appropriate periods of time in a good faith effort to alleviate the crisis.

Documentation must reflect the reason for continuous care and the skill needed.

Patients rights for Continuous Care:

A patient is entitled to and must be offered continuous around the clock nursing care in their home or place of residence if they are having out of control symptoms, a crisis situation or imminent death with complications.

The hospice must make a “good faith” effort to control the symptoms at home.

For more information about Continuous Care and Hospice Patient rights, please contact our friends at "The Hospice Patients Alliance", www.hospicepatients.org