Hospice Level 3: General Inpatient Care

When a hospice patient faces severe symptoms and pain that can’t be managed at home, their hospice team may recommend general inpatient care (GIP), also known as level three hospice care.

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Patients may be asked to stay in an inpatient facility for a short amount of time until their pain and symptoms are under control. In some cases, inpatient care is the step right before death. In others, it stabilizes the patient’s pain and symptoms so that they can return to in-home hospice care.

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What Happens During General Inpatient Care?

During general inpatient care or GIP hospice, the patient is admitted to a facility, such as a hospital or skilled nursing facility. At the location, a patient can be monitored and receive medical care in addition to any other services needed to effectively manage their pain, acute symptoms, and chronic symptoms. For the hospice team, the goal is for the patient to return home once the pain and symptoms are under control.

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Which Patients Need General Inpatient Care?

Patients experiencing severe symptoms or pain that cannot be effectively managed at home may need general inpatient care. For these patients, it means moving from in-home care to GIP hospice. The physician overseeing the hospice care plan makes the ultimate decision. Situations warranting general inpatient care can include needed medication adjustments, psycho-social monitoring, or close observation.

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Patients who elect hospice care during the tail end of a hospital stay might begin their hospice care journey with general inpatient care—if their symptoms and pain require it. During their time spent inpatient, the same hospice care team can set up in-home hospice services so patients can move to continuous home care or routine home care.

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Home is where most people say they prefer to die. In-home hospice care helps make that possible for many patients.

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Where Can Patients Receive General Inpatient Care?

Hospitals, skilled nursing facilities, and hospice inpatient facilities can provide general inpatient care for hospice patients. If someone is in need of GIP hospice, your hospice team will choose a facility that accepts your insurance, whether that’s private insurance, Medicare, Medicaid, or VA benefits.

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For patients using Medicare to pay for hospice, the facility must also:

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Have 24-hour registered nursing coverage
Have appropriate patient areas
Allow patients to receive visitors at any time of day, with privacy

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General Inpatient Care vs. Inpatient Hospice Care Centers

Hospice patients can choose where they want to receive hospice services. While many people elect to receive hospice services in their current home, some choose to move into an inpatient hospice care center. Inpatient hospice care centers and general inpatient care for hospice might sound like the same thing, but they have some differences.

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For starters, general inpatient care describes a short-term facility stay for hospice patients whose symptoms and pain cannot be controlled at home. By contrast, an inpatient hospice care center is a residential facility that provides both short-term and long-term hospice care services to patients, including general inpatient care.

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From an insurance standpoint, Medicare typically covers the full cost of short-term general inpatient care provided by a Medicare-approved inpatient hospice care center. However, Medicare does not cover the room and board costs for a patient who chooses to live at a hospice care center for their entire hospice journey.

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Level 3 of Hospice Care: General Inpatient Care Is Necessary

Some patients can start in GIP hospice or start with in-home hospice care. The levels of hospice care do not mean that patients start at level one and move up. General inpatient care makes it possible for patients to receive nearly 24-hour care, higher medication management, and symptom management in a dedicated location.

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In the end, any type of hospice care shares the same goal: to help patients die with dignity and spend time with those they love.

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Are you suffering from caregiver burnout? Respite care may be the break you need.

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