Hospice Knowledge Center
What is Continuous Home Care? Hospice CHC level of care
Continuous Home Care (CHC) is one of the four Medicare hospice levels of care. It supports patients in symptom crisis who can be safely managed at home with intensive predominantly nursing care.
CHC, in one sentence
CHC is intensive short-term hospice care at home, provided predominantly by nursing, for a symptom-crisis period that would otherwise require inpatient admission.
Criteria for CHC
CHC requires: (1) a medical crisis such as unrelieved pain, severe dyspnea, or terminal agitation; (2) predominantly nursing care — at least 8 hours in a 24-hour period, more than half of which are nursing (RN or LPN); (3) the patient is at home (routine home care setting).
Hourly documentation
Every hour of CHC must be documented individually: who provided care, what was done, and clinical justification for continued crisis-level care.
When to step down
As soon as the symptom crisis is resolved and the patient can be managed at routine home care, step the level of care back down. Prolonged CHC without documented ongoing crisis is a common audit-risk pattern.
Frequently asked questions
What is the minimum CHC duration in a day?
Can CHC be provided in a facility?
How is CHC billed?
Sources & further reading
Educational content only. Not a substitute for your organization’s policies, your medical director’s clinical judgment, or current CMS guidance.
Keep going.
Save your progress, earn achievements, and get personalized next-step learning with a free Goodwin Hospice Academy account.