Understanding Hospice Care: Medical Terms and Abbreviations

Table of Contents

Introduction

Have you ever heard of hospice care? Hospice care is a special kind that helps people who are incredibly sick and have a fleeting time to live. Hospice care is not about curing the sickness but making the person feel comfortable and peaceful. Hospice care also helps the person’s family and friends cope.

Hospice care is especially important and helpful for many people. In the United States, about 1.5 million people received hospice care in 2020. That is a lot of people! Hospice care can be given at home, in a hospital, nursing home, or in a particular hospice facility.

In this article, we will talk about some common medical abbreviations and terminology that are used in hospice care. Abbreviations are short ways of writing long words. Terminology is the words and phrases used in a specific field or subject. Knowing these abbreviations and terminology can help you understand what hospice care is and how it works. It can also help you communicate better with the hospice team members and the doctors. Let’s get started!

Hospice Team Members and Their Roles

Hospice care is not something that one person can do alone. It takes a team of people to help the patient and the family. Each team member has a different role and a different way of helping. Let’s learn about some hospice team members and what they do.

Skilled Nurse (SN): A skilled nurse is a person who has special training and experience in caring for sick people. They can check the patient’s vital signs, give medicines, change bandages, and manage pain. A skilled nurse also teaches the patient and the family how to care for themselves and what to expect from hospice care.
Hospice Aide (HA): A hospice aide is a person who helps the patient with daily activities such as bathing, dressing, eating, and moving around. The aide also helps the patient feel comfortable and clean. The aide works under the supervision of a skilled nurse and follows a plan of care that is made for the patient.
Medical Social Worker (MSW): A medical social worker helps the patient and the family cope with hospice care’s emotional and social aspects. They can provide counseling, support groups, referrals, and resources. They also help the patient and the family with practical matters, such as making a will, arranging a funeral, or applying for benefits.
Spiritual Counselor (SC): A spiritual counselor is a person who helps the patient and the family with their spiritual needs and beliefs. A spiritual counselor can pray, read scriptures, meditate, or perform rituals. A spiritual counselor respects the patient and the family’s faith and values and does not try to change them.
Other Team Members: Other team members may also be involved in hospice care, depending on the patient and the family’s needs and preferences. These may include a doctor, a pharmacist, a therapist, a volunteer, a bereavement counselor, or a pet therapist. These team members can provide additional services and support to the patient and the family.

Hospice Levels of Care and Their Criteria

Hospice care is a special kind that helps people who are incredibly sick and have a fleeting time to live. Hospice care is not about curing the sickness but making the person feel comfortable and peaceful. Hospice care also helps the person’s family and friends cope.

There are four levels of hospice care, each focusing on the specific needs of the person receiving care. Medicare, a government-run health insurance program, defines these levels of care. Medicare pays for most of the costs of hospice care as long as the person meets specific criteria and conditions. Let’s learn about the four levels of hospice care and how they work.

Routine Home Care (RHC)

Routine home care is the most common level of care in hospice. It is for stable people who can control their symptoms, such as pain or nausea. Routine home care is usually provided in the person’s home or residence, where they feel most comfortable. A hospice team member, such as a nurse or an aide, visits the person regularly to check on their health and provide care. The hospice team also supports and educates the person’s family and caregivers.

An example of a person who may receive routine home care is someone who has cancer that cannot be cured but is not in severe pain or distress. The person may need help taking medicines, changing bandages, or doing daily activities. The person may also want to spend time with their loved ones and make plans for the future.

Continuous Home Care (CHC)

Continuous home care is for people who have a crisis or an emergency and need more care and attention. A crisis or an emergency is when the person’s symptoms, such as pain or breathing problems, become severe or complex to manage. Continuous home care is usually provided in the person’s home or residence, where they prefer to stay. A hospice team member, such as a nurse or an aide, remains with the person for at least 8 hours daily to provide care and comfort. The hospice team also helps the person’s family and caregivers cope.

An example of a person who may receive continuous home care is someone who has heart failure that gets worse and causes them to have chest pain and trouble breathing. The person may need oxygen, medicines, or other treatments to ease symptoms. The person may also need emotional and spiritual support to deal with their fear and anxiety.

General Inpatient Care (GIP)

General inpatient care is for people who need more intensive care and supervision than what can be provided at home. Intensive care is when the person needs special equipment, medicines, or procedures to manage their symptoms or pain. Supervision is when the person needs to be watched closely by a medical professional, such as a doctor or a nurse. General inpatient care is usually provided in a hospital or a hospice facility, where they have the resources and staff to provide the care. A hospice team member, such as a nurse or a social worker, coordinates the care and communicates with the person and their family.

An example of a person who may receive general inpatient care is someone who has a stroke that causes them to bleed in the brain. The person may need surgery, medicines, or other treatments to stop the bleeding and prevent more damage. The person may also require monitoring and testing to check their condition and recovery.

Inpatient Respite Care (IRC)

Inpatient respite care is for people with a caregiver who needs a break or a rest. A caregiver, such as a family member or friend, cares for the person. Taking care of a person who is exceptionally sick can be extremely hard and stressful, and sometimes, the caregiver may need some time off. Inpatient respite care is usually provided in a nursing home, a hospice facility, or a hospital, where the person can stay up to 5 days. A hospice team member, such as a nurse or an aide, provides care and comfort to the person. The hospice team also supports the caregivers and helps them relax and recharge.

An example of a person who may receive inpatient respite care is someone who has dementia, which causes them to forget things and act differently. The person may need help eating, dressing, or going to the bathroom. The person’s spouse may be their caregiver and feel tired and overwhelmed by the responsibility. The spouse may need time to care for themselves or do other things, such as visiting a friend or attending a doctor’s appointment.

Hospice Documentation and Billing Terms

Hospice documentation and billing are critical parts of hospice care. They help the hospice team communicate with each other, record the care given to the person, and get paid by Medicare or other insurance. Medicare is a health insurance program run by the government that pays for most hospice care costs. To get paid by Medicare, the hospice team has to follow specific rules and requirements for documentation and billing. Let’s learn some common terms and acronyms in hospice documentation and billing.

Notice of Election (NOE): A notice of election is a form that the person or their representative fills out when they choose to receive hospice care. The form contains information about the person, the hospice, the doctor, and the date hospice care starts. The hospice must send the form to Medicare within five days of the start of care. If the hospice does not send the form on time, it may not get paid by Medicare for the care that it provides.
Notice of Termination or Revocation (NOTR): A notice of termination or revocation is a form that the hospice sends to Medicare when the person stops receiving hospice care. The person may stop receiving hospice care for varied reasons, such as getting better, moving to another hospice, or passing away. The form has information about the person, the hospice, the reason, and the date hospice care ends. The hospice must send the form to Medicare within five days of the end of care. If the hospice does not send the form on time, it may have to pay back some money to Medicare for the care that it provided.
Face-to-Face (FTF): A face-to-face encounter is a visit that a hospice doctor or nurse practitioner makes to the person before they can continue receiving hospice care. The visit must happen before the third benefit period starts and every benefit period after that. A benefit period is when the person is eligible for hospice care. The first two benefit periods are 90 days each, and the following are 60 days each. The purpose of the visit is to confirm that the person is still terminally ill and needs hospice care. The hospice doctor or nurse practitioner must write and sign a note about the visit. The hospice must keep the note in the person’s medical record and send a copy to Medicare if requested.
Hospice Item Set (HIS): A hospice item set is a set of questions the hospice must answer about the person and the care they receive. The questions cover different topics, such as the person’s symptoms, medications, goals, preferences, and satisfaction. The hospice must submit the answers to Medicare within 30 days of the start and end of care. The purpose of the hospice item set is to measure the quality of hospice care and help the hospice improve its services.
Interdisciplinary Group (IDG): An interdisciplinary group is a group of hospice team members who work together to plan and provide care for the person. The group includes a doctor, a nurse, a social worker, a spiritual counselor, and other team members as needed. The group meets regularly to review the person’s condition, needs, and goals. The group also updates the person’s plan of care, a document that describes the care that the person will receive from the hospice.
Plan of Care (POC): A plan of care is a document that describes the care that the person will receive from the hospice. The care plan is based on the person’s condition, needs, and goals. The plan of care includes information about the person’s diagnosis, prognosis, symptoms, medications, treatments, services, and equipment. The plan of care also provides information about the person’s family, caregivers, and preferences. The interdisciplinary group makes the care plan and is approved by the person’s doctor and the hospice medical director. The care plan is updated as often as needed to reflect the person’s changing needs and wishes.

Hospice Clinical Terms and Their Definitions

There are some common clinical terms and abbreviations that are used in hospice care. Clinical terms are words that describe a person’s health and medical condition. Abbreviations are short ways of writing long words. Knowing these terms and abbreviations can help you understand hospice care and how it works. Let’s learn about some of them and what they mean.

Activities of Daily Living (ADLs): Activities of daily living are the things a person does every day, such as eating, bathing, dressing, getting in and out of bed, and using the toilet and telephone. Some people who are incredibly sick may need help with these activities from a hospice aide or a caregiver. The hospice team may use a scale to measure how well the person can do these activities and adjust the care plan accordingly.
Body Mass Index (BMI): BMI is a number that shows how much a person weighs compared to how tall they are. It is a way of measuring whether a person is underweight, overweight, or healthy. Some people who are incredibly sick may lose or gain a lot of weight, which can affect their health and comfort. If needed, the hospice team may check the person’s BMI regularly and provide nutrition counseling, supplements, or appetite stimulants.
Durable Medical Equipment (DME): Durable medical equipment are things that a person needs to use at home for their medical care, such as a wheelchair, a walker, a hospital bed, an oxygen tank, or a suction machine. These things are usually rented from a medical supply company and paid for by Medicare or other insurance. The hospice team may order the DME that the person needs and teach the person and the caregiver how to use them safely and correctly.
Do Not Resuscitate (DNR): Do not resuscitate is a document that tells the medical team not to try to restart the person’s heart or breathing if they stop. This means that the person does not want to have CPR (cardiopulmonary resuscitation), which is a procedure that involves pushing on the chest, giving electric shocks, or putting a tube in the throat. The person or their representative must sign the DNR document, and the hospice team must follow it. The person can change their mind and cancel the DNR at any time.
Karnofsky Performance Status (KPS): The Karnofsky performance status is a scale that measures how well a person can perform normal activities, such as working, walking, or taking care of themselves. The scale goes from 0 to 100, where 0 means the person has died and 100 means the person has no problems. The hospice team may use the KPS scale to assess the person’s condition and prognosis and adjust the care plan accordingly.
Palliative Performance Scale (PPS): The palliative performance scale is another scale that measures how well a person can perform normal activities, such as working, walking, or taking care of themselves. The scale goes from 0 to 100, where 0 means the person has died and 100 indicates the person is fully active. The hospice team may use the PPS scale to assess the person’s condition and prognosis and adjust the care plan accordingly.

Common Hospice Medical Abbreviations and Terms

Abbreviation or Term	Meaning
ADLs	Activities of daily living are the things that a person does every day, such as eating, bathing, dressing, getting in and out of bed, and using the toilet and telephone.
Admit	Admission to the provider’s service.
BID	Twice a day.
BMI	Body mass index is a number that shows how much a person weighs compared to how tall they are. It is a way of measuring if a person is underweight, overweight, or healthy.
CC	Continuous Care where a staff person will be present until a crisis is over or manageable by the caregivers.
CHC	Continuous home care (same as CC) where a staff person will be present until a crisis is over or manageable by the caregivers.
Comfort Kit	A set of medications, often of which several must be refrigerated, to help provide comfort and manage symptoms of the patient.
CM	Case Manager
CNA	Certified nursing assistant who helps the patient with their daily activities, such as bathing, dressing, eating, and moving around.
COPD	Chronic obstructive pulmonary disease which can include chronic bronchitis or emphysema or both.
CPR	Cardiopulmonary resuscitation – A violent attempt to restart the heart and manually keep the heart beating until EMS arrives.
CTB	Cease to breath; the time of death as established by a licensed health care professional.
CTI	Certificate of terminal illness. A document signed by the attending physician and the Medical Director (sometimes the same person) stating the patient has a prognosis of six months or less to live.
DME	Durable medical equipment are things that a person needs to use at home for their medical care, such as a wheelchair, a walker, a hospital bed, an oxygen tank, or a suction machine.
DNH	Do not hospitalize; treat the patient where they are located.
DNI	Do not intubate as it relates to the process of starting artificial ventilhation.
DNR	Do-not-resuscitate; do not perform CPR and allow the person to die naturally.
DOE	(Dyspnea on excertion) Shortness of breath with activity/exercise.
E-Kit	A set of medications, often of which several must be refrigerated, to help provide comfort and manage symptoms of the patient.
Eval	Evaluation for the appropriateness of the next steps (an admission, appropriateness for respite, appropriateness fora medication, etc.)
FAST	Relates to Alzheimer’s disease is a tool that helps doctors and caregivers measure how the disease affects a person’s ability to do everyday things. FAST stands for Functional Assessment Staging Tool. It has seven stages, from 1 to 7, that show how the person’s brain and body change over time.
FTF	A face-to-face encounter is a visit that a hospice doctor or nurse practitioner makes to the person before they can continue receiving hospice care.
GIP	General inpatient hospice in a hospital setting.
HA	Hospice Aide or Home Health Aide (HHA), often a certified nursing assistant (CNA) who helps the patient with their daily activities, such as bathing, dressing, eating, and moving around.
HS	At bedtime.
IDG	An interdisciplinary group is a group of hospice team members who work together to plan and provide care for the person. The group includes a doctor, a nurse, a social worker, a spiritual counselor, and other team members as needed.
IRC	Inpatient respite care (same as respite care) where the patient is placed in an appropriate facility for a period of time allowing the family a break.
IPU	Inpatient unit at a facility oven owned or otherwise contracted by the hospice provider.
KPS	Karnofsky performance status is a scale that measures how well a person can do their normal activities, such as working, walking, or taking care of themselves.
LCSW	Licensed clinical social worker,” which indicates a social worker has obtained additional state licensure after earning a master’s degree in the field.
LPN	Licensed practical nurse.
MSW	Master of Social Work; a social worker with a masters degree.
NYHA	A scale denoting the level of heart failure from stage 1 to stage 4.
PCP	Primary care physician. Often the primary doctor or certified nurse practioner for the patient.
POC	A plan of care is a document that describes the care that the person will receive from the hospice. The plan of care is based on the person’s condition, needs, and goals.
Post Admit	Post admission visit to ensure the patient has been properly admitted to the provider’s service and to follow up on any outstanding immediate needs.
PPS	Palliative performance scale is another scale that measures how well a person can do their normal activities, such as working, walking, or taking care of themselves.
PRN	As the need arises. Often used with medications but can also relate to additional services. Example: Take two Tylenol every 8 hours as needed for a headache. No headache means no Tylenol is taken.
Q__	Every X (number) of Y (time). Y time of H = hours, M = minutes, D= days. Common examples: Q2H – Every two hours Q4H – Every four hours Q3D = Every 3 days
QD	Daily.
QID	Four times a day.
Recert	Recertification – the process of providing information to the insurance provider and Medicare (can be one on the same as the insurance provider) reviewing continued eligibility of a hospice patient.
Respite	Respite service where the patient is placed in an appropriate facility for a peroid of time allowing the family a break.
Revoke	Stopping or otherwise disenaging from the provider.
RN	Registered nurse.
Routine	Any service, medication, or treatment that has a schedule that should be maintained. Examples such as taking a medication every day one hour before eating or a staff member coming Tuesday’s and Friday’s.
RHC	Routine Home Care – the most basic level of service and care in hospice consisting of scheduled visits.
SC	Spiritual Counselor who respects the patient and the family’s faith and values and does not try to change them.
SN	Skilled nurse such as an Licensed practical nurse (LPN) or Registered Nurse (RN)
SOB	Shortness of breath.
SOC	Start of care; the date of admission to the services by the provider.
SpO2	SpO2 is the oxygen saturation level measured by a pulse oximeter, which is a device that clips onto your finger or earlobe and uses light to estimate how much oxygen is in your blood.
TID	Three times a day.

Knowing the common hospice medical abbreviations and terminology can help you make better informed decisions.

Conclusion

This article taught us some common medical abbreviations and terminology in hospice care. We knew what they meant and how they related to the hospice care process. We also learned about the different types of hospice team members, levels of care, documentation and billing, and clinical terms.

Hospice care has many benefits for the person and the family. It can improve the person’s quality of life, reduce pain and suffering, and respect their wishes and values. Hospice care can also support the family emotionally and spiritually and help them prepare for the loss of their loved one.

If you want to learn more about hospice care, you can visit these websites or call these numbers:

National Hospice and Palliative Care Organization (NHPCO): This national organization provides information, education, and advocacy for hospice and palliative care. You can find a hospice near you, read about hospice stories, and access resources and tools for hospice care. You can also call their helpline at 1-800-658-8898.
Hospice Foundation of America (HFA): This national organization promotes understanding and awareness of hospice and end-of-life care. You can watch videos, read articles, and join webinars about these issues. You can also call their toll-free number at 1-800-854-3402.
CaringInfo: This website provides free information and resources to help people decide about end-of-life care and services. You can download brochures, guides, and forms about hospice care, advance directives, grief and loss, and more. You can also call their hotline at 1-800-658-8898.

We hope that this article was helpful and informative. Thank you for reading and learning with us. We wish you and your family all the best.