Only 25 percent of Americans are aware that hospice care is provided in a home setting, according to surveys by the National Hospice and Palliative Care Organization.  Most people think that hospice care is provided in a health care facility commonly referred to as "the hospice." This is not surprising as the root of the word “hos” also is the root of “hospital” and “hostel,” terms describing a health care facility and a temporary residence or hotel, respectively.  In medieval times, hospices were actually inns and in some cases refuges for the ill.  That same concept of nurturing care became the genesis of a movement in the 1960s by St. Christopher's Hospice in England to bring care into the home of the terminally ill. This home-based approach was introduced in the United States in the 1970s, and the first home-based hospice program began in Monterey County in 1976.  A six-bed inpatient care center was opened a year later in Carmel Valley.