Hospice Care Providers

Hospice Care is a specialized approach to end-of-life care designed for individuals with a terminal illness and a life expectancy of six months or less, as certified by a physician. Rather than pursuing curative treatments, hospice prioritizes comfort, dignity, and quality of life through comprehensive pain management, symptom control, and emotional and spiritual support.

The philosophy behind hospice recognizes that, at a certain point, the goal of care shifts from extending life to honoring the life being lived. Hospice makes it possible for patients and families to focus on what matters most during one of the most sensitive transitions a family will face.

Hospice is a concept of care, not a specific location. Patients receive services wherever they are most comfortable - in their own home, a family member's residence, an assisted living community, a skilled nursing facility, or a dedicated inpatient hospice facility. The care travels with the patient.

Signs it may be time to consider hospice:

• Your loved one has made multiple visits to the emergency room in recent months.
• The condition continues to progress despite treatment, affecting quality of life.
• Your loved one has been hospitalized several times in the past year with the same or worsening symptoms.
• The individual wishes to remain at home rather than continue hospital-based care.
• Your loved one has decided to stop receiving curative treatment.

Hospice does not hasten death. Studies have consistently shown that patients who choose hospice often live as long as, or longer than, those with similar diagnoses who do not. The focus is entirely on comfort and dignity, and if a patient's condition improves, they can be discharged from hospice and return to curative treatment at any time.

Hospice providers operating in the United States are subject to federal and state regulations that define the standards for licensure, staffing, services, and patient rights.

Federal Medicare Conditions of Participation

Hospice organizations that participate in Medicare are required to comply with the Medicare Conditions of Participation for Hospice Care (42 CFR Part 418), administered by the Centers for Medicare and Medicaid Services (CMS). These regulations establish requirements including:

• Licensure in the state where the hospice operates.
• Disclosure to the patient and family of the terminal diagnosis and prognosis.
• A written care plan developed and updated by the interdisciplinary team.
• Pain control and symptom management available to the patient as needed.
• Trained volunteers providing supplemental support.
• Bereavement services for family members following the patient's death.
• A quality assessment and performance improvement program.

Medicare-certified hospices are subject to regular inspections by state survey agencies on behalf of CMS. Survey results and complaint histories are publicly available through CMS.

State Licensing Requirements

All states require hospice providers to be licensed. Specific requirements vary by state and may address staffing ratios, physician oversight, infection control, advance directive documentation, and patient rights. State regulations also govern the requirements for hospices that contract with Medicaid programs.

For state-specific regulatory codes, visit the National Hospice and Palliative Care Organization (NHPCO) at www.nhpco.org or the Hospice Association of America at www.hospicealliance.org.

Patient Rights in Hospice Care

Federal regulations require that every hospice patient and their family receive a written notice of patient rights at the time of admission. These rights include the right to be informed about the plan of care, to participate in care decisions, to refuse treatment, to be treated with dignity and respect, and to voice grievances without fear of retaliation.

Medicare (Part A - Medicare Hospice Benefit)

Medicare Part A covers hospice care when a patient meets the following criteria: a physician certifies a life expectancy of six months or less if the illness runs its natural course, the patient chooses to receive comfort-focused care rather than curative treatment, and the hospice provider is Medicare-certified. There is no lifetime limit on hospice care under Medicare as long as the patient continues to meet eligibility criteria. Coverage includes nursing visits, aide services, medications related to the terminal diagnosis, medical equipment, therapy services, social work, chaplaincy, counseling, and bereavement support.

For questions about Medicare eligibility and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.

Medicaid

Medicaid covers hospice care in all 50 states and the District of Columbia for patients who meet income and medical eligibility requirements. Benefits vary by state. Visit www.medicaid.gov for state-specific information.

Private Insurance

Most private health insurance plans include a hospice benefit. Coverage details, including any cost-sharing requirements, vary by plan. Contact your insurance provider directly to confirm your benefits and any prior authorization requirements.

Veterans Benefits

The U.S. Department of Veterans Affairs (VA) provides hospice care to eligible veterans. Services may be available through VA facilities, community providers, or in the veteran's home. Contact your local VA medical center or visit www.va.gov to learn about eligibility and how to access services.

Uninsured and Underinsured Patients

Most hospice organizations are nonprofits. Many provide care on a sliding fee scale or at no cost to patients with limited income and resources, funded through charitable sources. No eligible patient should be turned away from hospice care based on inability to pay. Ask the hospice organization directly about their financial assistance policies.

Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings.

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available. 

Hospice Foundation of America is to provide leadership in the development and application of hospice and its philosophy of care with the goal of enhancing the U.S. health care system and the role of hospice within it.

National Association for Home Care & Hospice is a trade association that represents the nation’s 33,000 home care and hospice organizations and the caregivers who provide in-home health and hospice services.

National Hospice and Palliative Care Organization (NHPCO) The largest nonprofit membership organization for hospice and palliative care providers. NHPCO publishes consumer guides, state-specific information, and the CaringInfo helpline at 1-800-658-8898. 

U.S. Department of Veterans Affairs - Hospice Care Information on hospice and palliative care services available to eligible veterans through the VA system.

Centers for Medicare and Medicaid Services (CMS) - Hospice Federal regulations, quality measures, and inspection data for Medicare-certified hospice providers.