How to choose a hospice agency

Hospice is one of the most comprehensive benefits Medicare provides. It is available for people who have a life expectancy of 6 months or less, when certified by a physician. It brings needed professionals – nurses, social workers, chaplains – into the home. In the best cases, physicians are available for house calls or tele-health visits. It can also provide higher levels of care if symptoms are hard to manage – at home or in a hospital or other inpatient center. When you start looking into hospice, it is an emotional time. Here are some key questions to ask as you begin your search. Remember too, that in many locations there are multiple hospice agencies and you are always free to switch as long the person still qualifies for hospice. 

If your loved one is frail and has serious illness, hospice could be the in home support you need. People often wish they had enrolled sooner.

  • Are you Medicare-Certified and State-Licensed? 

    • Medicare certification is essential if the patient is using Medicare Hospice Benefit. 


    How long have you been serving the community? 

    • More experience often means better coordination and established care teams. 


    Are you nonprofit or for-profit? 

    • This can affect care philosophy and services—nonprofits may offer broader support. 

  • What is the ratio of patients to hospice nurses? 

    • Lower ratios usually mean more personalized attention and likely nurses will stay with the agencies longer 

    Do you have a full interdisciplinary team? 

    • Should include: doctor, nurse, social worker, chaplain, and bereavement counselor. 

    Who is the medical director? 

    •  Will they come see the patient, in person or via telehealth? 

    • How long has the medical director been providing hospice care? Are they full time with you or do they have a separate full-time job? 

    • How do I get in contact with the physician in charge of my care?  

    How often do nurses visit? Will this change based on needs?

    Is help available 24/7—including nights, weekends, and holidays? 

    • How many nurses are on after hours and what geography do they serve? 

    • Do on call staff have access to telehealth for immediate in-home access? 

    • Can a physician or nurse practitioner do telehealth visits during the day and/or after hours? 

  • How do you keep families updated on the patient’s condition?

    • Is there a portal?

    • Can we text with the care team? 

    Will we have one consistent nurse/caregiver or rotating staff?

  • What types of support do you offer that differentiate you from other agencies?

    If the patient needs a higher level of care for symptoms to be managed, can that be provided in the home? If they need an inpatient setting where will this be done? What are the options and how far are they from where we live?

    Do you provide hospice aides for personal care (bathing, dressing)?

    • How many hours a week can we expect this service? 

    What types of medical equipment and supplies are provided?

    Do they have special services like music therapy, massage therapy or other services?

    Are volunteers available for visits?

    If we wanted to privately pay for inpatient care is that possible and what is the cost?

  • What support is available for family caregivers?

    • Look for respite care and ask where it is available – Medicare generally covers 5 days of respite, and this may happen more than once while on hospice if needed 

    • Counseling, and education

    Do you offer grief support and bereavement counseling?

    • Should continue for at least 13 months after the patient’s passing. 

  • How do you measure and report quality of care? 

    • Ask about CAHPS Hospice Survey scores (Medicare rates hospice agencies). 

    Have you had any complaints or deficiencies in recent inspections? 

    Can you provide references from other families you’ve served?