Hospice Care Resources — Guides, Checklists & FAQs

A hospice referral is appropriate when a patient has a life-limiting illness with a prognosis of six months or less if the disease follows its expected course, and when curative treatment is no longer effective or no longer what the patient wants. Research consistently shows that earlier hospice referrals — weeks or months before death, not days — lead to better pain and symptom control, fewer emergency department visits, fewer unnecessary hospitalizations, and significantly higher family satisfaction with the care experience. In Los Angeles, many families and providers wait too long to initiate a referral, which limits the benefit hospice can provide.

The Medicare Hospice Benefit covers skilled nursing care, physician services, medications related to the terminal diagnosis, durable medical equipment and supplies, home health aide visits, medical social work services, spiritual and pastoral care, bereavement counseling for family members (for up to 13 months after the patient's death), and short-term inpatient and respite care. There is no deductible for hospice services under Medicare. Prescription copays are capped at $5 per medication, and respite care has a small daily copay. Hospice care under Medicare is available to patients aged 65 and older, as well as younger patients who qualify for Medicare through disability.

No. The patient's attending physician can and should remain involved in directing care throughout the hospice period. The hospice medical director works collaboratively with the attending physician, not as a replacement. Most families find that the relationship with their regular doctor continues seamlessly, with the hospice team handling the day-to-day symptom management and the attending physician remaining available for consultations and ongoing involvement in care decisions.

Yes. A patient or their authorized representative can revoke hospice at any time for any reason and return to full curative treatment coverage under Medicare. Additionally, some patients genuinely improve under the intensive symptom management hospice provides and are discharged by the hospice agency because they no longer meet the six-month prognosis criteria. These patients can re-elect hospice later if their condition declines again. Revoking or being discharged from hospice does not affect future eligibility.

Palliative care is a broader medical specialty focused on relieving symptoms, managing pain, and improving quality of life for patients with any serious illness at any stage — and it can be delivered alongside curative treatment. Hospice care is a specific, Medicare-defined benefit program for patients who have a terminal prognosis of six months or less and who have elected to forgo curative treatment in favor of comfort-focused care. All hospice care is palliative in nature, but not all palliative care is hospice. In Los Angeles, many hospitals and health systems now have both palliative care consultation teams and hospice referral pathways, and New Vision Hospice can help families understand which option is appropriate for their situation.

Many hospice agencies in the Los Angeles area employ bilingual and multilingual clinical staff, including Spanish, Mandarin, Cantonese, Korean, Armenian, Farsi, Tagalog, Vietnamese, and Russian-speaking nurses, social workers, and chaplains. When you call New Vision Hospice, tell our coordinator your family's language preference during the initial assessment and we will match you with an agency that has the appropriate language capacity on their active clinical team — not just a phone interpreter, but in-person bilingual care.

Yes, but it requires thoughtful planning. Home hospice under Medicare typically assumes the presence of a primary caregiver in the home who can assist with daily needs between nursing visits. For patients who live alone, the hospice agency works with the family to develop a realistic care plan that may include increased aide visit frequency, a rotation of family members or friends, hired private-duty caregivers, or enrollment in adult day programs. If a safe and adequate home care situation cannot be established, facility-based hospice — either in a skilled nursing facility or an inpatient hospice unit — is an appropriate alternative. Our coordinators help families think through these options during the referral process.

Hospice agencies operating in California must be licensed by the California Department of Public Health (CDPH) and, to accept Medicare patients, must also be certified by the federal Centers for Medicare & Medicaid Services (CMS) through a survey process. Many agencies additionally hold voluntary accreditation from recognized bodies such as The Joint Commission (TJC), the Accreditation Commission for Health Care (ACHC), or the Community Health Accreditation Partner (CHAP). Every hospice agency in the New Vision Hospice network meets all required state licensing and federal certification standards, and we verify these credentials during our initial vetting and on an ongoing basis.