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What Questions Should You Ask Before Choosing a Hospice Provider?

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Choosing a hospice provider is a decision families often have to make quickly, sometimes within days of a diagnosis or a hospital discharge. Not all hospice providers offer the same level of care, availability, or communication, and the right questions can help you understand what to expect before your loved one’s care begins. Below are the key questions to ask any hospice provider you’re considering, and why each one matters.

Is the Provider Licensed, Certified, and Medicare-Approved?

Every hospice provider should be Medicare-certified and licensed in the state where they operate. This certification ensures the provider meets federal standards for staffing, care planning, and patient rights. Ask directly whether the hospice is Medicare-certified and how long they’ve operated in your area. 

A provider with deep roots in the community, like ours in Burbank and across Los Angeles County, will usually be able to speak specifically to how local hospitals, physicians, and skilled nursing facilities work with their team.

What Does the Care Team Actually Look Like?

Hospice care is delivered by an interdisciplinary team, not a single nurse. Ask who will be involved in your loved one’s care: a registered nurse, a hospice aide, a social worker, a chaplain, and a physician should all be part of the plan. It’s worth asking how often each team member visits and how the team communicates with the family between visits. Our hospice team page outlines the specific roles involved in a Journey Palliative and Hospice care plan, so you know exactly who to expect at your door.

What Services Are Included?

Hospice benefits typically cover more than nursing visits. Ask a provider to walk you through their full range of services, including palliative care for symptom management, specialized pain management, wound care, and durable medical equipment like hospital beds or oxygen concentrators. If mobility or physical comfort is a concern, ask whether physical therapy is available as part of the plan.

Learn more: The Role of Physical Therapy in Hospice Care

Where Will Care Be Provided?

Hospice care can happen at home, in an assisted living community, or in a skilled nursing facility, and the right setting depends on the patient’s needs and the family’s capacity to provide day-to-day support. Ask the provider directly whether they can deliver care in your specific setting and how their team adjusts the care plan based on location. For a closer look at how the two most common settings compare, our post on hospice care at home vs. facility breaks down what families should weigh before deciding.

How Available Is the Care Team After Hours?

One of the most important, and most overlooked, questions is what happens at 2 a.m. when a symptom changes suddenly. Ask whether the hospice provides 24/7 phone support, whether a nurse can come to the home overnight if needed, and how quickly medication deliveries happen when a prescription changes. Families consistently point to responsiveness during off-hours as one of the biggest differences between hospice providers.

What Support Is Available for the Family, Not Just the Patient?

Hospice care extends to the family. Ask what bereavement services are available after a loved one passes, and whether respite care is offered to give a primary caregiver a break. These services are part of the Medicare hospice benefit, but not every provider promotes or actively offers them, so it’s worth asking specifically rather than assuming they’re included.

How Does the Provider Explain Costs and Coverage?

Most hospice care is fully covered under Medicare, Medi-Cal, or private insurance, but the details can vary. Ask the provider to explain what’s covered, what isn’t, and how they handle situations where a patient’s needs change. A provider who answers this clearly and without pressure is generally a good sign of how they’ll communicate throughout care.

Can You Speak With Current or Past Families?

Reviews and testimonials can only tell you so much. If a provider is willing to connect you with a current or former patient family (with permission), that’s a strong signal of transparency. It’s also worth asking how the provider handles a shift in a patient’s condition, including what happens if a patient’s status changes or if a family decides hospice isn’t the right fit anymore.

Learn more: What Happens If You Decide to Leave Hospice Care?

What Should You Expect in the First Few Days?

Ask the provider to walk you through what happens after admission: how quickly the first nurse visit happens, how the care plan is built, and what changes for the family day to day. A provider who can answer this in detail, rather than in general terms, is more likely to deliver a smooth start. Our what to expect page walks through what a new patient and family typically experience in the first days of care with our team.

A Few Misconceptions Worth Clearing Up First

Some of the hesitation families feel when choosing a hospice provider comes from misunderstandings about hospice itself, not the provider. Before your first conversation with any hospice team, it may help to understand what hospice actually involves and doesn’t involve. Our post on 10 Common Hospice Care Myths (And the Facts Behind Them) addresses the misconceptions we hear most often from families in Burbank and across Los Angeles County.

Choosing With Confidence

Choosing hospice is an important decision, and you should never feel rushed or pressured. Asking thoughtful questions and comparing providers can help you find a team that aligns with your loved one’s goals and your family’s expectations. The right hospice partner will not only provide expert medical care but also offer emotional, spiritual, and practical support every step of the way.

If you’re exploring hospice care and would like to discuss what services may be right for your family, our team proudly serves patients and families throughout Burbank and the surrounding communities. We’re here to answer your questions, explain your options, and help you make an informed decision with confidence. Reach out through our contact page or call us directly at (818) 748-3427 to speak with a member of our team.

When Is It Time for Hospice? Clear Signs by Diagnosis (Dementia, CHF, COPD, Cancer)

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Deciding when hospice care is appropriate is rarely a single moment. It’s usually a pattern that builds over weeks or months: more hospital visits, less response to treatment, and a shift in what the patient and family actually want out of care. 

Because that pattern looks different depending on the illness, we’ve broken down some of the general signs care teams and families look for by diagnosis. These are meant as a starting point for a conversation with a physician, not a substitute for one, only a physician can certify hospice eligibility.

The General Signs That Apply Across Any Diagnosis

Regardless of the underlying illness, a few patterns tend to show up when hospice becomes appropriate: frequent trips to the emergency room or hospital, declining ability to manage daily activities like eating, bathing, or moving around independently, and a noticeable shift in how the patient talks about their goals, often moving away from aggressive treatment and toward comfort. 

If a physician has already used the phrase “life expectancy of six months or less if the illness runs its expected course,” that’s the Medicare standard for hospice eligibility, and it’s worth bringing up hospice directly at that point. Our hospice eligibility guidelines page can help you understand what our clinical team looks for during that first conversation.

Signs of Decline in Dementia and Alzheimer’s Disease

Dementia and Alzheimer’s disease can be among the most challenging conditions to assess for hospice eligibility because the decline is often gradual rather than marked by a single medical event. Instead of focusing on one symptom, physicians evaluate the overall progression of the disease and how it affects the person’s ability to function and maintain quality of life.

As the disease advances, physicians typically look at a patient’s ability to communicate, walk, eat, and perform basic activities of daily living such as bathing, dressing, and toileting. When someone with advanced dementia is no longer able to speak more than a few meaningful words, requires assistance with all personal care, and spends most of the day in bed or a chair, it may indicate that the illness has reached a more advanced stage.

Other signs of decline include frequent infections such as pneumonia or urinary tract infections, repeated hospitalizations, ongoing weight loss, reduced appetite, and increasing difficulty swallowing food, liquids, or medications. 

These changes can place patients at greater risk for complications and often prompt discussions about whether hospice care is appropriate. At that point, hospice can help manage symptoms, provide comfort-focused care, and support both the patient and their family throughout the progression of the disease.

Learn more: 10 Common Hospice Care Myths (And the Facts Behind Them)

Signs of Decline in Congestive Heart Failure (CHF)

For patients with congestive heart failure (CHF), physicians evaluate both how well the heart is functioning and how the condition affects everyday life. Recurrent hospitalizations for fluid buildup, worsening swelling, increasing fatigue, and shortness of breath, even while resting or performing simple activities-can all indicate that the disease is progressing. 

Physicians also consider whether standard heart failure treatments are becoming less effective at managing symptoms. If a cardiologist determines that additional procedures or aggressive treatments are unlikely to improve the patient’s condition or quality of life, it may be time to discuss hospice care. At that point, the focus often shifts from trying to slow the disease to prioritizing comfort, symptom management, and support for both the patient and their family.

Signs of Decline in COPD

Chronic obstructive pulmonary disease (COPD) often follows a pattern of recurring flare-ups followed by periods of partial recovery, with each episode leaving the patient a little weaker than before. Frequent hospitalizations or emergency room visits, increasing dependence on supplemental oxygen, and the need for repeated courses of steroids or antibiotics are common signs that the disease is advancing. 

Physicians also look for unintentional weight loss, ongoing fatigue, persistent coughing, and increasing difficulty breathing during everyday activities such as walking, dressing, or bathing. When a patient becomes short of breath even at rest or struggles to perform basic tasks despite treatment, it may be appropriate to begin a conversation about hospice. 

Hospice care can help manage symptoms, reduce unnecessary hospital visits, and improve comfort while allowing patients to remain in a familiar and supportive environment.

Signs of Decline in Cancer

For cancer patients, the picture often looks different depending on whether treatment is still an option. When a physician determines that curative treatment is no longer effective or that the burden of treatment outweighs the benefit, that’s typically when hospice becomes part of the conversation. Other signs families and care teams notice include increasing fatigue, more time spent in bed, and a decline in appetite that doesn’t reverse with intervention. 

Why Timing the Referral Matters

Families sometimes wait longer than necessary to start hospice care, often because the word itself feels like giving up. In practice, earlier referrals tend to give patients and families more time to benefit from the full range of support hospice provides, including specialized pain management, wound care, and emotional and spiritual support for the whole family. 

Starting hospice care earlier doesn’t shorten the time a patient has; it generally means more of that time is spent as comfortably as possible.

What Happens Once Hospice Starts

Once a physician has confirmed eligibility, an assessment typically happens within a day or two, and care can begin the same day it’s confirmed. Our what to expect page walks through what those first days generally look like, including who visits, how often, and how the care plan gets built around the specific diagnosis.

Talk to a Physician First

None of the signs above are meant to replace a physician’s evaluation. Every diagnosis progresses differently, and the only way to confirm hospice eligibility is through a physician’s certification. If you’re noticing several of these patterns in a loved one, the most useful next step is usually a direct conversation with their doctor about where things stand and whether hospice should be part of the plan.

When You’re Ready to Talk It Through

If you’re trying to figure out whether it’s time for hospice, whether the diagnosis is dementia, CHF, COPD, cancer, or something else, our team is available to talk through what you’re seeing and help you understand the next step. 

We serve families throughout our service areas in and around Burbank. Reach out through our contact page or call us at (818) 748-3427 whenever you’re ready.

Bereavement Support After Hospice: A Family Guide

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Under the Medicare Hospice Benefit, bereavement support for surviving family members is a required component of hospice care, not an optional add-on. Families are entitled to grief counseling, support groups, memorial services, and community referrals for at least 13 months following the death of their loved one. 

This guide explains what hospice bereavement services include, how the process works, and what families in Burbank and Los Angeles County can expect from Journey Palliative and Hospice after a loss.

Hospice Care Doesn’t End When Your Loved One Dies

Most families don’t know this: the care relationship with your hospice provider legally continues after death.

The Centers for Medicare and Medicaid Services (CMS) requires that Medicare-certified hospice programs provide bereavement services to surviving family members and caregivers following a patient’s death. This isn’t a courtesy; it’s a federal mandate, and it’s included in what your family has already paid for through the Medicare Hospice Benefit.

If no one from your hospice team has contacted you about bereavement support, that’s worth knowing, because you’re entitled to it.

Journey Palliative and Hospice’s bereavement services are available to every family we serve in Burbank and across Los Angeles County, beginning the moment your loved one passes and continuing through the months that follow.

What Hospice Bereavement Support Includes

Bereavement services vary between hospice providers, but the Medicare Hospice Benefit sets a minimum standard. At Journey Palliative and Hospice, that support includes:

  • Grief counseling – individual sessions for adult family members, close friends, and children. Counseling provides a structured, confidential space to process loss at your own pace with a trained professional who understands the specific grief that follows a terminal illness.
  • Patient grief counseling – grief doesn’t begin at death. The patient themselves often needs support processing their own sense of loss: the life they’d planned, the milestones they’ll miss, the relationships they’re leaving behind. Journey’s bereavement counselors are available to the patient during active hospice care as well as to the family after.
  • Support groups – group settings where families share experiences with others navigating similar losses. Many people find that hearing “me too” from a stranger going through the same thing is more grounding than almost anything else.
  • Memorial services – structured opportunities to gather and pay tribute to your loved one’s memory. These can be especially meaningful for families who didn’t hold a traditional service or who want an additional moment of community acknowledgment.
  • Relaxation and therapeutic techniques – art therapy, relaxation methods, and other evidence-informed approaches that help manage the physical toll of grief. Grief is not purely emotional – it affects sleep, appetite, immune function, and cardiovascular health. Non-clinical tools matter.
  • Spiritual counseling – available to practitioners of all faiths, and to those without a formal religious tradition. Journey’s team is multicultural and multilingual, and spiritual support is adapted to your family’s beliefs and background.
  • Community referrals – when a family’s needs extend beyond what hospice bereavement services provide, Journey connects families with community resources: therapists, grief support organizations, cultural and faith-based programs, and mental health services in the Burbank and Los Angeles County area.

How Long Does Bereavement Support Last?

The Medicare Hospice Benefit requires hospice providers to offer bereavement services for at least 13 months after the patient’s death. This timeframe is not arbitrary – it covers the first full calendar year of grief, including all anniversaries, holidays, birthdays, and milestones that are especially difficult in that first year, plus a buffer month beyond it.

The 13-month period begins from the date of death, not the date of the last visit or the date the hospice closed the patient’s chart.

Who Is Covered by Hospice Bereavement Services?

Bereavement services are not limited to a spouse or primary caregiver. CMS defines the eligible population broadly to include immediate and extended family members, close friends, and others identified as part of the patient’s support network.

If a grandchild, a longtime neighbor, or a family friend was significantly involved in the patient’s care and is grieving the loss, they may be eligible to access bereavement support through the hospice. Talk to your Journey care coordinator to understand who can be included.

Grief After a Long Illness Is Its Own Kind of Loss

Families often assume that because they “knew it was coming,” they’ll be more prepared for grief after a prolonged illness. The research does not support that assumption.

Anticipatory grief – the grief that happens during the illness – does not replace the grief that comes after death. In many cases, families who devoted months or years to caregiving experience a compounded loss: the person they loved, the role that gave their days structure and purpose, and the version of themselves that existed before the illness began.

Caregiver grief also carries a particular weight. If you spent months managing medications, coordinating appointments, staying up through the night, and holding space for someone else’s fear and pain – your body and mind have been through something significant. Recovery from that experience deserves attention, not just the grief itself.

Journey’s in-home caregiving team works alongside families through the full arc of a loved one’s hospice stay, and the transition to bereavement services is designed to feel continuous – not like a door closing.

Bereavement Support for Families in Burbank and Los Angeles County

Journey Palliative and Hospice serves families across Burbank, Glendale, Pasadena, the San Fernando Valley, and greater Los Angeles County. Our bereavement team is multicultural and multilingual, and services are available to families regardless of cultural or religious background.

All bereavement services for families of Journey patients are provided as part of the Medicare Hospice Benefit at no additional cost for covered services.

See more of our Service Area

Frequently Asked Questions

  • Is hospice bereavement support free?
    • For families of Medicare hospice patients, bereavement services are included under the Medicare Hospice Benefit at no additional cost for covered services. Coverage is administered through the hospice provider – you do not need to file separately or find an outside provider.
  • How does Journey Palliative and Hospice reach out after a loved one passes?
    • A bereavement coordinator from Journey will contact the family within a few days of death to introduce themselves, offer condolences, and begin the process of understanding what level of support the family wants. From there, outreach is customized – some families prefer regular check-ins, others want to initiate contact when they’re ready.
  • Can children receive bereavement support through hospice?
    • Yes. Journey’s bereavement services include counseling for children as well as adults. Children grieve differently than adults and often need age-appropriate support from someone trained to work with them. If a child in your family has lost a grandparent, parent, or other loved one, they are eligible for bereavement support through the hospice program.
  • What happens if I need more support than hospice bereavement provides?
    • Your bereavement counselor can refer you to community mental health resources, licensed therapists specializing in grief, and cultural or faith-based support programs in the Burbank and Los Angeles County area. There is no stigma in needing more – the hospice bereavement program is designed to recognize when that’s the right step and help you find it.
  • Does bereavement support end after 13 months?
    • The Medicare-required period for hospice bereavement services is 13 months from the date of death. After that point, formal hospice bereavement services through Journey conclude. If you still need support at or after the 13-month mark, your bereavement coordinator can connect you with community and clinical resources to continue that support.

Grief Deserves the Same Care as the Rest of the Journey

Your loved one’s comfort was the center of everything during hospice care. Your family’s well-being matters in the time that follows.

If you’re a current Journey Palliative and Hospice family and have questions about bereavement services, call us at (818) 748-3427. If you’re a family considering hospice for a loved one and want to understand the full picture of what support looks like – including what comes after – we’re here for that conversation too.

Breakthrough Pain in Hospice: How Rescue Doses Keep Your Loved One Comfortable

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Breakthrough pain is a sudden, temporary spike in pain that occurs even when a patient is already on scheduled pain medication. In hospice care, rescue doses – small, fast-acting doses of medication are prescribed specifically to address these episodes. 

This guide explains what breakthrough pain looks like, how rescue doses work, when to use them, and what families in Burbank and Los Angeles County should know before a crisis happens.

What Is Breakthrough Pain in Hospice?

Most hospice patients receive around-the-clock pain medication on a scheduled basis. That baseline dosing is designed to control what clinicians call “background pain”- the persistent, ongoing discomfort that comes with a serious illness.

Breakthrough pain is different. It’s a sudden flare of pain that breaks through the protection that scheduled medication provides. These episodes can come on quickly, often within minutes, and may last anywhere from a few minutes to an hour. They can happen during movement, during personal care, or entirely without warning.

For families caring for a loved one at home, witnessing breakthrough pain can be frightening- especially if they don’t know what to do. That’s exactly why hospice teams send families home prepared.

What Are Rescue Doses?

A rescue dose is a separately prescribed, fast-acting medication given specifically for breakthrough pain. It is not a substitute for the regular pain regimen- it is a safety net layered on top of it.

Your loved one’s hospice physician or nurse practitioner will calculate the rescue dose based on their total daily opioid requirement, typically prescribing 10–15% of the 24-hour total as a single as-needed dose. The medication is usually the same drug as the long-acting medication, just in an immediate-release form.

Journey Palliative and Hospice includes rescue medication in every personalized, specialized pain management plan. Medications are delivered directly to the home, and our team ensures caregivers know exactly how and when to use them before a crisis occurs.

Types of Breakthrough Pain

Understanding the type of breakthrough pain your loved one experiences helps the care team optimize their medication plan.

  • Spontaneous (idiopathic) pain occurs without a clear trigger. It is unpredictable and often associated with nerve-related conditions or advanced cancer.
  • Incident pain is triggered by a specific activity- repositioning, bathing, transferring from bed to chair, or even coughing. Because it’s predictable, the care team can time a rescue dose 20–30 minutes before the activity to head off the pain.
  • End-of-dose failure happens when the long-acting medication wears off before the next scheduled dose. If your loved one is consistently in more pain in the hours before their next dose, that’s a signal the current regimen needs adjustment- not a reason to simply increase rescue dose frequency.

Your hospice nurse documents these patterns and adjusts the care plan accordingly. If you’re noticing a trend, note the time of day, what was happening beforehand, and how long the episode lasted. That information directly shapes the medication plan.

When to Call the Hospice Team

Rescue doses are effective for most breakthrough pain episodes, but there are situations where you should call your hospice nurse rather than- or in addition to- giving the medication:

  • The rescue dose was given, and pain did not improve within 30–60 minutes
  • Your loved one is having more than three or four breakthrough episodes per day (this signals the baseline needs adjusting)
  • The pain episode is unusually severe or different in character from prior episodes
  • Your loved one is having trouble breathing, appears confused, or cannot respond normally
  • You are uncomfortable with the situation for any reason

Frequent breakthrough episodes are not a failure of the rescue dose- they are clinical information. Your care team uses that data to refine the pain management plan so your loved one is more consistently comfortable throughout the day.

Complementary Approaches Alongside Rescue Medication

Medication is the most effective tool for breakthrough pain, but it works best as part of a broader comfort strategy. The Journey Palliative and Hospice care team also incorporates:

  • Positioning and repositioning: Small adjustments in body position can significantly reduce incident pain. Our home health aides and in-home caregiving team helps families learn proper repositioning technique.
  • Physical therapy: Gentle movement and physical support reduce pain caused by immobility and muscle tension. See how our team approaches this in The Role of Physical Therapy in Hospice Care.
  • Relaxation and distraction: Breathing techniques, music, and calming touch can reduce the perception of pain- particularly for anxiety-linked breakthrough episodes.
  • Massage and complementary therapies: Part of Journey’s individualized approach to pain management when clinically appropriate.

How Journey Palliative and Hospice Manages Breakthrough Pain in Burbank and Los Angeles County

Pain management in hospice is never one-size-fits-all. Journey Palliative and Hospice serves patients across Burbank, Los Angeles County, and surrounding communities with a multi-disciplinary team that includes registered nurses, a hospice physician, social workers, chaplains, and home health aides- all coordinating around a single goal: keeping your loved one comfortable.

Every patient receives a personalized plan that accounts for their diagnosis, comorbidities, current medications, and preferences. That plan is reviewed continuously, adjusted as symptoms evolve, and communicated clearly to family caregivers so no one feels unprepared.

Families who are unsure whether their loved one is ready for hospice- or who are weighing the decision between hospice and continuing treatment- can review our recent post, Hospice vs. Continuing Treatment: How Families Decide.

Frequently Asked Questions

  • How often can a rescue dose be given?
    • Rescue doses are typically prescribed with a minimum interval between doses- often every one to four hours as needed. If breakthrough pain is occurring more than three to four times per day, that is a signal that the patient’s scheduled medication needs to be adjusted. Frequent use of rescue doses should always be reported to the hospice nurse.
  • What should I do if the rescue dose doesn’t work?
    • If pain has not improved 30 to 60 minutes after giving a rescue dose, call your hospice on-call nurse. A single failed dose may indicate the dose needs adjustment, a different route of administration, or that the pain has a different cause than expected. Do not give a second dose without guidance unless specifically instructed by the care team to do so.
  • Does using rescue doses mean my loved one is close to death?
    • Not necessarily. Breakthrough pain can occur at any stage of a serious illness. Using rescue medication as prescribed is a sign that the care plan is being followed, not that death is imminent. If you have concerns about the progression of your loved one’s condition, speak openly with your hospice nurse.
  • Are rescue doses covered by Medicare?
    • Yes. Under the Medicare Hospice Benefit, all medications related to the terminal diagnosis- including rescue dose medications- are covered. This includes the drug itself and delivery to the home. Journey Palliative and Hospice works directly with Medicare to ensure families experience no out-of-pocket surprise for covered medications.

Your Team is Here for You

Breakthrough pain is one of the most stressful situations a family caregiver can face. The difference between feeling prepared and feeling panicked in that moment is education, a written plan, and a care team you can actually reach.

Journey Palliative and Hospice serves families across Burbank and Los Angeles County with around-the-clock nursing support, home delivery of medications, and hands-on caregiver education before you ever need it.

Call us today at (818) 748-3427 or request care online to speak with our team.

What Is Hospice Recertification and Why Does It Happen?

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Hospice recertification is the routine process where a hospice physician confirms a patient still meets Medicare’s eligibility criteria for hospice care. It happens at set intervals, the first two 90-day periods, then every 60 days after, and it does not necessarily mean a patient’s condition is worsening. It simply ensures continued coverage and keeps the care plan aligned with the patient’s current needs.

Why “Recertification” Can Sound Alarming

If you’ve recently heard the word “recertification” from your loved one’s hospice team, it’s natural for your mind to jump to the worst-case interpretation. For many families, hospice already feels like unfamiliar territory, full of new terms, new routines, and new people in the home. Adding a word like “recertification” into the mix can make it feel like something has shifted, or that a decision is being made about your loved one’s future without your input.

Take a breath. In almost every case, recertification is simply part of how hospice care is structured under Medicare. It’s a built-in checkpoint that happens for every hospice patient, on a predictable schedule, regardless of whether their condition has changed.

Understanding what’s actually happening behind this term can take a lot of the anxiety out of the process and help you feel more confident asking questions when your care team brings it up.

How the Hospice Benefit Is Structured

To understand recertification, it helps to understand how Medicare organizes hospice care into what are called “benefit periods.” These are blocks of time during which hospice services are authorized:

  • The first benefit period lasts 90 days
  • The second benefit period also lasts 90 days
  • Every benefit period after that lasts 60 days, and there is no limit to how many a patient can have, as long as they continue to qualify

At the start of each new period, before hospice services can continue, a hospice physician or medical director must certify in writing that the patient still has a life expectancy of six months or less, assuming the illness follows its typical course. This is the “recertification.”

Beginning with the third benefit period, Medicare requires something additional: a face-to-face encounter. This means a hospice physician or nurse practitioner must visit the patient in person before recertifying them, to personally assess their condition and confirm that hospice remains appropriate.

This structure isn’t unique to any one hospice provider. It’s a Medicare requirement that applies across the country, which means every hospice patient on Medicare goes through this same rhythm of certification and recertification.

Learn More About What to Expect When Starting Hospice

Why Recertification Exists in the First Place

It’s worth asking: why does Medicare require this at all? A few reasons sit behind the policy, and most of them are actually protective for patients and families.

  • It keeps the care plan honest and current. Hospice is meant for patients with a limited life expectancy, but the course of an illness isn’t always predictable. Some patients decline steadily. Others stabilize for weeks or months, sometimes due to the comfort and symptom management hospice provides. Recertification gives the medical team a structured opportunity to step back, look at the full picture, and confirm that hospice is still the right fit, or to flag if something has changed.
  • It protects the integrity of the Medicare hospice benefit. Because hospice is a Medicare-funded benefit with specific eligibility criteria, the program includes checks to ensure that care continues to be medically appropriate. This isn’t about distrust of families or patients. It’s a system-wide safeguard built into how the benefit is designed.
  • It creates a natural moment for reassessment. Even outside of insurance requirements, regular reassessment is good clinical practice. Recertification visits give the hospice physician a reason to revisit symptom control, medication needs, equipment, and the goals of care, making sure everything still reflects what the patient and family want and need.
  • It supports continuity, not interruption. Perhaps most importantly for families: recertification, when completed properly, means hospice services continue without a gap. Medications keep arriving. Nursing visits continue. Equipment stays in place. The administrative process happens quietly so that the day-to-day care your loved one relies on doesn’t skip a beat.

What Families Can Expect During the Recertification Process

For most families, recertification happens largely behind the scenes. Your hospice team handles the documentation, scheduling, and physician sign-off as a normal part of ongoing care. Still, it helps to know what might show up on your radar:

  1. A scheduled visit from a hospice physician or nurse practitioner. Starting with the third benefit period, this face-to-face visit is required. The visit itself is usually calm and conversational; the clinician is checking in on comfort, symptoms, and overall condition, not conducting an exam that feels invasive or alarming.
  2. A conversation about how things have been going. Your hospice team may ask you and your loved one questions about recent changes, whether symptoms feel well-managed, and whether anything new has come up since the last review.
  3. Continuity of services. As long as the patient continues to meet eligibility criteria, recertification simply renews the benefit period. There’s no action required from families in most cases, no paperwork to sign, no gap in care to plan around.
  4. Possible adjustments to the care plan. Sometimes recertification visits surface small changes worth addressing, perhaps a new medication, an additional piece of equipment, or a referral to a service like physical therapy or specialized pain management. These adjustments are part of hospice doing its job well.

What If a Patient No Longer Meets Eligibility?

Occasionally, a patient’s condition improves enough that they no longer meet the criteria for hospice, often because their disease has stabilized longer than expected. When this happens, the hospice physician will not recertify the patient for the next benefit period.

This isn’t a punishment, and it isn’t a sign that something went wrong. If anything, it reflects a positive change in the patient’s condition. In these situations, the hospice team will talk openly with the family about what it means, what other services or care settings might be appropriate, and how to make the transition as smooth as possible. Patients can also be re-admitted to hospice later if their condition changes again and they once again meet the criteria.

What This Means for Your Family

At its core, recertification is one of the quiet mechanisms that keep hospice care running smoothly and responsibly. It exists to make sure that:

  • Care remains medically appropriate
  • Coverage continues without interruption
  • The care plan reflects the patient’s current condition
  • Families have a built-in checkpoint for questions and conversations with the care team

If your loved one is approaching a recertification period, you don’t need to prepare anything special. The best thing you can do is use it as a natural opportunity to ask your hospice team any questions you’ve been holding onto, about symptoms, about what to expect next, or about how the plan of care might evolve.

Related Reading

We’re Here for Your Loved One’s Care

Recertification is just one part of a much bigger picture: your loved one’s comfort, dignity, and quality of life. If you have questions about where things stand in their care plan, our team is happy to walk through it with you, plainly and at your pace.

Contact Journey Palliative and Hospice or call (818) 748-3427.

See What Our Clients Are Saying About Us!

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Journey Palliative and Hospice5.0
Based on 21 reviews
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Serine K.
2 months ago
Our family is deeply grateful for the exceptional care and compassion provided by Journey Palliative hospice team during my father-in-law’s final days. From the very beginning, they were always there for us 24/7 responding quickly to every request and ensuring that all of his needs were met with professionalism and kindness. A special thank you to Ovsanna, RN whose knowledge, expertise, and dedication to patient care were truly remarkable. She handled every situation with confidence, compassion, and professionalism, providing guidance and reassurance to our family during an incredibly difficult time. The continuous care provided by the experienced and professional nursing staff was an enormous source of comfort and support. Knowing that skilled and caring nurses were by his side gave us peace of mind and allowed us to focus on spending precious time with our loved one. Throughout this journey, the entire hospice team showed genuine understanding, empathy, and respect. They treated our father-in-law with dignity and cared for our family as if we were their own. Their support made an immeasurable difference during one of the most challenging times of our lives. We cannot thank them enough for their outstanding service, compassion, and unwavering commitment to providing exceptional end-of-life care. We highly recommend Journey Palliative and Hospice services to any family in need of professional, caring, and trustworthy support and will definitely consider working with them in the future if any of our family member may need hospice services and care.
Zahira I.
6 months ago
We are incredibly grateful for the hospice team and the care they provided during such a difficult time. Everyone was kind, informative, and truly supportive every step of the way. They truly made the process feel less overwhelming. We also deeply appreciate the delivery drivers who would come late at night to make sure we had the medications we needed, their dedication truly meant so much to us. We couldn’t have asked for better care and are so thankful for everything they did for us.
Adrine K.
7 months ago
We are deeply grateful for the compassionate care and support this hospice team provided to my late father. During an incredibly difficult time for our family, they treated him with dignity, kindness, and genuine respect. Nurse Ovsanna, in particular, made an extraordinary difference through her gentle presence, unwavering compassion, and genuine dedication. She cared for my father as if he were her own, offering comfort, reassurance, and heartfelt kindness when we needed it most. The staff was attentive, patient, and always available to answer questions or offer comfort—not only to my father, but to our entire family. Their guidance helped ease our worries and allowed us to focus on spending meaningful time together. We will never forget the warmth, professionalism, and empathy they showed, and we truly appreciate everything they did for our father in his final days.
Martiros S.
7 months ago
Journey Palliative and Hospice came into our lives during one of the hardest seasons we have ever faced, and they truly felt like a blessing. From the moment they began caring for my mother, it was clear that she was in loving, compassionate hands. She was in their care for quite some time, and throughout that journey, the entire hospice team showed extraordinary kindness—not only to my mother, but to our whole family. My mother was treated with unwavering dignity, respect, and genuine love. Every interaction reflected how deeply they cared for her comfort, her peace, and her humanity. They tended to her physical needs with professionalism and urgency, while also surrounding our family with emotional support, patience, and understanding. They listened to us, reassured us, and walked beside us through every painful step. During a time filled with uncertainty and heartache, their compassion and empathy brought us comfort and strength. The difference they made in our lives is immeasurable, and we will always be grateful for the care they gave my mother and the kindness they showed our family. We wholeheartedly recommend Journey Palliative and Hospice to any family seeking truly compassionate, patient-centered end-of-life care.
Sharon
8 months ago
I really cannot imagine how I would have gotten through the last chapter of my mother's live as her 24/7 caretaker without the kind wisdom, and steadying...
Sharon
8 months ago
I really cannot imagine how I would have gotten through the last chapter of my mother's live as her 24/7 caretaker without the kind wisdom, and steadying...
Rosio A.
10 months ago
I am so very grateful to Journey Palliative and Hospice care for the amazing care they gave my sister. They came to our home and provided everything she...
Rosio A.
10 months ago
I am so very grateful to Journey Palliative and Hospice care for the amazing care they gave my sister. They came to our home and provided everything she...
chris M.
2 years ago
I had an amazing tour and discussion about the features and services at Journey Palliative Hospice. I found thier staff to be very attentive and caring to the patients while I was there
Pam R.
2 years ago
My Mom was under their care for a month. They are the most kind caring people. They knew just what to do at all stages. It was a very difficult time but they help me get through it every moment. Thank you so much .