How to File a Complaint About a Hospice

To file a complaint about a hospice, start with the hospice's own grievance line, then, if it is not resolved, escalate to your state survey agency, Medicare's Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), or 1-800-MEDICARE. You have the right to complain without retaliation, and serious concerns like neglect, abuse, or fraud should be reported right away.

Step 1: Raise it with the hospice first

Every Medicare-certified hospice must have a grievance process and must give you the contact information at admission. Call the agency's designated complaint or patient-advocate line, describe the problem clearly (dates, names, what happened), and ask what they will do and by when. The hospice is required to investigate and respond. Keep a written log of each call. Your right to do this safely is covered in our guide on your rights as a hospice patient.

Step 2: Contact your state survey agency

If the hospice does not fix the problem, contact your state survey agency (often part of the state health department), which licenses and inspects hospices. They investigate complaints about care quality and safety and can cite a provider for deficiencies. You do not need the hospice's permission to call them.

Step 3: Use Medicare's quality oversight

For concerns about the quality of care a Medicare patient received, you can file with the BFCC-QIO, Medicare's contractor that reviews quality-of-care complaints and certain discharge disputes. You can also call 1-800-MEDICARE (1-800-633-4227) to lodge a complaint or get directed to the right office. Have the patient's Medicare number and the hospice's name ready.

Step 4: If accreditation is involved

If the hospice is accredited (for example by a national accrediting body), you can also file a complaint with the accreditor. Our guide on hospice accreditation explains how that oversight works.

Reporting suspected fraud or abuse

If you suspect Medicare fraud, such as billing for visits that never happened, enrolling patients who are not eligible, or pressure tactics, report it to the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) hotline or to 1-800-MEDICARE. Suspected abuse or neglect of a vulnerable adult should also be reported to Adult Protective Services or local authorities, and emergencies to 911. Our guides on hospice fraud warning signs and spotting a low-quality hospice describe what to watch for.

Issue	Where to file
Day-to-day care problems	Hospice grievance line first
Care quality / safety	State survey agency; BFCC-QIO; 1-800-MEDICARE
Accredited provider	The accrediting organization
Suspected fraud	HHS-OIG hotline; 1-800-MEDICARE
Abuse / emergency	Adult Protective Services; 911

Which channel fits which problem

Choosing the right channel speeds resolution. Use this decision guide:

• A missed visit, a rude staff member, a supply that didn't arrive: start with the hospice's grievance line. Most day-to-day problems are fixed fastest internally, and the agency is required to respond.
• The hospice didn't fix it, or the problem is about safety or clinical quality: escalate to the state survey agency and/or the BFCC-QIO. These bodies can investigate and cite deficiencies.
• You're being discharged and disagree with it (a live discharge dispute): the BFCC-QIO handles certain discharge appeals; call them promptly because timelines can be short. See live discharge explained.
• You suspect billing fraud or ineligible enrollment: report to the HHS-OIG hotline and 1-800-MEDICARE.
• You suspect abuse, neglect, or an immediate danger: contact Adult Protective Services, and call 911 for an emergency.

You can pursue more than one channel at once — for example, filing internally while also notifying the state agency.

What to document

• Dates, times, and names of staff involved.
• What was promised in the plan of care versus what happened.
• Copies of any letters, bills, or messages.
• Names of witnesses, including other family members.

What happens after you file, and your protection from retaliation

After an internal grievance, the hospice must investigate and respond within its policy's timeframe; ask for that timeframe in writing. When you file with a state survey agency or the BFCC-QIO, an investigator may interview you, review records, and in some cases conduct an on-site survey; substantiated problems can lead to a plan of correction or formal deficiencies. Outcomes are not always shared in detail because of privacy rules, but your report still drives oversight. Importantly, it is your right to complain without retaliation — a hospice cannot lawfully punish a patient or discharge them simply for raising concerns. If you fear retaliation, document everything and tell the state agency. You can also exercise a parallel right at any time: changing providers.

You can also switch providers

Filing a complaint and changing hospices are not mutually exclusive. You may change your designated hospice once per benefit period with no penalty; see how to switch hospice providers. A complaint helps protect future patients even if you move on.

Frequently asked questions

Will complaining get my loved one discharged or treated worse?

You have a right to complain without retaliation, and a hospice cannot lawfully discharge a patient for filing a grievance. If you experience retaliation, report it to your state survey agency immediately and keep written records.

Do I have to go through the hospice first before contacting Medicare or the state?

No. Starting with the hospice often resolves day-to-day issues fastest, but you can contact your state survey agency, the BFCC-QIO, or 1-800-MEDICARE at any time, especially for safety, quality, fraud, or abuse concerns.

What's the difference between the state survey agency and the BFCC-QIO?

The state survey agency licenses and inspects hospices and investigates care and safety complaints. The BFCC-QIO is Medicare's contractor that reviews quality-of-care complaints and certain discharge disputes for Medicare beneficiaries. You can use either or both.

How do I report suspected hospice fraud?

Report it to the HHS-OIG hotline or 1-800-MEDICARE. Examples include billing for visits that never occurred, enrolling patients who are not eligible, or high-pressure marketing. See hospice fraud warning signs.

Your practical next step

Write down the timeline and call the hospice's grievance line today; if you are not satisfied within a reasonable time, escalate to the state agency or 1-800-MEDICARE. If you are choosing a new provider, you can compare hospices near you on quality and family-survey scores.