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.

Who to call: the short list

• The hospice itself: ask for the administrator or the person who handles grievances.
• Your state survey agency (care quality, safety, neglect): CMS publishes every state's complaint number on its State Survey Agency contact page.
• Your BFCC-QIO (Medicare quality-of-care complaints and fast appeals of a hospice discharge): which organization covers you depends on your state; 1-800-MEDICARE can connect you.
• 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048): to complain, report suspected fraud, or be routed to the right office.
• HHS Office of Inspector General (fraud): oig.hhs.gov/fraud/report-fraud or 1-800-HHS-TIPS (1-800-447-8477).
• Adult Protective Services or 911 (abuse, neglect, or immediate danger).

Step 1: Raise it with the hospice first

Federal rules for Medicare-certified hospices give the patient the right to voice grievances about care that is, or fails to be, provided, and the right not to face discrimination or reprisal for doing so (42 CFR 418.52). The hospice must give you spoken and written notice of these rights at the initial assessment visit, before care starts; check that packet for the complaint contact. Call that contact, describe the problem clearly (dates, names, what happened), and ask what they will do and by when. If the complaint is about mistreatment, neglect, abuse, injuries of unknown source, or misappropriation of the patient’s property by anyone providing services for the hospice, the hospice must investigate immediately and act to prevent further problems while it does. 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. Find your state's number on the CMS contact list or by calling 1-800-MEDICARE. Hospices themselves must report verified abuse, neglect, or mistreatment to the state survey agency within 5 working days of learning of it.

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 hospice discharge appeals. Medicare points families here especially if they are uncomfortable raising the issue with the hospice or unhappy with how it responded. 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, you can also file a complaint with the accreditor. The accrediting organizations CMS approves for hospices are the Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Partner (CHAP), and The Joint Commission; ask the hospice which one, if any, accredits it. 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, online at oig.hhs.gov/fraud/report-fraud or by phone at 1-800-HHS-TIPS (1-800-447-8477), 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
Disagree with a hospice discharge	BFCC-QIO fast appeal (deadline: noon the day before services end)
Hospice care in a nursing home or assisted living	Also the Long-Term Care Ombudsman
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): ask for a fast appeal by the BFCC-QIO before the deadline on your Notice of Medicare Non-Coverage (details below). 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.

If the hospice is discharging you and you disagree

A discharge is not a complaint you have to wait on; it has its own fast appeal. When a hospice ends Medicare-covered care because it believes the patient is no longer eligible, it must give you a written Notice of Medicare Non-Coverage at least 2 days before services end. If you did not get one, ask for it. To appeal, contact the BFCC-QIO listed on the notice no later than noon the day before the termination date on the notice; you can request it by phone or in writing. The hospice carries the burden of showing the discharge is correct, must give you a detailed written explanation the same day the QIO notifies it, and coverage continues until the date on the notice unless the QIO reverses the decision. The QIO must decide within 72 hours of your request. If the QIO agrees with the hospice, you won't pay for hospice services before the end date on the notice.

Hospice care in a nursing home or assisted living

If the patient lives in a nursing home, board and care home, or assisted living, the state's Long-Term Care Ombudsman program can also help. Ombudsmen investigate and work to resolve complaints made by or on behalf of residents, and can help sort out whether a problem lies with the hospice, the facility, or both.

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, ask the hospice in writing how it will investigate and when you will hear back. 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 — federal hospice rules protect patients from reprisal for exercising their rights, and Medicare allows a hospice to discharge a patient only for specific reasons (such as no longer being terminally ill, moving out of the service area, or for cause), not 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.

Who do I call to report a hospice?

For poor care, safety problems, or neglect, call your state survey agency (numbers on the CMS contact list) or your BFCC-QIO. 1-800-MEDICARE (1-800-633-4227) can take the complaint or route you. For fraud, use the HHS-OIG hotline, 1-800-HHS-TIPS. For abuse or immediate danger, call Adult Protective Services or 911.

How do I appeal a hospice discharge?

Call the BFCC-QIO named on your Notice of Medicare Non-Coverage by noon the day before the termination date on that notice. The QIO decides within 72 hours, and your coverage continues until the date on the notice while it reviews.

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.