Moving a Loved One Into Hospice From the Hospital

To move a loved one from the hospital onto hospice, ask the unit for the discharge planner or case manager, choose any Medicare-certified hospice (not just one the hospital suggests), sign the hospice election, and arrange transport to home or a facility. With coordination, this transition can often happen the same day or the next, so symptom-focused comfort care begins quickly.

Step 1: Start the conversation early

If hospital treatment is no longer helping or your loved one wants to stop aggressive care, raise hospice with the medical team. Ask the doctor a direct question such as, "Is it time to focus on comfort?" The hospital's case manager / discharge planner coordinates the logistics, but the choice of hospice is yours.

Step 2: Choose your hospice, not just the default

Hospitals often have hospices they routinely refer to, but you have the right to pick any Medicare-certified hospice that serves your area. It is worth a few minutes to compare hospices near you on quality and family-survey scores before you decide, even under time pressure. You can also change your designated hospice later, once per benefit period, with no penalty.

Step 3: The hospice evaluates and admits

The hospice sends a nurse to assess your loved one, often right in the hospital room. The hospice physician (with the attending physician) certifies the terminal prognosis, which is a clinical judgment of six months or less if the illness runs its normal course, not a family checklist. You then sign the election statement and consent forms. Gather the items in our guide on documents you need to start hospice to speed this up.

Step 4: Decide where care will happen

• Home: most common. The hospice arranges a hospital bed, oxygen, and other equipment, often delivered the same day, plus comfort medications.
• Nursing home or assisted living: hospice can follow your loved one there; note that the hospice benefit does not cover the facility room and board under Routine Home Care.
• Inpatient hospice unit: if symptoms are severe, a short General Inpatient stay may be appropriate until they stabilize.

Step 5: Arrange transport

The case manager helps schedule transport home or to a facility. Confirm who pays; routine non-emergency transport home is not always covered, so ask in advance. The hospice should have equipment and medications in place before or at the time your loved one arrives.

Step 6: Prepare the home before arrival

If care will happen at home, a little preparation makes the first night far smoother. Clear a path for a hospital bed and any equipment, decide which room will become the care space (often a main-floor room near a bathroom), and make sure there is a working phone with the hospice's 24/7 number saved. The hospice typically delivers a bed, oxygen if needed, and a small kit of comfort medications — sometimes called a "comfort pack" or "emergency kit" — to keep on hand for symptoms that arise after hours. Ask the team how to store and use it, and who to call before using anything. Knowing the equipment and medicines are in place before your loved one arrives prevents the common scramble of a discharge that outruns the supplies.

Can it happen the same day?

Often, yes. Hospices are set up for rapid admissions, and many can complete an evaluation and admission within hours when a patient is ready to leave the hospital. Our guide on same-day hospice admission explains what makes a quick transition possible and what can slow it down (waiting on equipment, transport, or certification).

What can speed up or slow down the transfer

Speeds it up	Slows it down
You've already chosen a hospice	Still comparing providers at discharge
Documents and ID gathered in advance	Missing paperwork or decision-maker unavailable
Home is ready for a bed and equipment	Equipment or transport not yet arranged
Decision-maker present to sign	Family disagreement about the plan
Hospice already serves the facility	Certification still being completed

What to confirm before you leave the hospital

• The 24/7 hospice on-call number, and that you call hospice, not 911, in a crisis at home.
• That comfort medications and equipment will arrive in time.
• Who the first hospice contact will be after discharge.
• A clear medication plan, so hospital and home orders do not conflict.

The misconception to correct

Two assumptions trip families up at discharge. The first is that you must use whichever hospice the hospital names; you do not — the choice is yours, and you can compare options even under time pressure, and switch later if needed. The second is that calling 911 is the right move if a crisis happens once your loved one is home on hospice. It is not. At home on hospice, you call the hospice's 24/7 line, not 911, because the hospice team manages crises and a 911 call can trigger interventions that conflict with the comfort-care plan. Make sure everyone in the household knows this before discharge.

How the bills change after you elect hospice

Electing the Medicare Hospice Benefit shifts how care for the terminal illness is paid. From the election date forward, the hospice covers team visits, comfort medications, and equipment for the terminal diagnosis, with no deductible and only two small cost-shares: a drug copay of up to $5 per prescription and a 5% coinsurance of the Medicare-approved amount for any inpatient respite stay. What hospice does not pay is room and board under Routine Home Care — so if your loved one is going to a nursing home or assisted living, that residence bill continues as before. One detail that surprises families: if the patient was in a Medicare-covered skilled hospital or nursing stay, electing hospice for that same condition generally ends the skilled benefit, so ask the case manager to walk through the cost picture before signing. Care unrelated to the terminal illness can still be billed to regular Medicare separately.

Frequently asked questions

Do I have to use the hospice the hospital recommends?

No. You may choose any Medicare-certified hospice that serves your area. Hospitals often have a default referral, but the decision is yours, and you can take a few minutes to compare quality and family-survey scores first.

Who pays for the ride home?

It varies. Routine non-emergency transport home is not always covered, so confirm with the case manager who pays before discharge day. The hospice itself covers care, medications, and equipment for the terminal illness, but the transport home is a separate question worth settling in advance.

What if my loved one needs intense symptom control on arrival?

If symptoms are severe, the team can begin at a higher level of care — a short General Inpatient (GIP) stay — until things stabilize, then step down to home care. Discuss this with the hospice during the evaluation so the right setting is arranged from the start.

Can the hospice admit my loved one over a weekend or holiday?

Yes. Hospices admit seven days a week and run a 24/7 clinical line. A weekend or holiday discharge can still proceed, though confirming equipment and transport ahead of time helps avoid delays.

What documents do we need ready?

Have the patient's ID and insurance/Medicare information, any advance directive or POLST, the medication list, and the contact details for the healthcare decision-maker. Our guide on documents you need to start hospice covers the full list.

What happens next

Once home, the hospice completes its initial assessments and finalizes the plan of care. Our guides on day-one intake and how to enroll a loved one in hospice cover what to expect.

What to do next

Ask to speak with the hospital case manager today, name the hospice you have chosen, and request that the hospice evaluate your loved one before discharge so care continues without a gap. Confirm the 24/7 number, the equipment delivery, and the transport plan before you leave — those three details prevent most first-day problems.