What If I'm Unhappy With My Hospice?

If you are unhappy with your hospice, you have real options: raise concerns with the team, escalate formally, file a complaint, and, if needed, switch to a different hospice. You can change your designated hospice once per benefit period with no penalty and no gap in your Medicare coverage. You are never trapped.

Start by naming the problem to the team

Many issues, missed visits, slow callbacks, uncontrolled symptoms, poor communication, can be fixed once the right person hears them. Ask to speak with the patient care coordinator, the nurse case manager, or the agency's director of nursing. Be specific: what was supposed to happen, what actually happened, and what you need. Your plan of care can be revised, and a good agency will respond quickly.

Knowing your rights as a hospice patient gives these conversations weight. You are entitled to responsive symptom management, clear information, and respectful care.

Common complaints and what usually fixes them

It helps to match the problem to the right first move, because not every issue needs a formal escalation:

Problem	First step
Symptoms (pain, breathlessness) not controlled	Call the on-call line now; request a plan-of-care review and a nurse visit
Missed or late visits	Ask the nurse case manager for a written visit schedule and accountability
Slow after-hours callbacks	Ask the director of nursing about on-call staffing and expected response times
Aide is inconsistent or a poor fit	Request a specific aide or a replacement; this is a reasonable ask
Poor communication / feeling unheard	Request a care conference with the interdisciplinary team
Trust is broken or care is unsafe	File a complaint and begin researching a switch in parallel

Request a care conference

One of the most underused tools is the care conference — a sit-down (in person or by phone) with the nurse, social worker, and often the hospice physician to review what is and isn't working. You can ask for one at any time. Come with a written list of specific incidents (dates, names, what happened) and a clear statement of what you need to change. A care conference often resolves communication and scheduling problems faster than informal calls, because it puts the whole team and the plan of care on the table at once. If symptoms are the issue, this is also where medication and visit frequency get adjusted.

If talking does not fix it

When direct conversation does not resolve the problem, you can escalate beyond the agency:

• File a formal complaint with your state hospice licensing or survey agency, and with Medicare. Our guide on how to file a complaint about a hospice lists where to turn.
• Contact the accrediting body if the hospice is accredited, and your state's Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for quality-of-care concerns.
• Switch providers. If trust is broken, you can change hospices.

Switching hospices, the right way

Medicare lets you change your designated hospice once in each benefit period without penalty. Switching is not a discharge from the benefit and does not restart your prognosis clock; it simply moves your care to a new agency. There should be no gap in coverage if the transition is coordinated. Read how to switch hospice providers and whether you can fire your hospice for the step-by-step.

Decision guide: escalate, complain, or switch?

• Is this a one-off that the team can fix? Start with the case manager or a care conference; give them a specific deadline.
• Is it a recurring pattern despite asking? Escalate to the director of nursing in writing, and file a complaint with the state agency and Medicare so there's a record.
• Is care unsafe, or is trust gone? File the complaint AND begin researching alternatives immediately, so a switch can happen without a coverage gap.
• Is the issue a single rude staff member, not the whole agency? Request a different team member before assuming you must leave the provider entirely.

What to document before you escalate

Whether you stay and push for change or move to a new provider, a written record makes you far more effective. Keep a simple log with the date and time of each problem, who you spoke with, what was promised, and what actually happened. Note missed or late visits, how long after-hours callbacks took, and any periods of uncontrolled symptoms. This log does two things: it turns a vague “the care isn't good” into specific, answerable items the agency's leadership must address, and it becomes the backbone of any formal complaint to the state, Medicare, or an accreditor. Families who arrive at a care conference with dates and names almost always get a faster, more concrete response than those who describe a general feeling of dissatisfaction. Keep copies of the plan of care and any written visit schedules alongside the log.

How a coordinated switch actually works

If you decide to change providers, the transition is meant to be seamless. You (or the patient's representative) sign a statement changing the designated hospice; the new hospice handles certification and starts care, and the prognosis clock does not reset. The two agencies coordinate so medications, equipment, and the plan of care carry over without a gap. Because the change uses your once-per-benefit-period right, time the switch thoughtfully — but never delay so long that your loved one suffers. Researching a backup provider before you formally switch means the new team can start almost immediately once you decide.

The misconception, corrected

Families often believe that once they sign on, they are stuck, or that complaining will get their loved one discharged or labeled "difficult." Neither is true. Choosing hospice does not waive your rights, and you cannot be punished for advocating for good care. Switching is a built-in protection, not a loophole, and the freedom to leave is part of what keeps providers accountable.

Frequently asked questions

Will switching hospices interrupt my loved one's coverage?

It shouldn't. A switch within a benefit period is not a discharge from the Medicare hospice benefit and doesn't restart the prognosis clock. As long as the change is coordinated between the old and new agencies, coverage continues without a gap.

Can the hospice discharge us for complaining?

No. Advocating for good care is your right, and complaints are not grounds for discharge. Discharge happens for defined reasons — such as the patient no longer being eligible, moving out of the service area, or a documented safety situation — not for raising concerns.

How many times can I switch?

You may change your designated hospice once per benefit period without penalty. Benefit periods are two initial 90-day periods followed by unlimited 60-day periods, so over a longer stay there are multiple opportunities to switch if needed.

Who do I complain to outside the agency?

Your state hospice licensing/survey agency, Medicare, the accrediting body if the hospice is accredited, and your state's BFCC-QIO for quality-of-care concerns. See how to file a complaint about a hospice for specifics.

What if symptoms are out of control right now?

Treat it as urgent: call the hospice on-call line immediately and ask for a nurse visit and a medication review. Uncontrolled pain or breathlessness is exactly what the 24/7 line exists for, and persistent failure to respond is itself a reportable quality concern.

Your practical next step

Write down the specific problems with dates and names, then request a meeting with the agency's nursing leadership and state clearly what you need fixed and by when. If the response is inadequate, begin researching alternatives right away so a switch can happen smoothly. Use family-survey scores and quality measures to vet candidates, and compare hospices near you before you move. Acting early, while you still have options, protects your loved one's comfort.