While HFA does not monitor or regulate providers, below are options for patients and families who are dissatisfied with the quality of their hospice care.
- Most hospice providers in the United States are regulated by the Centers for Medicare and Medicaid Services (CMS), a federal agency that offers resources to address complaints about the quality of medical care, including hospice care.
- Most hospice patients are enrolled in Medicare or Medicaid, giving them certain rights and protections.
- State health departments also have oversight over hospice providers and processes for addressing complaints about the quality of care.
Start with your provider
If you are unhappy with the quality of hospice care you or your loved one is receiving, try to resolve the issue directly with your provider. CMS suggests talking with hospice staff, management, or administrators about your concerns.
If you are unable to resolve the complaint directly, see Options 1 and 2 in the CMS chart below.
Transfer to a new provider
If you are dissatisfied with your current hospice provider, you may transfer care to another local agency. Under the Medicare benefit, this is allowed once during the patient’s initial 60-day certification period, or once during the 60-day benefit periods that follow.
To transfer care to a new provider:
- Talk with the new hospice agency to confirm that it will care for the patient and accept the patient’s insurance.
- Formally notify your current hospice provider that you are going to transfer care to another hospice agency.
- Obtain paperwork that documents the transfer. It must specify the current provider, the date the new provider will begin care, and the transfer date. Both hospice organizations will be familiar with the paperwork required.
- Exchange durable medical equipment. It is unlikely that you will be able to keep medical equipment in place when changing hospice providers. The new provider will probably replace the hospital bed, oxygen compressor, bedside commode, and other equipment. The two hospice agencies will work together to make this transition as smooth as possible.
Learn more about filing a complaint
These resources from CMS will help you determine whether you should file a complaint and provide guidance on how and where to file.
- Learn about Immediate Advocacy and how it helps people with Medicare.
- Determine whether you should file a complaint and how to get started.
- Watch a video about how to report a complaint to your state Health Department or a CMS healthcare oversight organization.
- See a list of state survey agencies where you can file a complaint about hospice care.
- Review your rights and protections under Medicare.
