Can I Change Hospice Providers Midway? Your Rights Explained
Yes, you can change hospice providers midway through care. Patients and their families have the right to switch providers if they are dissatisfied with the care being provided or if they find a provider better suited to their needs. This article explains your rights as a hospice patient, the process for switching providers, and key considerations to ensure a smooth transition.
Hospice patients are entitled to specific rights under federal law, as outlined in the Medicare Conditions of Participation. These include the right to be treated with dignity and to receive quality end-of-life care. Patients have the right to be involved in creating and updating their care plans and are also free to choose both their hospice provider and their attending physician. Importantly, patients can express concerns or complaints without fear of retaliation, and they are guaranteed access to appropriate pain and symptom management. These protections empower patients and families to advocate for better care when their current provider is not meeting expectations.
There are many reasons why someone may decide to change hospice providers. A common issue is dissatisfaction with care, such as missed visits, poor communication, or insufficient symptom management. Other times, the hospice’s style or philosophy may not align with the patient’s personal, spiritual, or cultural preferences. Geographic relocation is another factor—moving to a new city or state often necessitates finding a provider closer to the patient. In some cases, a patient may require services that the current hospice does not offer, prompting the need to find a provider with specific expertise or resources.
The process of switching hospice providers is straightforward but must follow Medicare regulations. The first step is to inform both the current and new hospice providers. This ensures both agencies can begin the coordination process. Medicare also requires a signed statement from the patient or their representative, which includes the name of the current hospice, the name of the new hospice, and the effective date of the transfer. After this, the current hospice is responsible for transferring all necessary medical records and clinical documentation to the new provider. If the patient is in their third or a subsequent benefit period, Medicare requires a face-to-face encounter before continued coverage—if one has not been done, the new hospice will need to perform it.
The new hospice provider will then file a new Notice of Election with Medicare. Importantly, this does not reset your benefit period timeline—it is a continuation of your current hospice benefit.
Under Medicare guidelines, patients are allowed to switch hospice providers once during each election period. The benefit period includes two 90-day periods followed by an unlimited number of 60-day periods. Switching providers during an election period is considered a transfer, not a revocation, and does not impact eligibility or existing benefits.
To avoid any disruption in care, patients and families should carefully plan the timing of the transfer. Both hospices should work together to ensure there is no gap in services, medications, or equipment. For a seamless experience, patients should consider initiating the transfer only after securing a new provider and confirming all logistics.
Before committing to a new provider, it’s important to do your homework. Research potential hospices using Medicare’s Care Compare tool, and review each agency’s services, staffing, and patient satisfaction scores. Ask about their availability, how often visits occur, and what support is available after hours. Also confirm that the new provider accepts your insurance or Medicare coverage without added out-of-pocket costs.
Once the transfer is finalized, the new hospice provider assumes full responsibility for care. This includes coordinating medications, managing durable medical equipment, and delivering all necessary physical, emotional, and spiritual support. Patients continue to receive care under the same federal protections as before.
That said, switching hospice providers is not always necessary. In many cases, concerns can be resolved without transferring care. It is often helpful to discuss your concerns directly with the hospice nurse, social worker, or administrator. If issues remain unresolved, filing a formal complaint can trigger a review and potential improvements in care. Open communication is often the best first step before making a decision to transfer.
In conclusion, patients and families have the legal right to change hospice providers during care. If your current provider is not meeting expectations or no longer fits your needs, a switch may be appropriate. By understanding your rights, following the Medicare transfer process, and thoroughly evaluating new providers, you can ensure that hospice care continues without interruption and meets the standards your loved one deserves. Always prioritize open dialogue and informed decision-making when navigating this transition.
