Hospice Care Basics | Hospice in Arapahoe County CO

Revoking the Medicare Hospice Benefit: What You Need to Know

August 17, 2026 by Aspen Hospice Care

Choosing hospice care is not a one-way door. Patients and families have the right to revoke the Medicare hospice benefit at any point, for any reason, and to return to standard Medicare coverage. Revocation is different from discharge, and it does not permanently close the door on hospice care in the future. This article explains what revocation means, how the process works, and what happens to coverage before and after.

What Revocation Actually Means

Revoking hospice means the patient (or their representative) is choosing to end their current hospice election. Once revoked, the patient is no longer covered under the Medicare hospice benefit for the remainder of that election period, and coverage resumes for the standard Medicare benefits that were waived when hospice was originally elected, including curative treatment for the terminal illness.

The hospice must then file a notice of termination or revocation with its Medicare contractor within 5 calendar days of the effective date of revocation, unless a final claim has already been filed.

This is distinct from a hospice discharge, which is typically initiated by the hospice team, often because a patient no longer meets eligibility criteria, moves out of the service area, or transfers to another hospice. The patient or family initiates revocation. If you’re unsure which situation applies to your family’s circumstances, our FAQs page and team can walk you through the distinction.

Revocation Must Be in Writing

A verbal revocation of benefits is not acceptable under Medicare rules. The patient or their representative must submit a written statement to revoke hospice care, and that statement sets the effective date of revocation. An individual may not designate an effective date earlier than the date the revocation is actually made. This means coverage under hospice continues through the date the written revocation is signed, not retroactively.

Any days remaining in that election period at the time of revocation are forfeited. This is an important detail families sometimes miss: revoking does not “bank” unused hospice days for later use within the same election period. If hospice is elected again in the future, it begins under a new election period.

What Happens to Coverage After Revocation

Once a patient revokes their hospice election, Medicare coverage of all benefits that were waived at the time hospice was elected resumes under standard Medicare. That typically means coverage returns for things like hospitalization, procedures, or treatments aimed at curing or managing the terminal illness, rather than the comfort-focused approach used under hospice.

Families sometimes revoke because a loved one wants to pursue a new treatment option. After all, circumstances at home have changed, or simply because they want a period of standard medical care before reconsidering hospice. Whatever the reason, the choice belongs to the patient and family. A hospice cannot revoke a patient’s election on their behalf, and cannot request or pressure a patient into revoking.

Can You Re-Elect Hospice Care Later?

Yes. An individual may, at any future time, elect to receive hospice coverage again for any other hospice election period for which they remain eligible. There is no permanent penalty for revoking hospice once.

CMS has also clarified timing rules that used to confuse. There is no waiting period for a beneficiary to re-elect the hospice benefit after revocation, and a new election period can begin immediately after re-election if the individual still meets eligibility requirements. Patients do not need to wait for all remaining days in a benefit period to lapse before re-electing. The one exception: a patient cannot immediately re-elect hospice with the same hospice organization on the same day they revoked, and a revocation and a new election cannot be processed for the same date.

In practical terms, this means a patient could revoke hospice on one day and, if still eligible, re-elect hospice care (with a different hospice, or the same hospice starting the next day) without an extended gap in comfort-focused support. If you’re weighing whether your loved one still meets the guidelines, that’s a conversation worth having with your care team before deciding.

Learn more: What are the hospice eligibility guidelines

Why Families Sometimes Consider Revocation

There’s no single reason families revoke hospice, and none of them require justification. Common situations include:

A new treatment or clinical trial becomes available that the family wants to pursue
A hospitalization for an unrelated condition changes the immediate care picture
The patient’s condition stabilizes or improves beyond what was expected
The family wants time to reconsider their approach to care

None of these situations close off hospice permanently. If circumstances change again, families can revisit starting hospice care and the levels of hospice care available, as long as eligibility requirements are still met.

Talk to Your Care Team Before Deciding

Revocation is a significant decision, and it’s worth talking through with your hospice team, your loved one’s physician, and family before making it. Our social work and emotional support teams are available to help families think through what revocation would mean for care, coverage, and next steps, not just the paperwork involved.

If you’re navigating this decision or have questions about how revocation would affect your loved one’s specific situation, our team is available to talk it through with you.

Have questions about revoking or re-electing the Medicare hospice benefit? Talk to our team online or call us at (720) 999-9854.

Shortness of Breath and Oxygen: Gentle Tips for Breathing Easier at Home

August 3, 2026 by Aspen Hospice Care

Shortness of breath, also called dyspnea, is one of the most common symptoms hospice patients experience, and it can feel frightening for both the patient and the family watching it happen. It can often be eased through positioning, airflow, oxygen therapy, pacing, and calm reassurance, and the hospice team manages it as part of routine care under the Medicare Hospice Benefit. If breathing changes suddenly or comfort measures don’t seem to help, that’s a call to the hospice team, not something to manage alone.

Why Breathing Changes Happen in Hospice Care

Watching someone you love struggle to catch their breath in hospice care is one of the hardest parts of caregiving. It’s natural to feel helpless in that moment, or unsure whether what you’re seeing is an emergency or simply part of how the illness is progressing.

Shortness of breath, known clinically as dyspnea, can happen for several reasons as an illness advances, including:

Reduced lung capacity or fluid buildup around the lungs
Weakness in the muscles used for breathing
Anxiety, which can tighten the chest and make breathing feel harder
Underlying heart, lung, or other chronic conditions
Changes in activity tolerance as the body conserves energy

It’s important to understand that dyspnea is a subjective experience. Two patients with similar oxygen levels can describe very different sensations of breathlessness, and a patient’s own report of how they feel is one of the most reliable signs your care team uses to guide treatment. That’s part of why open, honest communication with your hospice team matters so much.

The reassuring part is that shortness of breath is one of the most manageable hospice symptoms. Your hospice team, including your registered nurse, assesses breathing changes at every visit and adjusts the care plan so your loved one stays as comfortable as possible, day by day.

Gentle Ways to Help at Home

Between hospice visits, there’s a lot families can do to ease breathlessness in the moment. These are simple, low-risk adjustments, and none of them replace your care team’s guidance. Think of them as tools you can reach for while waiting to hear back from your nurse, or as everyday comfort habits that make breathing feel a little less effortful.

Adjust positioning. Sitting upright or reclining at an angle, rather than lying flat, gives the lungs more room to expand and can reduce the sensation of breathlessness almost immediately. Extra pillows behind the back, under the arms, or supporting the head can help maintain a comfortable upright position for longer stretches, including overnight.
Bring in moving air. A small fan pointed gently toward the face, or an open window on a mild day, can meaningfully ease the sensation of breathlessness, even without changing actual oxygen levels. Airflow across the face stimulates nerve receptors that reduce the brain’s perception of “air hunger.” It’s one of the simplest and most underused comfort measures available.
Slow the pace. Rushing through transfers, meals, bathing, or conversation can worsen breathlessness because it asks the body to do more work than it can comfortably manage. Building in rest breaks between tasks, speaking in shorter sentences, and allowing extra time for movement all reduce the physical effort behind daily activities.
Keep the room cool and uncluttered. Warm, stuffy, or crowded rooms make breathing feel harder and can heighten anxiety. A cooler space, good ventilation, and limiting the number of people at the bedside during difficult moments can ease both the physical effort of breathing and the emotional strain around it.
Watch for the anxiety connection. Breathlessness and anxiety often feed each other. Feeling short of breath can trigger anxiety, and anxiety can, in turn, make breathing feel more labored. Calm reassurance, a steady voice, dimmed lighting, and quiet company can help interrupt that cycle. If anxiety is a recurring issue for your loved one, our guide on calming anxiety and restlessness in hospice covers this connection in more depth.
Keep a simple symptom log. Jotting down when breathlessness happens, what seems to help, and how long episodes last gives your nurse valuable information at each visit. You don’t need anything formal; a note on your phone or a small notebook by the bedside works well.

How Oxygen Therapy Fits In

When breathing changes are related to low oxygen levels, your hospice team may recommend supplemental oxygen as part of the overall symptom management plan. Under the Medicare Hospice Benefit, oxygen concentrators and related durable medical equipment (DME) are delivered, set up, and maintained by the hospice team, and families are not billed separately for this equipment.

A few practical notes families often ask about:

Oxygen isn’t a cure-all. It helps most when low blood oxygen is contributing to the breathlessness. In many cases, positioning, airflow, and pacing provide just as much relief, which is why your team looks at the whole picture rather than reaching for oxygen automatically.
Tubing and cord safety matter. Oxygen tubing should be kept away from walkways, stairs, and areas where a patient or caregiver might trip. Our home safety and fall prevention guide has more tips on keeping the home safe as mobility changes.
Settings are managed by your care team. Flow rates and equipment settings should only be adjusted by your hospice nurse or care team based on assessment, never independently at home.
Equipment issues get fast attention. If a concentrator sounds different, stops working, or you’re unsure it’s functioning correctly, call your hospice team right away rather than troubleshooting alone.

When to Call the Hospice Team

Shortness of breath is expected and, in most cases, well managed through routine hospice care. Still, some changes call for a same-day check-in rather than a wait-and-see approach. Contact your hospice team promptly if you notice:

A sudden or significant change in breathing pattern
Breathing that seems distressing despite trying comfort measures
New confusion, restlessness, or agitation alongside breathing changes
Bluish tint to the lips or fingertips
Visible panic, gasping, or a patient who seems frightened by their own breathing

Hospice teams are reachable 24/7 for exactly these moments, and there’s no such thing as calling too often about a symptom that’s worrying you. As an illness progresses, your team may also recommend a temporary higher level of hospice care if breathing symptoms need more intensive, hands-on management for a period of time.

One Conversation Can Change How This Feels

Shortness of breath can be one of the more unsettling symptoms to witness as a caregiver, but it’s also one of the most responsive to good hospice care. With the right combination of positioning, airflow, pacing, and support from your care team, most patients find real, lasting relief, and families find real relief too, in knowing they’re not facing it without help.

If you’re noticing changes in your loved one’s breathing, or simply want to talk through what “normal” looks like at this stage, reach out to our hospice team. You don’t need a crisis to call.

Speak With Our Hospice Team or call (720) 999-9854.

Supporting the Heart: Emotional Care for Patients and Families

July 27, 2026 by Aspen Hospice Care

Hospice comfort plans are often described in physical terms: pain control, symptom management, medication adjustments. But comfort has an emotional dimension too, and it belongs to both the patient and the family around them. This post looks at what emotional care actually addresses in hospice, from a patient’s fear and need for meaning to a family’s need to stay connected, and how a hospice team builds that support into daily care rather than treating it as separate from medicine.

Emotional Care Is Part of the Comfort Plan, Not Separate From It

When people hear “comfort plan,” they usually picture medication schedules and symptom tracking. That’s accurate, but incomplete. Our post on how comfort plans are built and adjusted explains that a hospice comfort plan is designed to keep a patient physically, emotionally, and spiritually comfortable, not just pain-free. Emotional distress is treated with the same seriousness as physical symptoms, because unmanaged fear, anxiety, or unresolved grief can be just as disruptive to a patient’s quality of life as unmanaged pain.

What Emotional Care Looks Like for the Patient

A terminal diagnosis brings up questions that don’t have easy answers: fear of the dying process itself, worry about being a burden, unfinished conversations, and the desire to feel that a life mattered. Emotional care in hospice is built around meeting patients in that space, not rushing past it.

Presence over problem-solving. Much of what a hospice team offers isn’t a solution, it’s steady presence. Registered nurses and CNAs and aides build daily trust with patients through small, consistent care, and that trust becomes its own source of emotional steadiness.
Space for life review. Many patients want to talk through their lives, not to relive regret, but to make sense of what mattered. Social workers and chaplains are often the ones who create room for this, letting patients set the pace rather than steering the conversation.
Dignity as an emotional need, not just a value statement. Patients frequently worry about losing independence or becoming unrecognizable to themselves. A medical director overseeing a coordinated care plan helps ensure physical care decisions also protect a patient’s sense of self and control wherever possible.
Spiritual and existential support, on the patient’s terms. Spiritual care in hospice isn’t about pushing belief systems onto patients. It’s about being present for whatever questions of meaning, faith, or purpose a patient is sitting with, including patients who don’t identify with any particular tradition at all.

What Emotional Care Looks Like for the Family

Family members are living through their own emotional experience alongside the patient, often while also managing caregiving logistics, and that dual weight can be exhausting.

Anticipatory grief needs to be named, not just felt. Grieving someone who is still here is disorienting, and families often feel guilty about it. A hospice team that acknowledges this openly helps families stop wondering if what they’re feeling is normal.
Communication support when words are hard to find. Families frequently don’t know what to say to a dying loved one, or to each other. Social workers can help families navigate conversations they’ve been avoiding, from practical decisions to the things that matter most to say out loud.
Connection to each other, not just to the patient. Hospice support often becomes the space where strained family relationships get attention too, whether that’s a sibling dynamic or a spouse who’s been holding things together quietly for too long.
Ongoing support that doesn’t end abruptly. Bereavement care continues well past a patient’s death, because a family’s emotional needs don’t resolve on hospice’s timeline.

Why This Matters for Quality of Life

Emotional distress can worsen physical symptoms, and unmanaged physical symptoms can deepen emotional distress. The two are connected, which is why hospice teams don’t treat emotional care as a “soft” add-on to clinical work. A patient who feels heard, respected, and less afraid often experiences their remaining time differently, and a family that feels supported is better able to be present for the moments that matter most, rather than being consumed by logistics and fear.

This connection also shapes how care teams adjust plans over time. A patient whose anxiety spikes overnight, or a family member who seems withdrawn during visits, is information a hospice team pays attention to, not just a passing mood. Emotional shifts often signal that a comfort plan needs revisiting, the same way a change in pain level would. Treating emotional wellbeing as clinical data, not just a feeling to acknowledge, is part of what makes hospice care feel coordinated rather than fragmented.

Supporting the Whole Person, and the Whole Family

Hospice care works best when it treats the heart with the same attention as the body. If your family is navigating a hospice diagnosis and wondering what kind of emotional support is actually available, you don’t have to guess.

Learn more: Understanding Family Support

Your Next Steps

Aspen Grove Hospice serves families throughout Aurora, Denver, and the greater Front Range. To talk through what emotional and spiritual support could look like for your family, call us at (720) 999-9854 or contact our team and review our Four Levels of Care to understand how care adapts as needs change.

Anxiety, Restlessness, and Agitation in Hospice: Calming Strategies That Help

June 22, 2026 by Aspen Hospice Care

Anxiety, restlessness, and agitation are among the most distressing symptoms a hospice patient can experience – and among the most difficult for families to witness. These symptoms are common in the final weeks and days of life, but they are not something a family should have to manage alone or simply accept as unavoidable. With the right support, most patients can be made significantly more comfortable.

This guide explains what causes these symptoms, how they differ from one another, what caregivers can do at home, and how the hospice team responds when a more clinical approach is needed.

What Are Anxiety, Restlessness, and Agitation in Hospice?

These three terms are often used interchangeably, but they describe distinct experiences that may have different underlying causes and require different responses.

Anxiety is a state of internal distress, worry, or fear. A patient may express worry about dying, about leaving loved ones behind, about unfinished conversations, or about physical sensations they do not understand. Anxiety can be verbal – spoken concern, repetitive questioning, or physical, showing up as shallow breathing, muscle tension, or an inability to settle.

Restlessness refers to an inability to stay still, often without a clear or articulable reason. A patient may shift constantly in bed, try to get up when it is unsafe, pick at bedding or clothing, or make repetitive movements with their hands or feet. Restlessness can occur in patients who are minimally conscious or fully alert.

Agitation is typically more intense. It may involve confusion, distress, calling out, combativeness, or extreme physical movement. Agitation is often associated with a condition called terminal restlessness or terminal delirium, which is recognized by the medical community as a distinct syndrome that can occur in the final hours to days of life.

Understanding which of these a patient is experiencing matters because the response should match the cause.

Why These Symptoms Occur at the End of Life

There is rarely a single explanation. These symptoms typically arise from a combination of physical, psychological, and existential factors that converge as the body approaches death.

Physical causes may include:

Uncontrolled pain or discomfort that the patient cannot clearly communicate
Urinary retention or constipation, which can cause significant distress in a patient who cannot verbalize it
Medication side effects or interactions
Metabolic changes, including shifts in oxygen levels, sodium, or kidney function
Neurological changes as the brain is affected by the dying process

Psychological and emotional causes may include:

Unresolved grief, fear, or guilt
Anxiety about the dying process itself – not knowing what to expect
Feeling out of control or unable to participate in decisions
Spiritual distress, including questions about meaning, forgiveness, or what comes next

Environmental causes may include:

Overstimulation from noise, light, or too many people in the room
Unfamiliar settings or caregivers
Disrupted sleep-wake cycles

Regular, thorough nursing assessments are such an important part of hospice symptom management.

Non-Medical Calming Strategies Caregivers Can Use at Home

Before reaching for a medication change, many families find that environmental and relational approaches can meaningfully reduce a patient’s distress. These are not substitutes for clinical care when symptoms are severe, but they are often effective for mild to moderate anxiety and restlessness – and they can be used alongside any medical treatment.

Create a Calm, Familiar Environment. Soft, consistent lighting is better than harsh overhead lights or complete darkness. Familiar objects – photographs, a favorite blanket, a beloved pillow – can be grounding. Reducing the number of people in the room, limiting loud sounds from televisions or other devices, and keeping conversations near the patient calm and reassuring all make a difference.
Use Gentle Touch and Voice. A calm, steady voice is one of the most powerful tools a caregiver has. Speak slowly and clearly, using the patient’s name. Identify yourself. Keep sentences short and reassuring. Even a patient who appears unresponsive may still be processing sound and emotional tone. Gentle, deliberate touch – a hand held, a forehead stroked – can communicate safety when words do not reach. Certified nursing assistants (CNAs) are trained in these comfort-focused care techniques and can demonstrate them for family members who want guidance.
Attend to Basic Physical Comfort. Before assuming a symptom is purely emotional, check the basics. Is the patient too warm or too cold? Is there any sign of physical discomfort – a repositioning need, a full bladder, binding clothing? Is pain being adequately managed? Patients who cannot express their needs sometimes express them through restlessness. Addressing physical comfort first is always the right place to start. For a full picture of how hospice teams approach physical comfort, see our related guide on pain in hospice: how comfort plans are built and adjusted.
Music and Sensory Comfort. Familiar music played softly – music the patient loved throughout their life – can have a measurably calming effect, even in patients with dementia or reduced consciousness. The goal is not entertainment but sensory anchoring. Familiar scents, the sound of a loved one’s voice reading aloud, or simply a quiet presence can serve a similar purpose.
Spiritual and Emotional Reassurance. Anxiety near the end of life often has a spiritual dimension. Patients may need permission to let go – reassurance that their loved ones will be okay, that they are not a burden, that their life had meaning. These are conversations that families may feel unprepared to have, and that is exactly where the hospice spiritual care team plays a critical role. Chaplains are trained to meet patients and families wherever they are spiritually – regardless of religious tradition or none at all. They can help facilitate meaningful conversations, offer presence during distressing moments, and support the family’s own emotional processing. If your loved one is showing signs of spiritual distress or existential fear, do not wait to ask for a chaplain visit.

What Families Should Know About Terminal Restlessness

Terminal restlessness, sometimes called terminal delirium, is a recognized clinical syndrome that affects a significant number of patients in the final 24 to 48 hours of life. It typically involves agitation, confusion, repetitive or purposeless movement, moaning or calling out, and an altered level of consciousness.

Witnessing this is profoundly difficult. Families often feel helpless, frightened, and unsure whether their loved one is suffering. It is important to know a few things:

The hospice team expects this and prepares for it. Your nurse will have talked with you about what the final hours may look like, and there are comfort medications available that can be given at home to ease this transition if it occurs.
Presence matters more than words. A calm voice, a gentle hand, and your continued presence in the room communicate more than any words could. You do not need to say the right thing. You only need to stay.
You should call your hospice nurse. If terminal restlessness begins, contact your on-call hospice nurse immediately. They can guide you through what you are seeing, ensure comfort medications are in place, and either come to the home or arrange to do so. You should not manage this alone.

How the Interdisciplinary Team Supports the Whole Family

Anxiety and agitation in a loved one create secondary distress in everyone around them. Caregivers who witness these symptoms often carry significant emotional weight – guilt, helplessness, and grief – long after their loved one has passed. This is why hospice care extends support to the entire family, not only the patient.

The hospice team includes emotional support services for family members alongside the clinical work. Bereavement care, which begins before the loss and continues for at least 13 months afterward, is part of the standard scope of hospice bereavement services. If you are struggling with what you are witnessing, please tell your hospice team. Supporting you is part of what they are there to do.

Volunteer support can also provide meaningful relief – a few hours of companionship with your loved one so that you can rest, take a walk, or simply step away from the intensity of caregiving for a short time.

Your Hospice Team Is Here for Moments Like These

Anxiety, restlessness, and agitation are some of the hardest moments in the hospice journey – for patients and for the families who love them. There are also moments where skilled, compassionate hospice care makes the most difference.

At Aspen Grove Hospice, our team is prepared to respond quickly, communicate clearly, and stay with your family through every stage of this process. We serve families across Aurora, Denver, Arapahoe, Adams, Douglas, Jefferson, Weld, Boulder, Elbert, Broomfield, Larimer, El Paso, and Pueblo counties.

If your loved one is experiencing distressing symptoms and you are not sure what to do next, call us at (720) 999-9854 or speak with our hospice team to talk through what support looks like.

Hospice at Home, Assisted Living, or Nursing Facility: How Care Works in Each Setting

June 15, 2026 by Aspen Hospice Care

Hospice care is provided wherever a patient calls home. Whether that is a private residence, an assisted living community, or a skilled nursing facility, the care team comes to the patient – not the other way around. Understanding how support looks across each setting helps families make informed decisions during one of the most significant transitions of a loved one’s life.

This guide walks through what to expect in each care setting, what stays the same regardless of location, and how to get started when you are ready to take the next step.

What Stays the Same No Matter Where Hospice Is Provided

Before exploring each setting, it helps to understand what does not change. According to the Medicare Hospice Benefit, covered services are consistent regardless of where a patient resides. That means families can expect the same core support whether a loved one is in a private home or a nursing facility.

In every setting, the hospice care team typically includes:

A registered nurse who manages symptoms, coordinates the care plan, and provides regular visits
A hospice medical director who oversees and authorizes the plan of care
Certified nursing assistants (CNAs) who assist with personal care and hygiene
A social worker who supports practical and emotional needs
A chaplain or spiritual care coordinator for spiritual and existential support
Bereavement support for family members, including at least 13 months of grief care after a loved one passes
Durable medical equipment (DME), such as a hospital bed, wheelchair, or oxygen delivered directly to wherever the patient lives
Volunteer support for companionship, errands, or caregiver relief

Medications and supplies related to the terminal diagnosis are also covered under the Medicare Hospice Benefit. For a full breakdown, see our guide on hospice medications and equipment: what’s covered and what to expect.

Hospice Care at Home

For many families, receiving hospice care at home is the option that feels most meaningful. It allows patients to remain in familiar surroundings, near family, in a space that reflects who they are.

What “Home” Means in Hospice. Home hospice care is not limited to single-family houses. It includes apartments, condominiums, mobile homes, and any private residence where the patient lives. The hospice team travels to the patient.
What Care Looks Like at Home. Nursing visits are scheduled based on the patient’s needs and can be increased as the illness progresses. CNAs typically visit several times per week to assist with bathing, grooming, and personal care. The social worker and chaplain check in regularly, and families always have access to a 24/7 on-call nurse for questions or urgent concerns between scheduled visits. The hospice team also delivers and sets up all necessary equipment. A hospital bed, bedside commode, walker, or oxygen concentrator is brought directly to the home – no separate arrangements needed.
The Role of Family Caregivers. At home, family members and loved ones play an active role in daily care. The hospice team works closely with family caregivers, providing education on how to manage medications, assist with mobility, and recognize signs of a changing condition. This partnership is at the heart of home hospice. If family caregivers need a break, short-term respite care is available under the Medicare Hospice Benefit, allowing a patient to be temporarily cared for in a Medicare-approved facility while their family rests. For families navigating the emotional weight of caregiving, our family support resources and emotional support services are available throughout the hospice journey.

Hospice Care in an Assisted Living Community

Patients who live in assisted living communities are fully eligible for hospice care. In this setting, two care teams work side by side: the assisted living staff who manage daily residential care, and the hospice team who oversees symptom management and comfort-focused medical support.

How the Two Teams Work Together. The assisted living facility continues to provide housing, meals, personal care, and social programming. The hospice team layers on top of that with clinical oversight, nursing visits, spiritual support, social work, and bereavement services. This partnership model means patients do not need to relocate when they enroll in hospice. They stay in their room, their community, and among the people they know. Familiarity and stability can be deeply comforting at this stage of life.
What Families Should Know. It is important to understand that hospice does not replace the services the assisted living community provides – it supplements them. Families pay their usual assisted living costs, and the Medicare Hospice Benefit covers the hospice-specific services on top of that. The hospice social worker often serves as a bridge between the family, the facility staff, and the hospice clinical team, helping coordinate care and communicate changes in condition clearly across all parties.

Hospice Care in a Skilled Nursing Facility

Patients who reside in a skilled nursing facility (SNF), sometimes called a nursing home, are also eligible for hospice care. This setting often involves patients with more complex medical needs who require 24-hour nursing oversight that a home environment cannot safely provide.

How Hospice Fits into Skilled Nursing Care. Similar to assisted living, hospice in a skilled nursing facility works alongside the existing staff. The SNF provides around-the-clock nursing care, meals, and custodial support. The hospice team adds a layer of specialized comfort care, including more frequent nursing assessments, dedicated pain and symptom management, chaplain visits, and bereavement support for the family. This dual-team structure is intended to fill gaps in comfort-focused care that SNF staff – who manage many patients with varying needs – may not have the bandwidth to provide at the depth hospice does.
Coordination and Communication. Good coordination matters. When a patient enters hospice in a skilled nursing facility, the hospice team works directly with the facility’s charge nurses and attending physicians to align on the plan of care. At Aspen Grove Hospice, our hospice medical director plays an active role in that communication, ensuring the patient’s comfort plan is understood and followed by everyone involved. For more on how hospice physicians and facility teams collaborate, see our related post: how physicians and hospice teams work together for better patient outcomes.

Can the Setting Change After Hospice Begins?

Yes. Life circumstances change, and hospice is designed to adapt to them.

A patient who starts on home hospice can transition to an assisted living community or skilled nursing facility if their care needs increase or family caregiving capacity changes. Likewise, a patient in a facility may move back home if their condition stabilizes and family support is available.

The four levels of hospice care – Routine Home Care, Continuous Home Care, Inpatient Respite Care, and General Inpatient Care – also reflect that care intensity shifts depending on need. Your hospice team will work with you to make sure the level of care and the setting are always aligned with what your loved one requires.

Choosing the Right Setting: Questions to Ask

There is no single right answer. The best setting depends on your loved one’s medical needs, your family’s capacity, and where your loved one feels most at peace. Here are a few questions that may help guide the conversation:

What level of daily caregiving support is available at home?
Does my loved one have a preference about where they receive care?
Are their current medical needs manageable in a home environment?
Is there an existing facility relationship that provides comfort and community?
What does our family need to feel supported through this process?

Your hospice team can walk through these questions with you honestly and without pressure. To learn more about what the enrollment process looks like, visit our starting hospice care page or review our hospice eligibility guidelines.

Frequently Asked Questions

Can hospice care be provided in any home, including an apartment or mobile home? Yes. Hospice care is available in any place the patient considers home, including apartments, condominiums, and mobile homes. The hospice team comes to the patient wherever they reside.
Does moving to hospice mean a patient has to leave their assisted living community? No. Patients can remain in their assisted living community and receive hospice services there. The hospice team works alongside the facility staff to deliver additional comfort-focused care without disrupting the patient’s living situation.
Will Medicare cover hospice care in a nursing facility? Yes. The Medicare Hospice Benefit covers hospice-specific services in a skilled nursing facility. The facility’s room and board costs are separate and are typically covered under Medicare Part A or Medicaid. A hospice social worker can help clarify what costs apply in your specific situation.
What if a patient’s condition changes and they need more intensive care? Hospice includes four levels of care that can be adjusted as a patient’s condition changes. If a patient at home experiences a crisis that cannot be managed in the home setting, they may temporarily transition to an inpatient facility for stabilization and then return home once symptoms are controlled.
Is hospice in a nursing home different from the care the facility provides? The nursing facility provides custodial and residential care. The hospice team provides an additional, dedicated layer of comfort-focused medical and emotional support. Both teams communicate and coordinate to ensure the patient receives well-rounded, consistent care.

Ready to Talk About Where Care Can Begin?

If you are thinking about hospice for yourself or someone you love, our team is here to answer your questions clearly and without pressure. Aspen Grove Hospice provides care at home, in assisted living communities, and in skilled nursing facilities across Aurora, Denver, Arapahoe, Adams, Douglas, Jefferson, Weld, Boulder, Elbert, Broomfield, Larimer, El Paso, and Pueblo counties.

Call us at (720) 999-9854 or speak with our hospice team to learn what care in your setting can look like.