One of the questions families ask most often before starting hospice care is a simple one: Does my loved one have to move?

The answer is no. Under the Medicare Hospice Benefit, hospice care can be provided wherever a patient calls home, whether that is a private residence, an assisted living community, or a skilled nursing facility. The setting does not determine eligibility. The patient’s diagnosis, prognosis, and goals of care do.

This guide explains exactly how that works in each of the three most common settings, so your family can make an informed decision without second-guessing where your loved one belongs.

What Stays the Same in Every Setting

Before breaking down the differences, it helps to understand what does not change regardless of where hospice is delivered.

In every setting, the Aspen Grove Hospice interdisciplinary team includes:

• A medical director overseeing the care plan
• Registered nurses for clinical visits and symptom management
• Certified nursing assistants and aides for personal care
• A licensed social worker for emotional and logistical support
• A spiritual care coordinator or chaplain for comfort beyond the physical
• Bereavement support for families, including for a full year after loss
• Volunteer support for companionship and supplemental family relief

All of these services are covered under Medicare’s Hospice Benefit when the patient meets eligibility criteria. There are no separate fees for choosing one setting over another from a hospice coverage standpoint.

Hospice at Home

How It Works

Home is the most common setting for hospice care in the United States, and for good reason. For many patients and families, being in a familiar environment surrounded by people and belongings they love provides a level of comfort no facility can replicate.

When hospice is delivered at home, the hospice team comes to the patient. Registered nurses visit on a scheduled basis to assess symptoms, manage pain, adjust medications, and support the family caregiver. CNAs and aides assist with personal hygiene, bathing, and daily comfort tasks.

Equipment and supplies are delivered directly to the home through Aspen Grove Hospice’s durable medical equipment (DME) coordination. This may include a hospital bed, oxygen, a bedside commode, a wheelchair, or specialized mattresses, depending on the patient’s needs.

A 24/7 on-call nurse line is available for any change in condition, day or night.

What Families Should Know

Home hospice requires a family caregiver or support person to be present and engaged between scheduled visits. This is not a 24-hour in-home staffing model under routine home care. The hospice team supplements the care you provide; it does not replace the presence of someone who loves the patient.

If symptoms escalate and the patient needs more intensive support at home, hospice can authorize continuous home care, a higher level of care that provides more hours of clinical presence during a crisis period.

Home Hospice Is a Good Fit When:

• The patient strongly prefers to remain at home
• A reliable family caregiver or support person is available
• The home environment can safely accommodate the necessary equipment
• Symptoms are manageable between clinical visits

Hospice in an Assisted Living Facility

How It Works

Assisted living communities provide housing, meals, and daily support for residents, but they are not licensed to provide skilled medical care or hospice services on their own. When a resident in an assisted living community is eligible for hospice, a separate hospice provider, like Aspen Grove Hospice, partners with the facility to layer additional clinical support on top of what the facility already provides.

The hospice team visits the resident in their assisted living room or apartment, just as they would visit a patient at home. The hospice nurse manages the medical and comfort-focused aspects of care. The facility staff continues their regular duties: meals, activities, and daily assistance. The two teams coordinate together around the patient’s care plan.

Assisted Living Hospice Is a Good Fit When:

• The patient is already a resident and is comfortable in that environment
• The family does not want to move their loved one during the final chapter of their life
• The facility has an existing relationship with or a willingness to partner with a hospice provider
• The patient needs daily personal care support beyond what the family can provide

Hospice in a Skilled Nursing Facility

How It Works

Skilled nursing facilities, sometimes called nursing homes, provide a higher level of medical and personal care than assisted living communities. They have licensed nurses on staff around the clock and are equipped to manage more complex medical needs.

When a skilled nursing facility resident elects hospice, the hospice provider again layers a separate, specialized layer of comfort-focused care on top of what the facility already provides. The hospice team’s role is to shift the focus of care entirely toward comfort, symptom management, and quality of life, moving away from curative interventions and toward peace.

Hospice nurses from Aspen Grove Hospice visit regularly, coordinate with the facility’s clinical staff on the patient’s care plan, and ensure that comfort medications, spiritual care, and social support are consistently available. Volunteer support and chaplain visits are available here as well, often providing a meaningful presence when family cannot be there.

What Families Should Know

One important distinction in nursing facility hospice: Medicare cannot pay for both Skilled nursing facilities’ skilled care and hospice care at the same time if both are being used for the same terminal condition. Once a patient elects hospice, the focus of their care shifts from skilled nursing rehabilitation to comfort-only hospice care.

This does not mean the patient loses access to the facility’s staff or support. It means the goals of that support change. Your hospice social worker can walk you through exactly what this means for your loved one’s specific situation and help you understand what Medicare covers under each scenario.

Nursing Facility Hospice Is a Good Fit When:

• The patient has complex medical or physical needs that require around-the-clock licensed nursing staff
• The family does not have the capacity to provide care at home
• The patient is already a long-term resident and is settled in that community
• Symptom management requires a higher level of on-site medical oversight

How to Choose the Right Setting

In most cases, the right setting is the one your loved one is already in or the one where they feel most at peace.

The hospice team does not require a patient to be in a specific place to receive excellent care. What matters is that comfort, dignity, and coordinated support are present regardless of the address.

If you are weighing options, ask yourself:

• Where does my loved one feel most safe and comfortable?
• What level of daily personal care is needed between hospice visits?
• What is realistic for our family to manage?
• Is a move at this point in their life something they want or that would cause additional distress?

The Aspen Grove Hospice social work team can help your family think through these questions honestly and practically, without pressure toward any particular setting.

If your loved one has recently been hospitalized or is transitioning out of a skilled nursing facility, this is often an ideal time to explore hospice. Our blog How Early Hospice Enrollment Can Help Patients and Families explains why timing matters and what earlier support can mean for quality of life.

We’re Here When You’re Ready

Wherever your loved one is today, Aspen Grove Hospice can meet them there. Our team serves families across Denver, Aurora, Arapahoe, Adams, Douglas, Jefferson, and surrounding Front Range communities in homes, assisted living communities, and skilled nursing facilities throughout the region.

Call us at (720) 999-9854 or speak with our hospice team to ask questions, confirm coverage, or take the next step toward comfort care. There is no pressure and no obligation. Only a team that genuinely wants to help.