Hospice Unveiled: Exposing Bad Actors and Finding True Care

The Alleviate Care Team
Jul 9
5 min read

The word "hospice" should evoke comfort and support, even as it finds patients and families with strong emotions at the end of a life. And yet, all of this is frequently made more difficult by unsettling stories of fraud, waste, or neglect. It's a painful reality that in an industry built on compassion, unethical practices can exist, sowing doubt when families need clarity most. At Alleviate Care, we believe it's time for an honest conversation about what hospice truly is, what it should be, and how to find the exceptional care your loved ones deserve.

Three Ways "Bad Hospices" Cheat and Steal

While the vast majority of hospice providers are dedicated to compassionate, high-quality care, it's crucial to acknowledge the issues that fuel public perception, regular news stories, and perennial government reports of fraud and abuse:

Outright Fraud and Abuse: This is the darkest side of the industry, the criminal underbelly, where unscrupulous actors steal personal information, enroll individuals in hospice inappropriately, or even prevent legitimate access to services by falsely claiming a patient is already receiving care. These are criminal acts that undermine the very foundation of trust in healthcare. If something feels off, or you're being pressured, trust your gut.
Exploiting the Benefit: Less egregious, but still highly unethical, are those disreputable hospices that are playing the system by inappropriately admitting patients or keeping them on service longer than clinically necessary, solely to "use up" the Medicare benefit. Once the benefit is depleted, patients may be discharged, only for the perpetrators to dissolve their business and start anew, repeating the cycle. Your hospice benefit is for your loved one's needs, not a business's bottom line.
Poor or Non-Existent Care: This might not be outright fraud, but it's a profound failure to deliver on promises and a betrayal of trust. Imagine being told you'll have 24/7 nursing support, only to find no one answers when a crisis arises. Or medications that never arrive, despite being promised. Patients and families are left feeling abandoned and stressed during their most vulnerable moments. This lack of care, though not always illegal, is a deeply harmful betrayal of trust. Your hospice should be a consistent, reliable presence. If you feel neglected or unheard, that's a serious red flag.

These issues create a significant challenge for the entire hospice industry, fostering misconceptions about what truly compassionate and high-quality care entails.

Bridging the Knowledge Gap: What Good Hospice Looks Like

The current public discourse on hospice often focuses on how to spot scammers, providing basic or generic advice. What's largely missing is clear, actionable guidance for patients and families on identifying good hospice care. How do you truly know what quality hospice looks, and feels, like?

If you asked 1,000 people with some knowledge of hospice, few could articulate the tangible indicators of excellent care. There's no equivalent of Yelp for hospice, and while Medicare star ratings offer some directional good, they often don't favor newer, innovative companies. Testimonials and reviews exist, but the overarching landscape lacks a centralized, trusted resource.

Your hospice provider should have:

Responsive, clear communication: You should always feel informed and heard, with direct access to your care team.
Personalized care plans: Care should be tailored to the patient's unique needs and wishes, not a one-size-fits-all approach.
A team that treats your loved one like family: Compassion, dignity, and respect should be at the heart of every interaction.
24/7 support: Crises don't keep office hours. Your hospice should be available around the clock.

What to do if you feel uncomfortable or distrustful:

If you or a loved one are currently receiving hospice care and feel that the quality is not what you were promised, or if you suspect unethical practices:

Communicate immediately: Speak directly with the hospice agency's leadership. Clearly articulate your concerns and the specific areas where you feel support is lacking.
Document everything: Keep a detailed record of dates, times, who you spoke with, and what was discussed. This is crucial if further action is needed.
Contact Medicare or your state's Department of Public Health: If your concerns are not addressed by the hospice agency, reach out to federal and state oversight bodies. They are there to investigate complaints and ensure compliance with regulations. In California, that's the California Department of Public Health (CDPH).
Seek a second opinion: Don't hesitate to consult with another hospice provider. A new perspective can help you evaluate your current care and understand available alternatives.

The Role of Regulation: Your Assurance of Quality

Understanding the regulatory landscape of hospice care is crucial for making an informed choice. These regulations are designed to protect patients and ensure high standards of care.

CMS Regulations: The Federal Framework. The Centers for Medicare & Medicaid Services (CMS) is the primary federal oversight body for hospice care in the United States. CMS establishes the conditions of participation that hospice providers must meet to be eligible for Medicare and Medicaid reimbursement. This includes stringent requirements for patient eligibility, the interdisciplinary team (nurses, doctors, social workers, spiritual counselors), care planning, symptom management, and bereavement support. Their role is to ensure that Medicare beneficiaries receive quality hospice care that complies with federal standards.
California-Specific Laws: Beyond federal CMS regulations, California has its own specific laws and licensing requirements that govern hospice operations. These state-level mandates often complement or add to federal guidelines. California Department of Public Health (CDPH) is the state oversight body responsible for licensing and certifying hospice agencies in California. They enforce California-specific laws that often enhance federal guidelines set by CMS.

Why should these regulations matter to you? These layers of regulation are designed to protect patient rights, ensure a consistent standard of quality care, and provide accountability for hospice providers. They establish a baseline for what you should expect, from the qualifications of the care team to how patient preferences are honored and grievances are addressed. Understanding that hospice providers operate within these frameworks can offer peace of mind and empower you to ask the right questions.

Our Commitment at Alleviate Care

At Alleviate Care, we believe every patient and family deserves to feel wrapped in a warm hug during life's most profound transitions. We aim to cultivate a sense of calm guidance and unwavering support when life gets chaotic and unpredictable. Our goal is to demonstrate our competency and legitimacy, providing clear, actionable information that empowers you to make informed decisions.

In the next parts of this series, we'll dive deeper into:

How to identify legitimate, high-quality hospice providers.
Key questions to ask about clinical quality, compassion, and modern operations.

Stay tuned for Part 2, where we'll equip you with tangible questions to ask potential hospice providers, so you can confidently choose the right partner for your family.

Alleviate Care is Southern California’s trusted hospice provider.