Your rights under federal hospice rules
Patient rights and how to file a complaint
Every hospice patient has rights under federal rule 42 CFR 418.52. You have the right to be told your rights in a way you understand, to help plan your care, to refuse care, to choose your attending doctor, to have pain and symptoms treated, to privacy, and to complain without fear of reprisal. You also have the right to choose your hospice and to change it. This page explains each right and lists where to take a complaint.
When and how are you told your rights?
During the first assessment visit, before care begins, the hospice must give you or your representative a notice of your rights, spoken and in writing, in a language and manner you understand. The hospice must also tell you its policies on advance directives and ask you to sign that you received the notice.
If a court has found that a person cannot make their own decisions, the person appointed by the court exercises these rights. Otherwise, a legal representative chosen under California law may exercise them to the extent the law allows.
What are your rights as a hospice patient?
| Your right | What it means day to day |
|---|---|
| To exercise your rights | You can use any right on this page. The hospice may not discriminate against you or punish you in any way for doing so. |
| Respect for you and your property | Staff treat you, your home and your belongings with respect. |
| To voice a grievance | You can complain about care that was given or not given, or about a lack of respect for your property, by anyone working on behalf of the hospice. The hospice must investigate and write down what it found. |
| Freedom from abuse and neglect | You have the right to be free from mistreatment, neglect, verbal, mental, sexual and physical abuse, injuries of unknown source, and misuse of your property. Staff must report any such concern to the hospice administrator right away, and the hospice must investigate. Verified violations are reported to state authorities within five working days. |
| Pain and symptom management | You have the right to effective management of pain and other symptoms related to the terminal illness. Our goal is comfort and dignity. |
| To take part in your plan of care | You help decide what care you receive. The team explains the plan and changes to it. |
| To refuse care or treatment | You can say no to any visit, medicine or treatment. |
| To choose your attending physician | You can keep the doctor you choose. The hospice medical director works with that doctor. |
| A confidential clinical record | Your record is private. It is used and shared only as privacy law allows. See our Notice of Privacy Practices. |
| To know what is covered | You have the right to be told which services the hospice benefit covers, the scope of services the hospice will provide, and any limits on those services. |
Your right to choose and change your hospice
Choosing hospice is your decision. You can stop hospice at any time and return to regular Medicare coverage. You have the right to choose your hospice.
No doctor, hospital, facility or health plan can require you to use one particular hospice. If you live in a nursing facility or an RCFE (residential care facility for the elderly), you still choose your own hospice.
Under Medicare you may change from one hospice to another once in each benefit period. You do this by signing a statement that names the hospice you are leaving, the hospice you are moving to and the date of the change. Changing hospices is not the same as stopping hospice, and it does not use up a benefit period. Read more in switching hospice providers.
You may also stop hospice altogether. This is called revoking the election. You sign a dated statement, and your regular Medicare coverage returns from that date. You can choose hospice again later if you are still eligible.
Your right to ask what hospice will not cover
When you elect hospice, you or your representative may ask for a written list called the "Patient Notification of Hospice Non-Covered Items, Services, and Drugs." It is also known as the election statement addendum.
The list names any conditions, items, services and drugs that the hospice has decided are not related to your terminal illness, and so will not be covered by the hospice. It gives the clinical reason for each one in plain words.
If you ask for the list when you elect hospice, the hospice must give it to you within 5 days of the date hospice starts. If you ask at any later time, the hospice must give it to you within 3 days. Signing the list means only that you received it. It does not mean you agree with it. If you disagree, you can ask Medicare's Quality Improvement Organization for immediate advocacy. See the complaint steps below. Costs are explained on paying for care.
How do you file a complaint about a hospice?
You can use any of these. You do not have to complain to the hospice first, and you may complain to more than one place. No hospice may punish you or reduce your care because you complained.
- Step 1
Tell Beta Hospice
Tell any member of your team, or contact Jack Demirchyan, Chief Operating Officer, at (909) 347-7000, info@betahospice.com, or 1525 N D Street, Suite 10, San Bernardino, CA 92405. We acknowledge every grievance promptly, check for any immediate safety concern, investigate, tell you what we found and document any corrective action. You receive an acknowledgment within 2 business days and a written answer within 14 days.
- Step 2
California Department of Public Health (CDPH)
CDPH Licensing and Certification licenses hospices in California and investigates complaints about them. You can file online through Cal Health Find (opens in a new tab) or call the CDPH district office for the county where the patient lives: San Bernardino County (800) 344-2896, Riverside County (888) 354-9203, Los Angeles County (800) 228-1019, Orange County (800) 228-5234, Ventura County (800) 547-8267. CDPH's statewide complaint line is (800) 236-9747.
- Step 3
Our accrediting body
Accreditation Commission for Health Care (ACHC), toll-free 855-937-2242, or the Submit a Complaint section at achc.org/contact (opens in a new tab). Mail: 139 Weston Oaks Court, Cary, NC 27513.
- Step 4
Medicare
Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Medicare takes complaints about any Medicare-certified hospice.
- Step 5
The Medicare Quality Improvement Organization
The Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) reviews complaints about quality of care for people with Medicare. It also handles fast appeals if you are told hospice is ending and you disagree. For California the BFCC-QIO is Commence Health (known as Livanta until August 2025), toll-free 1-877-588-1123. You can confirm the current organization on CMS's BFCC-QIO page (opens in a new tab).
Reporting suspected fraud
A complaint about care is different from a report of fraud. If someone signed you up for hospice without your understanding, offered gifts or money, or billed Medicare for hospice you did not receive, report it. The numbers are on how to verify a hospice.
Common questions about hospice rights
Can a hospice discharge me because I complained?
No. Federal rules bar discrimination or reprisal for exercising your rights. A hospice may discharge a patient only for limited reasons set out in Medicare rules, such as moving out of the service area or no longer being terminally ill.
Can my family member use these rights for me?
Yes, if that person is your legal representative under California law, for example an agent named in your advance health care directive, or a person appointed by a court.
Can I change hospices if I live in a facility?
Yes. The choice of hospice belongs to the patient, not the facility. You may change hospices once in each benefit period.
Do I have to sign the list of non-covered items?
You are asked to sign to show you received it. Your signature does not mean you agree. You can still ask the Quality Improvement Organization to look at the decision.
Do these rights apply if Medi-Cal or a private plan pays for hospice?
Medicare-certified hospices must give these rights to every patient they serve, whoever pays. Your health plan may give you extra grievance and appeal rights of its own.