Hospice care
Where hospice care happens
Hospice is a service, not a building. The team comes to wherever the person lives: a private home, a family member's home, an assisted living community or board-and-care home, or a nursing facility. Short hospital or inpatient stays are arranged only when symptoms cannot be managed where the person lives. In each setting the hospice care is the same. What changes is who provides daily care and who pays for room and board.
Reviewed by our medical director, September 24, 2026
On this page (6 sections)
Care settings compared
| Setting | Who gives daily care | What hospice adds | Room and board |
|---|---|---|---|
| Private home or a relative's home | Family, friends or hired caregivers | Team visits, medicines, equipment, supplies, a nurse by phone at any hour | Not applicable. Hired caregivers are paid privately or through other programs |
| RCFE, assisted living or board-and-care home | Facility caregivers | The same hospice services, coordinated with facility staff | Paid by the resident as before. Hospice does not change the monthly fee |
| Skilled nursing facility | Facility nurses and aides | The same hospice services, under a written agreement with the facility | Private pay, long-term care insurance, or Medi-Cal for those who are eligible |
| Hospital or inpatient unit (general inpatient care) | Facility nurses at all hours, directed by the hospice plan | Short-term symptom control | Part of the hospice benefit for those days |
Hospice at home
Most hospice care happens in a house or apartment. The team brings what is needed: a hospital bed in the living room if that is where the person wants to be, oxygen, medicines, supplies. Nurses and aides visit on a schedule set by the plan of care, and the team teaches the family how to give medicines and provide safe daily care.
Home hospice works when someone can be with the person. That is often a spouse, adult children taking turns, or a paid caregiver. If the person lives alone, tell us. The social worker helps plan for the time when living alone is no longer safe. It does not have to be solved before you call.
Hospice in an RCFE, assisted living or board-and-care home
In California, assisted living communities, memory care communities and small board-and-care homes are all licensed as residential care facilities for the elderly (RCFE) by the Department of Social Services. An RCFE resident can receive hospice and stay in the place they know. State law sets the conditions in Health and Safety Code 1569.73 and Title 22, section 87633.
For a resident to receive hospice in an RCFE:
- The facility holds a hospice care waiver from Community Care Licensing. Ask the administrator. Many facilities already have one, and a facility without one can apply.
- The resident, or their representative, chooses the hospice. The hospice must be licensed by the state and certified by Medicare. The facility cannot make that choice for you.
- The hospice and the facility agree on a written hospice care plan that says who does what. A copy is kept at the facility.
- The facility decides it can still meet the resident's needs with hospice support and without harm to other residents.
We care for people wherever they call home, including nursing facilities, RCFEs and board-and-care homes, in coordination with facility staff. The facility keeps providing meals, personal care and supervision, and the monthly fee continues as before. If care needs grow, some facilities charge a higher level-of-care fee. Ask for that in writing. Read more in hospice in assisted living.
Hospice in a skilled nursing facility
A person who lives in a nursing facility can choose hospice and stay there. Medicare requires a written agreement between the hospice and the facility. The hospice manages the care related to the terminal illness. The facility continues daily nursing, meals and personal care. One shared plan of care covers both.
Room and board. Medicare does not pay room and board where you live, and that includes a nursing facility. If the resident has Medi-Cal that covers long-term care, Medi-Cal or the Medi-Cal managed care plan pays room and board. The payment is routed through the hospice, which passes it to the facility. Families do not need to manage that, but it helps to know why the paperwork changes. Any Medi-Cal share of cost continues.
Rehab stays. If someone is in a nursing facility on a short Medicare-covered skilled stay after a hospital admission, choosing hospice for the same illness usually ends Medicare's payment for that stay, and room and board becomes the resident's responsibility. Ask us and the facility's business office to explain the numbers before deciding. See paying for care.
Hospice in a hospital: general inpatient care
Hospice can be provided in a hospital or other inpatient facility only when medically necessary during a symptom crisis, under the level called general inpatient care. It is short-term. The aim is to get pain or other symptoms under control and return the person home. See levels of care.
Some people are first referred to hospice while they are in the hospital. In that case a hospice nurse can meet the family at the bedside, and the hospice arranges equipment and medicines so they are in place when the person goes home. When general inpatient or respite care is needed, the hospice team confirms a contracted facility with an available bed and arranges the clinical handoff and transport before any transfer.
Common questions about care settings
Can you be on hospice in an assisted living facility?
Yes. In California an assisted living facility is licensed as an RCFE, and a resident can receive hospice there when the facility has a hospice care waiver and agrees it can meet the resident's needs with the hospice's support. The resident chooses the hospice. Hospice staff visit the resident there, just as they would in a private home.
Is an RCFE the same as assisted living?
RCFE is the California license. Assisted living, memory care and board-and-care are everyday names for facilities that hold that license. They range from six-bed homes in a neighborhood to large communities. All are licensed by the Department of Social Services, not the Department of Public Health, and none is a medical facility.
Does hospice pay for a nursing home or assisted living?
No. Hospice covers the hospice care. Room and board is separate in every setting. In a nursing facility, Medi-Cal pays room and board for residents who are eligible. In an RCFE, residents generally pay privately. Some use long-term care insurance, and some are in the Assisted Living Waiver, which is a separate program. See Assisted Living Waiver.
Can the facility tell us which hospice to use?
No. A facility may tell you which hospices visit there often, but you have the right to choose your hospice. The hospice you choose needs an agreement with a nursing facility, or an agreed care plan with an RCFE, before care starts. See how to choose a hospice.
Does the person have to move to a hospice facility at the end?
No. Most people on hospice stay where they live, and that is usually what they want. A move to inpatient care happens only when medically necessary during a symptom crisis. If you are not sure whether hospice fits yet, read is it time for hospice.
About this page
- Written by
- Beta Hospice care team
- Clinically reviewed by
- our medical director
- Last reviewed
- September 24, 2026
- Next review
- March 24, 2027
How we write and review this site
Sources
- California Health and Safety Code 1569.73: Hospice care in residential care facilities for the elderly (opens in a new tab)
- California Department of Social Services: Residential care facility regulations (Title 22, including section 87633) (opens in a new tab)
- 42 CFR 418.112: Hospices that provide care to residents of a nursing facility (opens in a new tab)
- 42 CFR 418.108: Short-term inpatient care (opens in a new tab)
- Medicare.gov: Hospice care coverage (opens in a new tab)
These sources support the general information on this page. For one person’s care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (909) 347-7000 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the person’s own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice