Hospice serves as the model for quality, compassionate care for people facing a life-limiting illness. It requires professionals who possess the expertise required to oversee the medical care, pain management, and emotional and spiritual support for patients while in hospice care. In 2014 alone, some 1.7 million patients received hospice services.
Hospice care focuses on caring, not curing. This means that hospice providers administer personalized care services as end-of-life care. Medicare, Medicaid, and most private insurance plans cover hospice care when a physician deems the condition terminal (life expectancy of six months or less).
As America’s elderly population grows, the demand for hospice care and the administrative professionals who ensure the safe and effective delivery of care continues to increase as well.
Where Hospice Administrators Work
According to the National Hospice and Palliative Care Organization, there are more than 6,000 hospice programs in operation in the United States, including both primary locations and satellite offices.
Hospice administrators oversee hospice programs in all 50 states. These programs range from small, volunteer agencies to corporate chains that care for thousands of patients every day. The vast majority (79 percent in 2014) of hospices, however, have 500 or fewer admissions each year.
Most hospice programs (60 percent) are independent, freestanding agencies. Others are part of a hospital system, home health agency, or nursing home. The majority (93 percent) possess certification through the Centers for Medicare and Medicaid Services.
Job titles for professionals in hospice administration often include:
- Hospice administrator
- Hospice director
- Hospice branch manager
- Hospice and advanced illness administrator
- Director of hospice operations
- Director of clinical services
- Executive director, hospice
- Hospice director of operations
Hospice Administrator Job Description
Hospice administrator jobs involve managing the interdisciplinary hospice team, which includes physician services, nursing services, social services, spiritual care bereavement care, and volunteer services. In some cases, hospice care services may even include physical, occupational, speech, and dietary therapy.
The hospice team provides services that address:
- The patient’s pain and symptoms
- The patient’s emotional, psychosocial, and spiritual needs
- Drugs, medical supplies, and equipment
- Family care
- Therapies, including speech and physical therapy
- Short-term inpatient care outside of the home
- Bereavement care and counseling to surviving family and friends
Hospice administrators coordinate the hospice team to ensure patients receive the appropriate level of care. Hospice patients receive one or more of the following levels of care:
- Home-based care
- Continuous home care
- General inpatient care
- Inpatient respite care
Hospice administrators manage the programs and care provided to hospice patients. Their daily job responsibilities include:
- Recruiting and hiring hospice personnel
- Evaluating and implementing policies
- Collaborating with members of the hospice team to evaluate and coordinate patient care plans
- Overseeing a team of nurses, therapists, social workers, and volunteers
- Performing financial budgeting activities
- Ensuring compliance with healthcare regulations
How to Become a Hospice Administrator: Degree and Certification Requirements
Becoming a hospice administrator generally involves completing the following:
- A bachelor’s degree from an accredited college or university
The first step to becoming a hospice administrator involves completing a bachelor’s degree from an accredited college or university. Many hospice administrators begin their careers as registered nurses; however, many also possess undergraduate degrees in disciplines such as:
- Health administration
- Business administration
- Human resources
- A master’s degree in health administration or a related field
The standard among hospice and other healthcare administration professionals is the master’s degree in health administration, which is structured a number of ways depending on the school or college that houses the program:
- Master of Business Administration (MBA)
- Master of Healthcare Administration (MHA)
- Master of Science (MS)
- Master of Public Administration (MPA)
- Master of Public Health (MPH)
A master’s degree in health administration prepares students via a competency-based education designed to prepare them for challenging leadership positions in healthcare administration, including hospice administration.
Many institutions offer master’s degrees in health administration that appeal to traditional students, mid-career professionals, and/or those desiring an accelerated program with distance study opportunities. The core curriculum of these programs includes study in:
- Healthcare finance
- Clinical issues for health services management
- Quality improvement in healthcare
- Healthcare marketing
- Health economics
- Health law
- Information systems in health services administration
Many of these programs also include a capstone project, designed to allow students to apply their recently acquired knowledge to a contemporary topic in health administration.
- Certification as a Hospice and Palliative Care Administrator
Hospice administrators may choose to demonstrate their specialized knowledge and expertise by achieving certification through the National Board for Certification of Hospice and Palliative Nurses.
The Certified Hospice and Palliative Care Administrator (CHPCA) certification requires candidates to possess at least two years of full-time hospice or palliative administrative experience before they can sit for the computer-based examination. The exam tests candidates’ knowledge of the following topics:
- Leadership and ethics
- Fiscal management
- Human resources management
- Quality management
- Community outreach and advocacy
- Organizational integrity and compliance
State Licensing Requirements for Hospices
Hospice administrators, unlike nursing home administrators, do not need a state license to practice. However, they must work in a hospice licensed by the state. Hospices must meet state requirements, which usually include operating within the state’s definition of a hospice.
Most states recognize hospices as providing the following basic services:
- Skilled nursing services
- Counseling services
- Medical direction
- Volunteer services
- Inpatient care
- Home health services/homemaker services
- Social work services
- Therapies (physical, occupational, speech, etc.)
State regulations also define the requirements of the members of the hospice care team. In South Carolina, for example, hospices must designate an individual to serve as an administrator/director, who must possess a minimum of a bachelor’s degree, or an associate’s degree and at least three years of experience in a health-related field within the past five years.
What is the Difference between Hospice and Palliative Care?
Palliative care focuses on ensuring patient comfort while relieving the symptoms related to chronic illnesses. Palliative care optimizes a patient’s quality of life by anticipating, preventing, and treating the suffering caused by illness and aging. Although hospice care is palliative in nature, the administration of palliative care occurs during any stage of a patient’s illness, while the administration of hospice care occurs when the patient’s illness has progressed to a point where a curative treatment is no longer desired or beneficial.
Both hospice and palliative care supports the patient and the patient’s family while focusing on relieving symptoms and offering comfort from pain, shortness of breath, fatigue, nausea, anxiety, constipation, insomnia, etc.
Hospice administrators may oversee both hospice and palliative care, provided to patients with chronic diseases and illnesses, such as:
- Alzheimer’s disease
- Amyotrophic Lateral Sclerosis (ALS)
- Cardiac disease
- Kidney failure
- Respiratory disease
Salary Expectations for Hospice Administrators
According to the Bureau of Labor Statistics (BLS), hospice administrators earned an average salary of $118,800 as of May 2020. Early career professionals in this field earned about $78,820 during this time, mid-level career professionals earned about $104,280, and senior-level hospice administrators with extensive experience and graduate-level education earned about $195,630.
Average salaries for hospice administrators tend to vary based on the setting in which they work, with top earners working in hospitals and larger health systems:
- General medical and surgical hospitals: $127,330
- Nursing care facilities: $100,160
- Home healthcare services: $100,880
May 2020 Bureau of Labor Statistics salary and job market trends for medical and health services managers and represent national data, not school-specific information. Conditions in your area may vary. Salary statistics representing entry-level/early career = 25th percentile; mid-level= 50th percentile; senior-level/highly experienced = 90th percentile. Data accessed August 2021.
Resources for Hospice Administrators
- Hospice and Palliative Nurses Association
- National Hospice and Palliative Care Association
- National Association for Home Care and Hospice
- Hospice Foundation of America
- National Hospice Foundation
- American Hospice Foundation
- American Academy of Hospice and Palliative Medicine
- Health Care Administrators Association
- American Association of Healthcare Administrative Management