Hospices “Trolling” For Patients In Hospital Is Unethical.

My uncle was told in hospital he had “end-stage heart failure” and to go home with hospice.  That day, someone from a hospice came and left their business card, saying they were available when the family was ready to go home.  Then, the hospital’s case manager came and gave the family a list of hospices to choose from. They are confused as to how this hospice person got their name, because they actually wanted a different hospice.  Doesn’t the family have the right to choose a hospice?


This is an increasingly unethical occurrence.  The business of hospice is extremely competitive, with increasing numbers everywhere trying to attract patients through multiple actions such as:  marketing staff are known to ‘troll’ the hospital listening and looking for patients who may need their service; going to nursing homes or assisted living facilities and offering help in exchange for referrals to their hospice; hospice medical directors insisting their own private patients take the hospice the doctor works for.  All these actions are prohibited by Medicare.

Medicare’s rules are clear.  First, every patient has the right to choose.  In the hospital, you must be given a “Choice Form” listing all participating agencies, and the case manager calls your selection.  Only then, should you be meeting them.  

Second, offering a service in exchange for referrals is not only unethical, it’s illegal – a violation of the federal Anti-Kickback Statute.  The Office of the Inspector General is looking for cases like this to prosecute.

Bottom line:  since every patient has the right to choose, report to the hospital or Medicare hotline [1-800-HHS-TIPS (1-800-447-8477)] any agency or physician trying to either leave a ‘calling card’ before you’ve been given the choice form, or tells you that you have no choice.