By Lea Rodriguez, PT, DPT, Founder/Managing Member, SilverMaple Assisted Living | Reviewed by Carmina Del Fonso, Founder/Managing Member | Last reviewed: [date of publish]
When a doctor first mentions hospice, your next question may be whether your parent has to move out. For hospice in assisted living, the answer is usually no. A licensed hospice provider can bring care into the home, and the assisted living caregivers keep doing the daily work they already do.
The harder questions are about everyday details: who calls the nurse at 2 a.m., who does the laundry, and which bills Medicare pays.
What You Should Know
Hospice in assisted living is comfort-focused care for a person with a serious illness whose doctor expects a life expectancy of six months or less, given in their assisted living home. Medicare.gov [1] states that hospice care can usually be given where a person lives, including assisted living. At SilverMaple Assisted Living in Fulshear, Texas, a licensed hospice provider brings in nursing visits, symptom care, equipment, social work and spiritual support. SilverMaple’s caregivers keep giving daily care on site 24/7. Medicare’s hospice benefit does not pay room and board, so the monthly private-pay cost of living at SilverMaple continues.
What families often see when hospice first comes up
Families often see a parent sleeping more, eating less, or spending more of the day in their room. Doctor visits and hospital trips may wear them out without making them feel better. Your parent may also say they are tired of treatments, or go quiet when the subject comes up. Changes like these often come slowly, and you may notice them before a doctor brings up hospice.
Hospice is your parent’s choice to make. Medicare requires the person to sign a statement choosing hospice care. Some older adults hear the word “hospice” and think it means giving up. Others worry about strangers coming into their room. Your parent may most want to keep their routines, their own room and a say in what happens next.
Can hospice be provided in assisted living?
Hospice care can come into an assisted living home, so a move is usually not needed. Medicare.gov [1] says you can usually get Medicare-approved hospice care in your home or another place where you live, such as assisted living or a nursing home.
How does hospice work at SilverMaple?
SilverMaple Assisted Living in Fulshear, Texas, is an assisted living home, not a hospice agency. Residents can receive hospice care in our home from a licensed hospice provider, while our caregivers keep up their daily care. Your beloved keeps their own room and the caregivers they know, and does not have to learn a new place near the end of life. Daily routines stay the same, such as meals prepared for their dietary needs and quiet time with the other residents. With 12 residents at most, our home keeps the same caregivers close by day and night. Ours is a faith-guided home, and we follow your beloved’s own faith and wishes in these final weeks. Carmina Del Fonso, one of our founders and the reviewer of this article, helped found the home partly because of her own hospice volunteer work.
Who does what during hospice in assisted living?
The hospice team treats the illness and keeps your parent comfortable, and the assisted living caregivers help with everyday tasks like meals, housekeeping and laundry. The National Institute on Aging [2] notes that when hospice is given at home, family and friends usually handle the day-to-day care while the hospice team visits and coaches them. At SilverMaple, our caregivers do much of that day-to-day work.
|
Need |
Hospice provider |
SilverMaple caregivers |
|
Nursing visits and the symptom and pain plan |
Yes, through hospice nurses and the hospice doctor |
No. SilverMaple does not provide nursing. |
|
Someone present at 2 a.m. |
A hospice nurse and doctor are on call by phone 24/7 |
Yes, caregivers are on site 24/7 |
|
Medical equipment and supplies for the illness |
Yes, covered under Medicare hospice |
No |
|
Meals, housekeeping and laundry |
No |
Yes, meals are prepared daily for your beloved’s dietary needs |
|
Social work, spiritual advisers and grief counseling |
Yes, for your parent and the family |
No. The hospice team provides these, and we follow each resident’s own faith and wishes. |
|
Room and board cost |
Not covered by Medicare |
Private pay, billed by SilverMaple |
If your parent needs nursing, it comes from the hospice provider or another licensed outside provider.
What are the benefits of hospice care for your parent?
Hospice makes your parent’s comfort the main goal of care. The NIA [2] describes hospice as care that focuses on the comfort and quality of life of a person with a serious illness who is approaching the end of life. The Medicare hospice booklet [3] lists the services that can be covered:
- Doctor services and nursing care
- Prescription drugs for pain and symptom control
- Medical equipment, such as a wheelchair or walker, and medical supplies
- Hospice aide and homemaker services
- Physical and occupational therapy and speech-language pathology services
- Social worker services and dietary counseling
- Grief and loss counseling for your parent and your family
- Short-term inpatient care for pain and symptom control
For your parent, hospice can mean fewer trips to appointments and more unhurried time at home, often with caregivers who already know their habits. A person on hospice can also keep their own regular doctor as the attending doctor if they choose.
Hospice also supports you and the rest of the family through its social workers, spiritual advisers and grief counseling.
Who pays for hospice in assisted living?
Medicare Part A pays for hospice services from a Medicare-approved hospice provider. Your parent pays nothing for most hospice services, except up to $5 for each outpatient prescription for pain and symptom control. Medicare does not pay for room and board, so the family usually keeps paying the assisted living home. Medicare does not cover hospice room and board, which is the cost of living in the home itself.
At SilverMaple Assisted Living, room and board is the private-pay cost of living in our home, and families keep paying it during hospice. To see how private pay works, read paying for senior care with private pay.
What rights does your family keep after choosing hospice?
Your parent chooses which Medicare-approved hospice provider to use. Your parent also keeps the right to stop hospice care at any time, and can return later if they still qualify. Medicare also lets your parent change hospice provider once during each benefit period. The hospice benefit runs in two 90-day benefit periods, followed by an unlimited number of 60-day periods.
These two rights help if the hospice provider is not working out for your parent, or if your parent decides to try a treatment again. Before your parent signs, ask any assisted living community these questions:
- Which hospice providers has the community worked with, and is each one Medicare-approved?
- Who calls the hospice nurse if your parent’s comfort changes overnight?
- How does the community share updates with you, and how often?
- What happens if your parent needs more care than the caregivers can give in the home?
Is hospice the same as comfort care?
Hospice is one kind of comfort care. Medicare has its own rules for who can get it, and one rule is that a doctor expects the person to live six months or less. Comfort care is a wider term that includes more than hospice. For a side-by-side look, read is comfort care the same as hospice.
Who is hospice at SilverMaple not right for?
Hospice at SilverMaple Assisted Living is not the right fit for someone who needs memory care or 24-hour nursing care, because SilverMaple does not offer memory care or nursing. A person with dementia who needs a secured setting needs a community licensed for memory care. A person who needs 24-hour nursing care may need short-term inpatient care through hospice, or a nursing home. Read nursing home vs. assisted living to compare the two.
What steps come first once hospice is recommended?
Once a doctor recommends hospice, these four steps, in this order, help your family set up hospice care in your parent’s assisted living home.
- Ask your parent what they want. Ask your parent what they want their days to look like, and bring their answer to the talk with their doctor.
- Talk with the doctor. Ask the doctor why hospice is being recommended now and what changes to watch for in the coming weeks. Write down the answers so the whole family hears the same thing.
- Ask the assisted living home the questions above. Start with which hospice providers the home has worked with and whether each one is Medicare-approved, then ask who calls the hospice nurse overnight.
- Get both costs in writing. Ask the hospice provider which services Medicare will cover, and ask the assisted living home for the monthly room and board cost during hospice.
Key points
- Hospice care can usually be given where your parent lives, including an assisted living home.
- A licensed hospice provider brings hospice care into the assisted living home, and the home’s caregivers continue daily care.
- Medicare’s hospice benefit covers hospice services from a Medicare-approved provider but not room and board.
- Your parent can stop hospice at any time and can change hospice provider once per benefit period.
- When hospice care comes into the assisted living home, your parent can spend the final weeks in their own room, on their own routine, with familiar faces nearby.
Talk it through with us
If a doctor has mentioned hospice and you want your beloved to stay in a home setting, a conversation with us is a good next step. Reach us at (346) 381-8585, or come see our home in Fulshear and ask how a licensed hospice provider would work alongside our caregivers. During hospice, we are still the same small home where your beloved is known by name.
Frequently asked questions
Does my parent have to move out of assisted living to get hospice?
Most people who choose hospice do not have to move out of assisted living. Medicare.gov [1] states that hospice care can usually be given where a person lives, including assisted living. A licensed hospice provider brings care into the home, so your parent can usually stay in their own room.
Does SilverMaple provide the hospice nurses?
SilverMaple Assisted Living does not provide hospice nurses. We are not a hospice agency, and nursing comes from the licensed hospice provider. Our caregivers continue daily care on site 24/7.
Does Medicare pay for assisted living during hospice?
Medicare does not pay for assisted living during hospice. Medicare’s hospice benefit pays for hospice services from a Medicare-approved provider, but it does not cover room and board. SilverMaple Assisted Living is private pay.
Can we change hospice providers?
A person on Medicare hospice can change hospice provider once during each benefit period. The benefit runs in two 90-day periods, then an unlimited number of 60-day periods.
Can my parent stop hospice care?
A person on hospice can stop hospice care at any time. Medicare states that a person can go back to hospice care later if they still qualify.
How often does a hospice nurse visit?
How often a hospice nurse visits depends on your parent’s hospice care plan, so it is different for each person. The Medicare hospice booklet [3] states that a hospice nurse and doctor are on call 24 hours a day, 7 days a week.
Does hospice help the family, too?
Hospice supports the family as well as the person who is ill. Medicare covers grief and loss counseling for the family, and hospice teams include social workers and spiritual advisers.
This article is for general education and is not medical, legal or financial advice. Talk with your parent’s doctor, a Medicare-approved hospice provider and Medicare about your family’s situation.
About the author
Lea Rodriguez, PT, DPT, is a licensed physical therapist with a Doctorate in Physical Therapy from the University of Texas Medical Branch and more than 30 years of experience in rehabilitation, hospital and senior living settings, including as a rehab director at Brookdale Senior Living in Houston. Lea is a TORCH-certified manager, co-founder of SilverMaple Assisted Living in Fulshear, Texas, and co-author of the upcoming book Why Senior Housing Matters. Read Lea’s bio.
Sources
[1] Medicare.gov
“Hospice Care Coverage”
https://www.medicare.gov/coverage/hospice-care
Centers for Medicare & Medicaid Services
Accessed October 2026
[2] National Institute on Aging
“What Are Palliative Care and Hospice Care?”
https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care
National Institutes of Health
Accessed October 2026
[3] Medicare.gov
“Medicare Hospice Benefits” (booklet, March 2026)
https://www.medicare.gov/publications/02154-medicare-hospice-benefits.pdf
Centers for Medicare & Medicaid Services
Accessed October 2026