Is Hospice Now Just a Big Business? How to Advocate for Change and Find a Not-For-Profit Alternative

One of the worst moments in life is when the doctor advises to call hospice for you or your loved one.  Inside, you panic.  This is navigating a new unknown.  The end is now close, and no one wants to contemplate this inevitable.

Hospice care is supposed to be specialized, compassionate care for individuals with terminal illnesses (generally less than six months to live) that is supposed to prioritize quality of life, comfort, and dignity over curative treatment. Supposed to be provided by an interdisciplinary team—often at home—it is supposed to manage pain and symptoms while offering emotional and spiritual support for both patients and families.

After having an experience with hospice care for my mother in 2005 that was caring, understanding, and responsive, a local not-for-profit hospice, and a horrific for profit hospice experience with my dying husband in 2023 that was a branch of a national company, both home care hospice services, I was not surprised to see the editorial in the New York Times Saturday, March 7, 2026, “Our Hospice System Subverts the Very Point of Hospice Care: Families have to bear far too many responsibilities when caring for loved ones,“ by Dr. Sandeep Jauhar, a cardiologist who writes about his dying father receiving awful hospice care.

I felt the title said it all.

However, he explained the reason so that I understood it, again even being a medical doctor while taking care of his dying father, who was ostensibly in hospice:

“The main problem was funding. In 2024 the average per patient Medicare payment in hospice agencies was about $200 a day, with an annual cap of $33,500. That outlet would barely pay for a part-time aide, yet it also needed to cover medications, medical equipment, and nurse visits. So hospice agencies are forced to shift the bulk of responsibilities to families as the dying process unfolds over weeks or months. . . .”

“Ironically, we could have put my father in an acute care hospital bed costing $3000 a day without any pushback from Medicare. The Medicare hospice benefit is supposed to provide a cost-effective alternative at home to expensive end of life care in hospitals. But by providing so little funding, Medicare often makes hospice care an unviable option.” (emphasis added)

 Dr. Sandeep Jauhar describes how the three principles for which hospice care was created are compromised, instead of relief of physical pain, preservation of dignity and respect for the psychological and spiritual aspects of death, he tells the truth, that the care responsibilities that lay people are required to undertake are overwhelming at a time when we are also grieving in the last days of our loved one’s life.

Personally, in my own experience with my dying husband in 2023, I complained to the hospice administrators. I complained to my husband’s doctors. My husband was dying and I could not get a hospice doctor to come to the house to ease his way, as only the hospice doctor can authorize an increase or change in pain medication. You can imagine my great distress spending literally hours upon hours trying to get him the care he needed. He lay in pain and I was inadequate to properly administer oral morphine and enough to keep him out of pain.

Please don’t wait to just complain when you are in over your head while your loved one is dying, when you are supposed to have the assistance of hospice. Remember, this editorial is written by a cardiologist. I was just a wife.

So, this is where our advocacy comes in, following his advocacy and seeking us to write and call and complain not when we need the hospice service, but before we do.

Remember the saying, “nothing is certain except death and taxes?”

Waiting until you need hospice service is putting your head in the sand.

Dr. Sandeep Jauhar, the cardiologist who writes about his own dying father, says:

“Compounding all these issues is the fact that dying in America is increasingly corporatized. Today, about 3/4 of hospice agencies are for profit, and many are owned by private equity companies. It is hardly a stretch to imagine that many of these companies scrimp on care to protect their bottom line.”

What should we ask for?

Here is a sample letter to copy and send to your Senator and Representative and how to contact them:

Dear [Congressperson or Senator]  _____,

Re: Mandating Medicare Hospice Funding Changes and Requirements

I am urging you to address the growing corporatization of hospice care, where nearly three‑quarters of agencies are now for‑profit and many are owned by private equity firms.

This profit‑driven model too often results in reduced staffing, fewer clinical visits, and inadequate end‑of‑life support for vulnerable patients.

The care responsibilities that lay family members are required to undertake are overwhelming at a time when we are also grieving in the last days of our loved one’s life.

Please take action by:

• Increasing Medicare’s hospice budget,

• Requiring a minimum of eight in‑person care visits per week, and

• Mandating regular physician or nurse practitioner visits that increase as death nears, ensuring timely symptom management and appropriate medication adjustments.

These steps are essential to protect the dignity and comfort of dying Americans.

Sincerely, 

[Your Name and Address]

How to Contact Your Senators and Representative:

1. Go to www.senate.gov/senators/senators-contact.htm to find and message your two U.S. senators.

2. Visit house.gov
 to locate and email your House member.

3. You can also call the U.S. Capitol Switchboard at (202) 224‑3121 to be connected directly to any office.

Find one of the approximately quarter of hospices that are not-for-profit according to Dr. Sandeep Jauhar that may be in your area.

As I was writing this blog post, I received word that a dear long (we never say old) friend was going to enter hospice, and using Catholic Hospice available locally in South Florida, not that either she nor her spouse are Catholic, and tell me, in fact, the not-for-profit hospice has a great rabbi.

Not for profit hospice still exists! Faith based non-for-profits exist. Here are a few:

Catholic Health Services.  

In South Florida 954-484-1515.

L'chaim Jewish Hospice Service (Miami-Dade/Broward): is a program of Catholic Hospice)   954-484-1515.

MorseLife Hospice & Palliative Care (Palm BeachCounty)  In Palm Beach County (561)268-0854

I discovered that the local not-for profit hospice that took care of my mother, Hospice By the Sea, has folded into another not-for-profit hospice:

Trustbridge Hospice Care (Regional): A community-based, non-profit organization.  Recognized by the National Institute for Jewish Hospices.

(561) 848-5200 Toll Free: 441-4040

Compare them for yourself and look for not-for-profit hospices in your community before you need them.

Save the not-for-profit hospices as contacts in your personal telephone directory.  When the doctor suggests a branch of a national for profit hospice, say, “no thank you,” with

Joy,

Mema