Agency & Contact Details Before starting your hospice registration, please verify your email address. Does your medical director hold board certification in Hospice and Palliative Medicine and/or certification from the Hospice Medical Director Certification Board (HMDCB)? Are you a faith-based hospice agency? Select faith-based hospice agency
Service Delivery Who you serve & what services you offer We offer pediatric-specific hospice care We offer neonatal-specific hospice care Experience with concurrent hospice care for veterans and/or pediatric patients? Yes, for pediatric patients Access to telephone and/or video interpreter services? In what clinical setting does your agency provide inpatient hospice care (GIP)?
Does your hospice have access to a hospice house or similar type facility? Yes, contracted and/or partnered with a local hospice house No access or not available in our service area Is your hospice affiliated with or part of a home health care agency?
Coverage area Where do you provide care? How to define your coverage area: Enter ZIP codes where your agency provides hospice services Your coverage zones will appear on the map automatically You can adjust these shapes by double-clicking a border and dragging the pins to refine the area. Alternatively, click the square icon in the upper right corner of the map (above the trash can) to draw a custom coverage area. When you're satisfied with the shape, press Enter on your keyboard to save it. No ZIP codes added yet. Add your first ZIP code to see your coverage area on the map.
MAID & Advanced Therapies Medical Aid in Dying participation and advanced treatment capabilities Medical Aid in Dying (MAiD) If legal and/or allowed in your state, do you participate in Medical Aid in Dying (MAiD)? Select participation level Restrict MAiD visibility? Choose who can see your MAiD information.
Advanced clinical capabilities Select any advanced modalities or capabilities your agency is equipped to offer. This represents your agency's capacity, not a guarantee for every patient.
Access, Infusions & Analgesia
Gastrointestinal & nutrition
Restrict advanced therapies visibility? If left unrestricted, patients and families will also be able to filter hospices by these advanced capabilities.
Clinical programs & outpatient palliative care What programs and therapies do you offer on a day-to-day level? Complementary Therapies Offered
Outpatient palliative care Do you provide outpatient palliative care services? What sort of outpatient palliative care services do you provide? If you provide symptom management as part of your outpatient palliative care program, does your team primarily prescribe medications? No, we provide recommendations to the primary care provider 