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Medicare Requires Hospice To Use Volunteers

Medicare Requires Hospice to Use Volunteers

Many people are surprised to learn that Medicare, as a condition of participation, requires certified hospice agencies to recruit, train, and use volunteers in their hospice operations. Surveys suggest using volunteers elevates the level of service in hospice. What’s more, hospice has become a wonderful volunteer opportunity for adults of all ages. Many people have experienced first-hand the positive impact on families that hospice can have. They, in turn, become inspired to be part of that and to help other families who are going through similar hard times. However, not all hospice volunteer work needs to be direct family interaction. There are many ways volunteers help at hospice agencies. Ready to learn more?

What Are Medicare’s Volunteer Requirements for Hospice?

To be allowed to bill Medicare, a hospice agency must work with volunteers. Not all agencies let their volunteers participate in direct patient-care roles, though.

  • Agencies must have at least one employee designated as a volunteer supervisor.
  • The agency must recruit volunteers.
  • The agency must provide training for volunteers.
  • Volunteers must be used in day-to-day administrative and/or direct patient-care roles.
  • Hospice agencies must document the cost-savings achieved using volunteers and report to Medicare annually.
  • The minimum allowed amount of volunteer hours is 5% of total patient-care hours of all paid hospice employees.

Sources: Medicare’s conditions for participation of hospice agencies can be found in the Code of Federal Regulations Title 42, Section 418, with further clarification in CMS Manual, “Publication 100-07 State Operations Provider Certification.”

Volunteers Improve Family Satisfaction with Hospice Care?

One might think that using volunteers instead of strictly professional labor may compromise the quality of the work. The opposite appears to be true. Eve Block, MD (Brown University) and colleagues analyzed the records of 305 hospice programs. Their work is published in the Journal of Pain and Symptom Management. They found that the more a hospice agency used volunteers in direct patient care, the more likely families were to rate the overall care as excellent.

How Hospice Volunteers Help

Hospice volunteers can help in a wide variety of ways including direct services to patients or their families and support work for the office. Here are a few examples.

Direct Family/Patient Care

  • Sitting with a dying person and tending to requests to give a break to family
  • Household chores
  • Shopping
  • Transportation (if the specific hospice is allowed by insurance and regulations to let volunteers do that)
  • Companionship, art projects, and pastime activities for the patient
  • Helping the patient make a life journal
  • Mowing the lawn
  • Walking the dog
  • Companion vigils


  • Helping with donations drives and fundraising
  • Helping set up at special events such as wellness screenings
  • Answering phones and filing
  • Helping with mailings to patients
  • Running office errands

Even people with no direct experience can be helpful to families with a dying family member. If volunteers have applicable expertise, that can be used as well. For instance, a legal professional can help with power of attorney documents, a certified therapy dog team can volunteer to visit homes, a counselor can volunteer to provide emotional support, a landscaper can volunteer for lawn mowing, etc.

Requirements/Qualifications for Hospice Volunteers

While being a hospice volunteer is a great activity for adults of all ages, there are a few requirements that must be met.

  • Age 18 or older
  • Pass a criminal background check (for all volunteers with access to patient records or direct patient contact)
  • The hospice agency must test volunteers for tuberculosis
  • Complete the agency’s volunteer training program


Hospice agencies would do well to enhance their services with more recruitment and coordination of volunteers. For people looking to do something positive with some of their free time, hospice volunteerism is always in demand. New hospice volunteers often note being surprised at how much the families appreciate their help and the big impact a little volunteerism can make.