Can someone on hospice stay in their care home?

Can someone on hospice stay, or move in?

Yes. A care home with the state’s hospice care waiver may keep a resident who starts hospice care, or accept a new resident who already receives it. Title 22 §87632(a)

7,996 of the 8,620 licensed homes in California have a hospice care waiver on the state record (CDSS records, November 12, 2026).

A home without the waiver must have the state’s approval before it accepts or keeps a resident on hospice. The department’s notice to homes says so:

What approval does the home need?

The approval is the hospice care waiver, granted by the California Department of Social Services. A home cannot give it to itself.

The department approves a request only when the home shows it can meet the care needs of residents who are terminally ill. The home must also be willing to add care staff if the hospice care plan calls for it. Title 22 §87632(c) The department answers a request within 30 days. Title 22 §87632(e)

Every home’s page on Covelight shows whether a hospice care waiver is on the state record. “Not on file” means the record we hold does not say, so ask the home.

Who pays for what?

For someone on Medicare, Medicare pays the hospice. It does not pay the care home’s own monthly charge, which covers the room, meals and the home’s care.

Hospice care

$0Medicare.gov, 2026

Drugs for pain and symptoms

Up to $5 for each prescriptionMedicare.gov, 2026

Respite care in a facility

5% of the Medicare-approved amountMedicare.gov, 2026

The care home’s monthly charge

Not paid by Medicare hospiceMedicare.gov

Ask the home in writing whether its monthly rate changes when hospice care starts.

What must happen before hospice care starts?

The state sets the order. Each step below comes from Title 22 or the Health and Safety Code.

1. 1

   Step 1: The resident chooses a hospice

   First

   The resident, or the person who makes health care decisions for them, arranges the hospice directly. The home cannot sign up a hospice for them. The hospice must be licensed by the state and certified by Medicare. Title 22 §87633(a)(3)

2. 2

   Step 2: The resident signs a written request

   On admission, or when hospice care starts

   The request asks the home to accept or keep them while they receive hospice care. Their health care decision maker may sign it. Title 22 §87632(d)(1)

3. 3

   Step 3: Everyone agrees to the hospice care plan

   Before hospice care starts in the home

   The hospice writes the plan: the care it adds to the home’s own care. The home and the resident, or their decision maker, agree to it first. Title 22 §87633(a)(4)

4. 4

   Step 4: Roommates agree

   Before hospice care starts in the home

   Anyone who shares the room agrees to let the hospice caregivers in. Health and Safety Code §1569.73(a)(6)

5. 5

   Step 5: The home tells the state

   Within 5 working days of hospice care starting

   The home writes to the department with the resident’s name, the date they moved in, and the hospice’s name and address. Title 22 §87632(d)(2)

Can the home care for conditions it usually can’t?

Title 22 lists health conditions that a care home may not accept or keep, such as stage 3 and 4 pressure injuries, gastrostomy and naso-gastric tubes, and tracheostomies. Title 22 §87615(a)

There is one narrow path for a resident on hospice. A home with the waiver does not need a separate exception from the state when the resident is terminally ill, receives hospice care, and the hospice care plan covers the treatment of the condition. Title 22 §87616(c)

This is not a home’s own permission to keep anyone. Without all four, the usual rules apply. A home that accepts or keeps residents with these conditions must also help them get home health or hospice care. Health and Safety Code §1569.39(a)

What if their condition changes?

If the hospice, the home or the resident decides that staying would put the resident or others at risk, the home may start a transfer. Health and Safety Code §1569.73(b)

An urgent move to a hospital or nursing home is decided together: by the department, the resident or their decision maker, the hospice, a doctor and the home. Title 22 §87224(i)

For the other reasons a home may ask someone to leave, and the notice it must give, see your right to stay in a care home.

Does the home have to call 911?

Not always. A home with the waiver may call the hospice instead of emergency services when all three of these are true Health and Safety Code §1569.73(c):

• the resident receives care from a licensed hospice;
• the resident has an advance directive that asks to forgo resuscitation;
• the hospice has trained the home’s staff on what to expect as the illness progresses.

Give the home and the hospice each a copy of the advance directive, and ask them how they will handle an emergency.

What should we ask a home?

Ask before hospice care starts, or before the move. A home’s answer in writing is worth keeping.