Referral Guidance
Hospital discharge to hospice in Dallas-Fort Worth
A practical guide for families and discharge planners coordinating hospice after a hospital stay, including referrals, equipment, and home setup.
A hospital discharge to hospice should give the patient a clear care plan, needed equipment, medication guidance, and a team the family can call after leaving the hospital.
Families often hear about hospice during a hospital stay, when decisions feel urgent. The patient may be weaker, treatment may no longer be helping as hoped, or the care team may recommend focusing on comfort. In that moment, the family needs practical steps more than general language.
Hospice can often begin after discharge to a private home, assisted living community, memory care community, nursing facility, or other care setting. The important part is coordination.
What needs to be coordinated
Before discharge, families and discharge planners should clarify:
- Where the patient will go after leaving the hospital
- Who will be present when the patient arrives
- What equipment is needed, such as a hospital bed, oxygen, wheelchair, or supplies
- Which medications are needed for comfort and symptom management
- Who signs hospice consents if the patient cannot
- Which physician information and clinical records are available
- Who the family calls if symptoms change after discharge
Hospice coordination works best when those questions are answered before the patient leaves the hospital.
What families should ask the hospital team
- Is hospice being recommended now, or should we ask for a hospice evaluation?
- What diagnosis or decline pattern is driving the recommendation?
- What records will be sent to hospice?
- What medications should continue after discharge?
- What equipment should be delivered before the patient arrives?
- Who should the family call first after the patient gets home?
What happens after the referral
After a hospice referral, the hospice team may review clinical information, speak with the family or responsible party, coordinate with the hospital or facility, and plan the first visit. If hospice begins, the care plan focuses on comfort, symptoms, medications, supplies, equipment, and family teaching.
The family should ask how quickly the first visit can happen and what number to call after hours.
Discharge to home or a facility
If the patient is going home, the family may need help preparing the room, understanding medications, and knowing when to call. If the patient is returning to assisted living, memory care, or a nursing facility, hospice coordinates with facility staff while also supporting the family.
Room and board or facility charges may be separate from hospice coverage, so families should ask what is covered and what remains separate.
How Caritas Hospice can help
Caritas Hospice works with families, physicians, discharge planners, and facility teams in Dallas-Fort Worth to make referral steps clearer. If a hospital team has mentioned hospice, call or use the referral page so Caritas can explain what information is needed and how the next step works.
What should be ready before the patient arrives
The safest discharge plan is practical. The family should know where the patient will rest, how transfers will happen, which medications are available, and what number to call if symptoms change. If equipment is needed, ask whether it should arrive before the patient leaves the hospital.
Families should also ask whether the first hospice visit is planned for the same day or shortly after arrival. Timing matters when the patient is weak, short of breath, in pain, confused, or actively declining.
Questions for discharge planners
Discharge planners can help the transition move faster when they send complete information. Helpful documents may include the current diagnosis, recent physician notes, discharge summary, medication list, insurance information, and any advance directive or responsible-party information available.
If the patient is going to a facility, the discharge planner should also clarify which facility contact will receive the patient and how hospice should coordinate with that team.
Avoiding a rushed discharge
Families can feel pressure to make quick decisions. It is reasonable to ask for plain answers: what is the goal of care now, what services will start after discharge, what symptoms should be expected, and what should the family do if the patient changes overnight?
Hospice discharge planning should reduce confusion. If the family does not know who to call, what medications are being used, or whether equipment is ready, those questions should be answered before discharge whenever possible.
About this guide
Written by Caritas Hospice Editorial Team
Published July 10, 2026
This article is for general educational information and does not replace medical advice or an individual hospice eligibility assessment.