When facing a terminal illness or age-related decline, hospice steps in to alleviate some of the stress and anxiety placed on the patient and their loved ones. The hospice process involves ensuring that patients receive quality care and comfort during their final days.

This type of care differs from other areas—it’s focused on treating the person, not attempting to cure what can’t be cured. Hospice brings kindness, dignity, and comfort to these final moments in life.

The goal of hospice is providing a comfortable experience to patients in their last moments. It’s more about caring and comfort—not curing. The role of the hospice administrator is similar to that of a hospital administrator but on a smaller scale.

If you’re interested in healthcare administration, but want to feel like you’re making a difference, the hospice administrator path may be well worth pursuing.

What is Hospice Administration?

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Where hospice nurses provide care and compassion in the trenches, the role of the hospice administrator is more on the macro scale. These people work to put together programs that ease the end-of-life process for patients and their families.

Hospice administrators involve managing the hospice team—which includes physicians, nurses, social workers, and the services each group provides. Additionally, things like religious services, volunteers, and therapy. In other words, this person is responsible for coordinating all that goes into making sure patients receive the best possible end of life care.

Hospice administrators are responsible for coordinating general inpatient care, home-based care, and continuous home care. At the top level, administrators must implement a care philosophy for the terminally ill. As such, they’ll need a background in ethics, finance, and standards of care. Compassion helps, too.

According to the National Hospice and Palliative Care Organization, there are upwards of 6,000 hospice facilities operating in the US. Hospice administrators are tasked with overseeing hospice programs across all 50 states.

Most hospice programs are independent, while others are part of a nursing home, a hospital system, or a home-based care agency. This career path works for nurses who want to work in administration, as well as those with a background in healthcare administration.

Education Needed

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Becoming a hospice administrator generally requires a bachelor’s degree from an accredited university or a college. You may find entry-level positions with an associate's degree, but it may be more challenging to get started on your career path.

Often hospice administrators start their career as registered nurses, but undergrad degrees in other areas of study may also be a good starting point. Health administration, business administration, finance, and human resources are all viable options.

Bachelor’s Degree

If nursing isn’t for you, a bachelor’s degree in healthcare administration may be your best bet. This area of study covers the full spectrum of the business end of healthcare. So, you’ll likely include the following:

  • Healthcare delivery
  • Legal and ethical issues
  • Information system
  • Finance
  • Health planning
  • Management

Internships in a hospice setting can be especially helpful for those seeking hands-on experience in this setting. This role differs from traditional hospital admin, it’s often in a smaller facility and focuses on palliative care.

Master's Degree

While there are plenty of opportunities to start your hospice administration career with a bachelor's degree, a master's will open the door for more opportunities in this field. Ideally, you'd go after a degree in health administration--which will cover a mix of healthcare courses and business, aimed at preparing graduates for advanced roles in healthcare administration.

Most candidates entering a master’s in healthcare administration program do have some background in clinical and non-clinical environments.

Courses usually include:

  • Long-term care administration
  • Healthcare program evaluation
  • Policy issues
  • Healthcare information systems
  • Staff management
  • Ethics and laws

Additionally, elective courses allow candidates to focus on specific areas, while internships and a thesis present an opportunity to specialize in hospice administration—over hospital admin jobs or in the healthcare benefits industry.

Healthcare administration is a major that focuses on the broader picture of the business of healthcare. As such, you'll want to pick and choose opportunities to concentrate on hospice work.

It’s also worth noting that in some states, you may need to have a state nursing license. Hospice administration is a viable option for people who have completed a nursing program or have a bachelor’s degree in hospice administration. There are some jobs available for people who only have a bachelor’s degree but getting your master’s degree opens more doors for higher paying positions.

While a master's degree in health administration is the standard among top-ranking hospice professionals, some alternative degree paths will land you similar opportunities. You can pursue a Master of Business Administration (MBA), a Master's of Public Health (MPH) or a Master's of Public Administration (MPA).

An MBA will be centered more on finance, marketing, and management, while an MPA or MPH will focus more on policy and legal issues.

Still, a master's in health administration may best prepare students for this unique role in hospice administration. This degree is focused on creating competent leaders with a strong foothold in health administration, clinical issues, marketing, economics, quality control, information systems and healthcare laws.

Additionally, many master's programs in health administrations target mid-career professionals and working adults seeking to advance their job prospects.

Many of these programs also include a capstone project, designed to allow students to apply their recently acquired knowledge to a contemporary topic in health administration.

Possible Roles in Hospice Administration

There is a wide range of possibilities in the field of hospice administration—whether you’re a nurse or a business person. As a point of reference, job titles might vary based on the size of the facility—and your career level. Some possibilities: hospice branch manager, director of operations, hospice director, administrator, etc.

In other cases, you might find work in a specific department. Some administrators work in volunteer recruitment or bereavement counseling. Those with a nursing background might find a job as a case manager or as head of a department.

A look at what you can expect from a job in hospice administration:

Administrator

As a hospice administrator, you manage the programs and care provided to hospice patients. In this role, your job is to recruit and hire hospice staff, plan internal policies, and evaluate the facility’s services. Additionally, you’ll be responsible for raising money, managing staff, and setting up volunteer programs.

An administrator with experience will be in charge of the whole facility, while those starting out might manage a specific department or work as an assistant, in billing, or with volunteers.

To further your career as a hospice administrator, you may need a master's degree in healthcare administration or several years’ experience with a bachelor's degree. Your role is similar to that of a hospital administrator. The aim here, being, to make sure financial goals are met, resources are being allocated, and that a competent staff is taking care of patients—from the paperwork process to things like grief, religious services, and volunteer programs.

That said, if you want to prove your competency on a grander scale, you could go for an admin credential. There are a couple of professional associations that provide these designations, more on that below.

Volunteer Coordinator

Hospice volunteer coordinators work to recruit volunteers and outline the role and responsibilities of volunteer staff. As a coordinator, your purpose is to develop volunteer training programs that meet the professional standards of hospice care. You'll select volunteers, assigning tasks that align with their interests, and oversee their job performance, ensuring they remain in compliance with rules and regulations.

Resident Case Manager

A registered nurse, may too, choose a path in hospice administration. As a resident case manager, you’ll assess the care given to patients and act as a liaison between family members and the hospice administration.

Instead of working as a hands-on nurse, your job is to oversee a team of nurses, ensuring that they meet certain quality and regulatory standards. Still, you’ll also need to be on-hand for intakes, medication, and rotations.

This role is ideal for someone who already has a career in healthcare but wants to work in an in-between place—part admin, part nurse. Additionally, there are plenty of certifications available to nurses who wish to advance their career. See below for details.

Certification and Continuing Education Requirements

Some administrators may choose to further their education by getting certified through the National Board for Certification of Hospice and Palliative Nurses or the National Board for Home Care and Hospice Certification (NBHHC).

NBHHC Certification

Not everyone is eligible to become a certified hospice administrator. In many cases, you’ll need to have achieved a certain level of education—a bachelor’s or master’s degree—combined with a certain amount of professional experience.

For example, the NBHHC requires candidates with a bachelor’s degree to have five years of hospice management experience or one year of experience working as a hospital administrator. Those with an associate’s degree must have even more experience under their belt—two years in hospice management or seven in an administrative role.

Exam

Once you’ve determined whether you’re eligible for certification, you’ll need to pass an exam. Hands-on experience will prepare you for many of the questions, but you’ll need to spend a considerable amount of time studying. Topics included on the exam include ethics, human resources, planning, management, financial planning, and state/federal regulations.

NBHHC Recertification Process

The NBHHC certificate must be renewed every two years. To get recertified, you’ll need to be actively employed and complete continuing education credits.

CHPCA Certification

Administrators may opt to pursue certification through the National Board for Certification of Hospice and Palliative Nurses as a way to demonstrate their expertise.

The Certified Hospice and Palliative Care Administrator (CHPCA), which has since been discontinued, was another option for administrators. The test served to demonstrate the following:

  • Leadership skills
  • Hospice ethics
  • Financial management
  • Human resources
  • Quality control
  • Operations
  • Community involvement
  • Compliance standards

We mention this certification because professionals who have been certified in the past can renew their license through another organization, the Hospice and Palliative Credentialing Center.

The HPCC is in charge of issuing certifications to hospice nurses looking to advance their career. While this designation isn’t created with the admin track in mind, it may help nurses gain some additional experience so they can further their career.

Licensing

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Hospice administrators do not need a license to work in their field. However, all hospice facilities need to have a state license. Hospices must meet a particular set of standards, which vary by region.

However, most states look for the following criteria when licensing a facility.

  • Volunteer programs
  • Bereavement programs
  • Counseling and therapy
  • Nursing staff
  • Inpatient care
  • Social services
  • Home services

In some cases, such as in South Carolina, a hospice facility must employ an administrator with a bachelor’s degree in a relevant area of study. All states require a license, while only some require a certificate of need. CHAP lays this out here.

CHAP licensing likely won’t be relevant at the lower levels, but if you’re running a facility or plan to open your own, site visits, and documentation will be concerns. The organization requires a considerable amount of literature. Some of what they’ll need:

  • Policy and procedures manual
  • Admission packet
  • Operating costs
  • Insurance coverage
  • Contracts
  • Patient list
  • Staff list
  • Strategic plan
  • And more

Salary and Career Outlook

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All signs point to a solid career in hospice administration. At the entry level, a hospice administrator can expect to earn an average salary of $80,000 per year, though that total accounts for bonuses, overtime, and tips. Administrators with 5-10 years of experience can expect to receive a slight bump in pay—an average of $83-$87k per year.

A Hospice Administrator with 20+ years of experience can expect to earn between $90k and $100k.

Graduates with a master’s degree may be eligible for several opportunities at the entry and mid-level--depending on the facility.

With an aging population, more and more hospice care is bound to be in demand. As such, a career in hospice administration is a promising career, one with plenty of growth potential.