Hospice Administrator - A Day in the Life


Hospice administrators oversee the operations of a hospice agency. While a nursing home or a long-term care facility will focus on patient longevity, hospice services are provided to people who are believed to be in their last six months of life. As such, the care here is less about prevention and recovery—and more about comfort and peace of mind.

Rather than seeking out cures, the hospice philosophy prioritizes the concept of care. Hospices are dedicated to supporting the patient, and the patient’s family, in their physical, mental, emotional, spiritual, and social needs. Hospice administrators, therefore, are experts at managing end-of-life care, taking into account both pragmatism and compassion.

Due to the demographic warp of the aging Baby Boomer generation, hospice facilities and hospice administrators, are expected to be in greater demand in the near future. As part of the broader category of medical and health services managers, the Bureau of Labor Statistics expects jobs in this field to grow 20 percent between 2016 and 2026—a rate that’s almost triple the national average for all professions.

Everyone deserves to die with dignity. And while that may be a topic that the average person spends most of their time avoiding, it’s something that hospice administrators dedicate their lives to achieving. This requires a careful balance of technical knowledge and compassionate understanding. Read on to get a glimpse into a day in the life of a hospice administrator.

Work Environment of Hospice Administrators

While hospice care can take place in a patient’s personal residence, a nursing home, or a long-term care facility, the majority of hospice programs are independent agencies. Other hospice programs are considered a part of a specific nursing home, home health agency, or hospital network. In each instance, a hospice administrator’s personal base of operations will be an office. But nearly 80 percent of hospices have fewer than 500 admissions in a year, meaning that most hospice administrators will retain a personal touch in their daily responsibilities.

Clinical Team

A primary responsibility of a hospice administrator is to oversee a hospice facility’s staff. End-of-life scenarios require a true concert of different specialties and in the course of their work, hospice administrators will interface with social workers, spiritual counselors, nurse practitioners, dieticians, and pharmacists, among others. Hospice administrators’ responsibilities include fostering collaboration between these different groups.

Typical Daily Responsibilities

The main role of a hospice administrator is to run a very delicate and compassionate business. On a purely administrative level, this includes overseeing financial operations and staff specifics. Management is a critical part of the hospice administrator position and they’ll need to maintain a supply chain of sanitation equipment, medical devices, food, staff, and medicine. In each of these avenues, a hospice administrator must keep the bottom line as well as strategic goals in mind. Even though the stakes are human, hospice care is, ultimately, a business—and one that hospice administrators need to be adept at running.

Some typical daily responsibilities of a hospice administrator include:

  • Implementing new organizational policies
  • Developing a budget to match operational strategies
  • Authorizing new expenditures
  • Coordinating communication between patients, families, and staff
  • Ensuring a hospice facility’s compliance with local, state, and federal regulations
  • Managing a supply chain of medicine, food, sanitary supplies, and medical devices
  • Assigning work schedules
  • Recruiting, hiring, firing, training, and disciplining hospice staff

No two end-of-life scenarios are identical. A hospice administrator must ensure that the staff is attending to the individual needs of both the patient and the patient’s family. The balance between administrative obligations (to financial and management issues) and humanitarian obligations (to compassionate communication and intra-staff collaboration) requires repeated recalibration and a solid educational background.

Required Skills and Knowledge

While it’s not a universal requirement, almost all hospice administrators will have at least a bachelor’s degree in an area like healthcare administration, business administration, or finance. And it’s becoming increasingly common for hospice administrators to pursue graduate education, such as a master of healthcare administration (MHA) or a related graduate healthcare degree. It’s at this stage that hospice administrators learn the intricacies of complex, industry-specific topics like healthcare finance, health law, health informatics, and marketing. It’s also possible to concentrate an MHA in specialized topics related to hospice care.

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There are some skills a hospice administrator needs that can’t be taught in the classroom. Compassion is the most precious resource in hospice care, as dealing with end-of-life issues never gets easier—and if it does get easy, that can be a symptom of compassion fatigue.

Other skills, however, can be taught and learned over time; communication skills, for example, are at a premium in hospice administration. This is a role that requires delicate conversations about serious issues and also requires having those conversations with a number of people from different personal and professional backgrounds. Hospice administrators are responsible for running a business, but they can never lose sight of their product: providing compassionate care for those at their most fragile.

Certification for Hospice Administrators

While hospices must be licensed in the states in which they operate, hospice administrators themselves do not need state-level certification or licensure. Voluntary certification, however, can be both professionally appealing and personally rewarding. While several designations have been retired over the years, the gold standard of professional certification for hospice administrators is still the National Board for Home Care and Hospice Certification (NBHCC).

The NBHCC offers three different levels of certification for hospice administration: certified hospice manager (CHM), certified hospice administrator (CHA), and certified hospice executive (CHE). The application fee and the exam fee cost a total of $598.

  • The CHM certification is for staff moving into higher leadership and management roles at smaller agencies. Candidates for the CHM certification need at least one year of experience as a manager in a hospice environment.
  • The CHA certification is for senior staff in a hospice environment, who have either worked as an administrator for one year or have worked as a manager for five years.
  • The CHE certification is for senior administrators who have at least three years of experience in a medium to large size agency.

For each certification, a bachelor’s or master’s degree is preferred; applicants with only a high school diploma or associate’s degree will need to show proof of additional work experience. Once deemed eligible, a certification candidate must pass a two-hour, 80- to 100-question exam.

Those who hold an NBHCC designation must recertify every four years by showing proof of employment for 12 out of the last 48 months, as well as completion of 50 contact-hours of professional development. These hours must be split between community support activities and continuing education. The renewal fees total $398.

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