For hospice owners and administrators
Hospice marketing for hospice referrals you control: families who call you directly.
We run Google Ads and local search for hospice providers so that families searching for hospice care in your service area find you and call you directly. Covered by a 60-day money-back guarantee.
- A referral source that does not depend on one hospital or liaison.
- Reporting in your units: inquiries and admissions, not impressions.
- A dignified search presence. No gifts, no pressure, no solicitation.
Free and without obligation. Any engagement that follows is covered by a 60-day money-back guarantee.
Free assessment, no obligation
Request your Referral Growth Assessment
Tell us where you serve. We review your Google visibility and local search demand, then walk you through the findings.
01Finding
A census built on three referral sources is a census you do not control.
Where did last quarter's admissions come from? If the honest answer is a short list, two or three hospitals, a few facilities, a handful of physicians, those relationships are valuable. They are also owned by someone else. A discharge planner's shortlist changes, a health system forms a preferred network, a liaison resigns, and the census moves within a quarter, before the budget can.
When the institutional referral arrives, it often arrives late. The median hospice stay among Medicare decedents was 19 days in 2024, and one patient in four was enrolled for five days or less.1 More than a quarter of hospice decedents enroll only in the last week of life, in part because some physicians delay the conversation until death is imminent.2 Among 78,647 decedents of one national hospice chain, more than half of referrals came from hospitals, and 55.6% of those patients died within seven days of admission, against 28.9% of patients referred from the community.3 The largest referral source is also the latest.
There is a second pathway. Patient self-referrals are inquiries that come directly from a patient or family, by phone or online, with no physician, hospital or facility referral in between. Anyone can call a hospice to begin the conversation; the hospice then assesses eligibility with the patient's physicians.4 Families are not required to choose the hospice a physician, hospital or nursing home recommends.5 The pathway is permitted, it is used far less than the hospital pathway,3 and it belongs to whichever hospice a family can find. Building it on purpose is the whole of our work.
-
19 days.
Median hospice length of stay among Medicare decedents, 2024. One in four was enrolled for 5 days or less; one in ten for 2 days or less.1
MeaningHalf of Medicare hospice decedents received less than three weeks of care. A quarter received less than a week.
-
More than 1 in 4.
Hospice decedents who enroll only in the last week of life.2
MeaningMedPAC attributes short stays partly to physicians who delay the hospice conversation. The delay begins before the referral is written.
-
55.6% vs 28.9%.
Hospital-referred patients who died within 7 days of admission, compared with community-referred patients, among 78,647 decedents of a national hospice chain (19 states, 2012 to 2016). Hospitals supplied 51.9% of referrals.3
MeaningWhere a referral starts is associated with how long a hospice can help. Patients who came from the community had roughly half the rate of very short stays.
02Mechanism
How a family chooses a hospice when no one has chosen for them.
A woman in her fifties has spent months driving her father to appointments. At the last one, a nurse mentions hospice. No referral follows. That evening she does what most adults her age have done with a health question: she looks it up online.6 She types the word hospice and the name of her county.
She wants to know what hospice is, whether her father qualifies, what Medicare covers, and who will answer if she calls tonight. Like nearly a third of adults 50 and older, she knows little about hospice,7 and she may not know she can call one herself.4
Three things decide whom she calls. Which hospices appear for that search in her county. Whether the page she opens answers her questions in plain words. Whether a person picks up. The hospice that is present, clear and reachable receives the call. If none is, she closes the laptop and waits for someone else to raise it. More than a quarter of hospice decedents enroll only in the last week of life.2
This is not a client story. It is the pattern by which patient self-referrals occur.
What changes
-
The conversation starts earlier.
A family that calls on its own is not waiting for a physician to decide the time is right. As the National Institute on Aging puts it, starting hospice early may be able to provide months of meaningful care.8 Timing is felt: in a 2005 national survey of 106,514 bereaved families, 11.4% said the referral came too late, and those families reported more unmet needs and lower satisfaction.9
-
The source belongs to you.
A search presence, a complete Google Business Profile and a plain page for families are assets the hospice owns. They do not resign, join a narrower network or drop off a shortlist.
-
Results are counted in admissions.
Every inquiry is logged by source. Your intake team records which inquiries were admitted, as counts only, and leadership sees it on a fixed reporting schedule.
03Intervention
The Community Pathway Protocol: four components, one service area.
The Community Pathway Protocol is the program we run for hospice providers. Each component is ordinary on its own. The discipline is in running all four for one licensed service area, in a register families can trust, with reporting a hospice executive can act on. Everything runs in your hospice's own name. Spend is paced to your intake capacity, and every engagement is covered by the 60-day money-back guarantee.
-
Intent-Matched Search Advertising
Google Search ads shown to people in your service area who are searching for hospice care.
- Build the keyword set from how families search in your counties (hospice care, hospice at home, how hospice works) and review the actual search terms on a fixed schedule.
- Limit targeting to the counties and ZIP codes you are licensed to serve, with negative keywords that exclude job seekers, vendors, clinicians looking for referral forms and searches for other hospices by name.
- Write ad copy in a calm, informational register, reviewed with your team: no urgency, no gifts, no inducements. No remarketing to people who searched for hospice care.
-
Local Presence Management
Your Google Business Profile and local listings, maintained so that the map and local results show a complete and accurate hospice.
- Verify and complete the Google Business Profile: categories, service area, hours, phone number, description, photographs and the questions families ask.
- Keep your name, address and phone number consistent across the directories Google relies on, and monitor duplicate listings and suggested edits.
- Set up a review-response practice your team can sustain, replying to families with dignity and never confirming or disclosing anything about a patient.
-
The Inquiry Pathway
The page and the phone line that turn a search into a conversation with your intake team.
- Build one dedicated family page that explains, in plain words, what hospice is, who is eligible, what happens after a call and how to reach a person now. Nearly a third of adults 50 and older say they know very little or not much at all about hospice,7 so the page explains before it asks.
- Make the number tappable on mobile and keep the form short, asking only what intake needs, with a request not to include medical details. Campaign calls run through a tracked line that forwards to your intake number, so every call is counted.
- Review answering and after-hours routing with your intake team. An unanswered call is a lost inquiry.
-
Measurement and Review
Reporting in the units a hospice runs on: inquiries, inquiries within service area and admissions, not impressions.
- Count inquiries by source, with job seekers, vendors and out-of-area callers separated out.
- Deliver a written report on a fixed schedule showing inquiry disposition as logged by your intake (eligible, not yet eligible, out of area, non-patient) and admissions attributed to direct inquiries, as counts only. Your intake log stays in your systems.
- Pace spend to your intake and admission capacity in a scheduled review with leadership, and configure measurement so that patient and family information stays out of advertising platforms.
04First step
Begin with a free Referral Growth Assessment.
Before anyone discusses an engagement, you should know three things: how many families in your service area search for hospice care, whether they can find you, and what they see when they do. The assessment answers those questions, on one short call and in writing. It is yours to keep whatever you decide.
What it includes
Service-Area Demand Estimate. Google's own estimates of monthly search volume for hospice-related terms across your counties, so you can see whether paid search is worth running at all.
Google Visibility Audit. Where your hospice appears today, and where it does not, in the map, the paid results and the organic results for the searches families in your service area use.
Competitive Field Snapshot. Which hospices and directories occupy those results now, and how complete your Google Business Profile is next to theirs.
Inquiry Pathway Check. What a family experiences from the search result to the phone: the page she lands on, the number shown, mobile speed and the after-hours arrangement as published.
Prioritized Plan. A short written summary that ranks the fixes and opportunities by expected impact and effort, including what you can do yourself.
05Evidence
The evidence, cited.
We cite sources a hospice board would accept: MedPAC, federal health agencies, national polls and peer-reviewed journals. The figures below describe the market, not our results. We publish no performance figures of our own until we can substantiate them in writing. What we can show is the public record, the method in full, a sample of how we report, and a 60-day money-back guarantee.
By the numbers
-
52.9%.
Share of Medicare decedents who used hospice in 2024, up from 51.7% in 2023 and a new high.10
MeaningDemand is at a record and still rising. The question is which hospice a family reaches.
-
6,706.
Hospices that billed Medicare in 2024, up from 4,840 in 2019.11
MeaningAbout 39% more programs in five years. The family's list of choices grew longer; your place on it is not automatic.
-
27.7%.
Hospice enrollees who entered from the community, in a national Medicare cohort of 7.65 million (2011 to 2018). The community share did not grow as hospice use expanded.12
MeaningThe pathway from home to hospice does not build itself.
-
79%.
Family caregivers who are online health seekers and began their last search at a search engine, in a 2012 Pew survey.13
MeaningThe search box was already the front door more than a decade ago.
Referral Growth Report
Illustrative sample. Not client data.
- Inquiries by source
- Paid search
- –
- Google Business Profile
- –
- Organic search
- –
- Inquiries within licensed service area (count and share)
- –
- Inquiries excluded
- Job seekers
- –
- Vendors
- –
- Out of area
- –
- Inquiry disposition as logged by intake
- Eligible
- –
- Not yet eligible
- –
- Out of area
- –
- Non-patient
- –
- Admissions attributed to direct inquiries (count)
- –
- Calls answered vs. missed; median speed to answer
- –
- Advertising spend billed by Google; advertising cost per inquiry
- –
- Search impression share for hospice terms in service area
- –
- Search terms that produced calls; negative keywords added
- –
- Next-period priorities
- –
06Safeguard
A 60-day money-back guarantee, stated plainly.
Every engagement is covered by a 60-day money-back guarantee. We offer it for a simple reason: a hospice should not have to take a marketing firm on faith, and 60 days is long enough to see how we work. It is a promise about our work and your money. It is not a promise of inquiries or admissions; no one can honestly guarantee what a family decides or what a physician certifies. Full terms are provided in writing before any agreement is signed.
07Indications
Who this is for, and who it is not for.
Who this is for
- Hospice owners, administrators and executive directors whose census depends on a small number of hospitals, facilities or physician practices.
- Directors of business development and marketing who want a search channel that complements liaisons and is reported in inquiries and admissions.
- Hospices whose intake answers the phone, including evenings and weekends, and can respond to a family the same day.
- Leaders, nonprofit and for-profit alike, who want a defined scope, cited evidence and a guarantee in writing before they commit.
Who it is not for
- Hospices looking for a referral broker, a patient list or a pay-per-admission arrangement. We are an advertising and local search firm; families contact you directly.
- Organizations that want promotional tactics aimed at families: gifts, incentives or pressure. We will not run them.
- Hospices that cannot yet staff intake to answer and follow up. More calls will not help until that is fixed, and the assessment will say so.
08Questions
Questions hospice executives ask first.
We already tried Google Ads and it did not work.
The account history usually explains why. Search campaigns go wrong in recognizable ways: ads shown across a whole metro instead of the licensed service area; no negative keywords, so the budget went to job seekers, vendors and clinicians seeking referral forms; clicks sent to a homepage written for referral partners; and no call tracking, so results were judged in clicks. None of these is a reason search cannot work for hospice. They are reasons it was not run for hospice. Share read-only access to the old account and the assessment will show what happened. If demand in your counties is too thin for paid search, we will say so.
Is this compliant? (HIPAA, Anti-Kickback, Medicare marketing rules)
We are a marketing firm, not a law firm; your compliance officer has the final word, and we welcome that review. Ads are shown to people in your service area who are searching for hospice care. No solicitation, gifts, incentives or pressure. Families call your intake team, not us; we take no part in eligibility or hospice election, which rest with the hospice and the patient's physicians.4 There is no government HIPAA certification, so we claim none. Measurement keeps patient and family information out of advertising platforms, and we build no advertising audiences from people who searched for hospice care.
How is this different from our liaisons and referral marketing?
Liaisons build professional relationships: discharge planners, physicians, facility administrators. Keep them. This program builds the other channel, the family who searches for hospice care and contacts you directly. The two do not compete. A liaison cannot be in the search results at nine in the evening, and a search campaign cannot sit across a desk from a case manager. There is one structural difference. Professional relationships tend to follow the person; when a liaison leaves, the referral source may leave too. A search presence, a Google Business Profile and a family-facing page belong to the organization and keep working through turnover.
How soon will we see inquiries?
We will not give you a number, because an honest answer depends on your service area, your budget and your intake. Paid search can begin showing ads within days of launch, so the first inquiries can arrive early; the early weeks are spent tightening targeting from real search terms. Google Business Profile and local search gains build more slowly, over months. Admissions lag inquiries, because a family's call starts a clinical process: eligibility, physician certification, the family's own timing. That is why the guarantee runs 60 days rather than a week. We do not forecast inquiries or admissions, and we are wary of anyone who does.
What does the 60-day guarantee cover?
It is a 60-day money-back guarantee on our services. Full terms are provided in writing before any agreement is signed, and we encourage you to read them, and show them to counsel, before you decide. We will not paraphrase the terms here, because a guarantee is only as good as its exact wording. We will say what it is not. It is not a promise of a number of inquiries or admissions; no honest firm can guarantee what a family decides or what a physician certifies, and a refund tied to referral counts would raise the compliance questions we exist to avoid.
Do we have to replace our website?
Usually not. Hospice websites are often written for referral partners and regulators; a family in a hard week needs something simpler. We build one dedicated page for families, with plain answers and a prominent phone number, and send search traffic there. It can live on your current site or alongside it. Google Business Profile work does not depend on your website at all. If your site has a problem that would undermine the program, such as loading slowly or being hard to read on a phone, the assessment will say so and rank it against everything else. A full rebuild is a separate decision, made on its own merits.
What does it cost?
We quote in writing after the assessment, because the right scope depends on your service area, the search demand in it, and how many counties and care settings you serve. A hospice serving three rural counties and one serving a metro area are unlikely to need the same program. You see the quote, together with the guarantee terms, before you sign anything. Whatever the scope, families contact you directly; we do not select, screen, steer or refer anyone. We do not publish a price here because we do not quote one before we understand the market.
We are a small or new hospice. Is this for us?
Possibly, and the assessment exists to answer that. Two things matter more than size. First, is there enough search demand in your service area to justify paid search? A small hospice in a county with modest search volume may find that a complete Google Business Profile and a clear family page do more than ads, and the assessment will say so. Second, can your intake answer calls, including evenings and weekends, and respond to a family the same day? A small hospice with a responsive intake can do well; a large one with an unanswered phone cannot. Either way, you keep the plan.
09Next step
Build the referral source your hospice controls.
Request the free Referral Growth Assessment and see, in writing, what families in your service area search for and where your hospice stands today. If the numbers support a program, we propose one under the 60-day money-back guarantee; if they do not, you keep the plan.
Request a Free ConsultationFree. No obligation. About 30 minutes of your time, and a written summary you keep.
Sources
- Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy, Chapter 10: Hospice services. March 2026. pp. 294, 303; Figure 10-1, p. 304. https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch10_MedPAC_Report_To_Congress_SEC.pdf
- Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy, Chapter 10: Hospice services. March 2026. p. 310, "Very short hospice stays signal opportunities for quality improvement." https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch10_MedPAC_Report_To_Congress_SEC.pdf
- Furuno JP, Noble BN, McPherson ML, et al. Variation in Hospice Patient and Admission Characteristics by Referral Location. Medical Care. 2020;58(12):1069-1074. https://pubmed.ncbi.nlm.nih.gov/32925461/
- CaringInfo, a program of the National Alliance for Care at Home. 10 Myths About Hospice Care. December 12, 2024. https://www.caringinfo.org/blog/10-myths-about-hospice-care/
- Hospice Foundation of America. How to Access Hospice Care. September 24, 2024. https://hospicefoundation.org/how-to-access-hospice-care/ ; Centers for Medicare & Medicaid Services. Medicare Hospice Benefits (CMS Product No. 02154). March 2026. pp. 4-5. https://www.medicare.gov/publications/02154-Medicare-Hospice-Benefits.pdf
- Wang X, Cohen RA. Health Information Technology Use Among Adults: United States, July-December 2022. NCHS Data Brief No. 482 and companion data tables. National Center for Health Statistics. October 2023. https://www.cdc.gov/nchs/products/databriefs/db482.htm
- University of Michigan Institute for Healthcare Policy and Innovation, National Poll on Healthy Aging. Palliative care and hospice poll reveals major gaps. November 6, 2025. https://ihpi.umich.edu/news-events/news/palliative-care-and-hospice-poll-reveals-major-gaps
- National Institute on Aging. What Are Palliative Care and Hospice Care? Content reviewed May 14, 2021. https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care
- Teno JM, Shu JE, Casarett D, Spence C, Rhodes R, Connor S. Timing of referral to hospice and quality of care: length of stay and bereaved family members' perceptions of the timing of hospice referral. Journal of Pain and Symptom Management. 2007;34(2):120-125. https://pubmed.ncbi.nlm.nih.gov/17583469/
- Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy, Chapter 10: Hospice services. March 2026. pp. 294, 302; Table 10-2, p. 301. https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch10_MedPAC_Report_To_Congress_SEC.pdf
- Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy, Chapter 10: Hospice services. March 2026. Table 10-1, p. 299; pp. 299-300. https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch10_MedPAC_Report_To_Congress_SEC.pdf
- Teno JM, Ankuda CK, Keohane L, et al. Pathway to Hospice: How Has Place of Care before Hospice Changed with the Growth of Hospice in the United States? Journal of Palliative Medicine. 2022;25(11):1661-1667. https://pubmed.ncbi.nlm.nih.gov/35549529/
- Fox S, Duggan M, Purcell K. Family Caregivers are Wired for Health, Part 1: Health Information Specialists. Pew Research Center. June 20, 2013 (survey fielded August 7 to September 6, 2012). https://www.pewresearch.org/internet/2013/06/20/part-1-health-information-specialists/