Hospice Doesn’t Mean “Stop Caring.” It Means “Care Differently."
And why bedside diagnostics can strengthen a hospice care plan (when used intentionally)
“Hospice” is often misunderstood as “no more care.” In reality, hospice is a different kind of care, comfort-focused, interdisciplinary, and centered on quality of life when a person is expected to have a life expectancy of about 6 months or less (if the illness runs its normal course) and chooses comfort care rather than curative treatment.
Hospice happens everywhere: private homes, assisted living, memory care, nursing facilities- wherever the patient calls “home.”
And that’s exactly why portable diagnostics can be such a natural fit.
The real-world dilemma we all see
Hospice teams and facilities still face real clinical questions every day:
“Did that fall cause a fracture?”
“Is this shortness of breath something we can relieve?”
“Is there a reversible contributor to this pain or agitation?”
“Do we need to adjust the plan tonight to keep them comfortable at home?”
These are not “curative medicine” questions. They’re comfort and symptom-management questions.
Portable imaging and testing can support hospice goals by helping the team make faster, calmer decisions, without the stress, risk, and disruption of an ER transfer.
Two buckets of requests: unrelated vs hospice-related
In the portable world, we commonly see two types of requests for hospice patients:
1) Unrelated to the terminal hospice condition
Example: a patient is on hospice for terminal lung cancer, but crushes a hand in a door and needs a hand X-ray.
Medicare guidance recognizes that services unrelated to the terminal condition may be billed to Medicare (as appropriate), and many billing workflows use the GW modifier to indicate the service is not related to the hospice terminal condition.
2) Related to the terminal condition (or related conditions)
These are services tied to palliation/management of the terminal illness and related conditions- where the hospice typically coordinates and is responsible for the plan of care under the hospice benefit.
Bottom line: the same patient may legitimately generate either type of request...what matters is the relationship to the terminal condition and the hospice plan of care, and making sure everyone is aligned.
Where portable diagnostics can help hospice the most
Portable diagnostics aren’t about “doing more.” They’re about doing the right amount, in the right place, at the right time.
Here are high-value hospice-aligned uses:
Confirming a suspected fracture after a fall to guide comfort measures (splinting, repositioning, medication choices) without a disruptive transfer
Evaluating acute respiratory symptoms when the plan is comfort, supporting decisions like oxygen adjustments, positioning, medication changes, or whether an escalation is truly consistent with patient goals
Reducing “crisis transfers” driven by uncertainty (“We don’t know what’s happening”) replacing panic with information
Supporting documentation and communication across the hospice RN, facility staff, attending physician/medical director, and family, so everyone is working from the same facts
Hospice is about dignity, comfort, and minimizing burden. Bedside diagnostics can support all three, when they’re used to clarify the path to comfort, not to chase cure.
A simple “4-question” ordering workflow that prevents chaos
When a hospice patient needs imaging, these questions keep everyone out of trouble:
Is the patient currently elected on hospice?
Is the request related to the terminal condition (or related conditions), or clearly unrelated?
Who is coordinating this- hospice team or facility/attending?
What is the desired decision after results (comfort action), and what escalation is off the table?
This small pause avoids duplicated orders, billing confusion, and last-minute family conflict.
A note on Medicare Advantage patients who elect hospice
One operational wrinkle: when a Medicare Advantage beneficiary elects the Medicare hospice benefit, claims processing for Medicare-covered services during that period typically routes through fee-for-service Medicare contractors (with rules for unrelated services still applying) That’s not a billing tutorial, just a heads-up that hospice election can change the usual “who processes what” rhythm.
Why hospices keep asking for bedside imaging
In plain language, hospices want portable diagnostics because it helps them:
Keep the patient where they are most comfortable
Avoid stressful transport, long waits, and exposure risks
Make faster, clearer comfort decisions
Support facilities that are trying to manage symptoms responsibly at 2 a.m.
Hospice isn’t “nothing.” Hospice is intentional care. Portable diagnostics can be one of the tools that makes that care steadier, kinder, and more patient-centered.
If you’re a hospice leader, here’s the opportunity
If your hospice serves patients in SNFs, assisted living, memory care, or at home, consider building a simple diagnostic protocol:
When bedside imaging is appropriate (comfort decision support)
Who approves/coordinates (hospice RN/MD workflow)
How “related vs unrelated” is documented for clean communication
Turnaround expectations (because hospice doesn’t have time for “sometime tomorrow”)
That’s where portable providers can become a true extension of the hospice team- not just a vendor.
Disclaimer: This is general information and operational perspective, not medical or billing advice. Always follow your hospice policies and Medicare billing guidance.
