HOSPICE & PALLIATIVE CARE -
MANDATORY REPORTING REQUIREMENTS
Mandatory Reporting Requirements – Hospice
Hospice and palliative care providers are subject to multiple mandatory reporting obligations under federal and state law. These requirements are triggered by specific events, observations, or allegations and often intersect with complaint investigations, surveys, and litigation.
Failure to report — or delayed reporting — can independently support regulatory citations, enforcement actions, and civil liability, even where the underlying clinical issue is disputed.
The sections below outline common mandatory reporting categories applicable to hospice providers nationwide. State-specific variations and timelines are addressed in the State-Specific Attorney Notes.
These resources are used by plaintiff and defense counsel nationwide for early case assessment, regulatory analysis, and litigation strategy in medically complex matters.
Abuse, Neglect, and Exploitation
Hospice staff are mandatory reporters of suspected abuse, neglect, or exploitation involving hospice patients, including incidents occurring in private homes, facilities, or inpatient hospice settings.
- Physical, emotional, sexual, or verbal abuse
- Neglect by caregivers or facility staff
- Financial exploitation or coercion
- Failure to provide necessary care resulting in harm or risk
Reporting obligation: Reports are typically required to state protective services agencies and, in some cases, law enforcement.
Death Reporting and Unexpected Outcomes
While death is an expected outcome in hospice care, certain deaths trigger mandatory reporting obligations due to their circumstances or timing.
- Deaths that are unexpected, unexplained, or occur shortly after admission
- Deaths associated with medication errors or adverse drug events
- Deaths involving suspected abuse, neglect, or diversion
- Deaths occurring during restraint, transfer, or discharge processes
Reporting obligation: Depending on circumstances, reports may be required to medical examiners, coroners, state agencies, or law enforcement.
Medication Errors and Controlled Substance Diversion
Hospice providers must report certain medication-related incidents, particularly those involving controlled substances commonly used in end-of-life care.
- Medication errors resulting in patient harm or death
- Suspected diversion by caregivers, staff, or third parties
- Loss, theft, or unexplained discrepancies of controlled substances
- Failure to properly secure, track, or dispose of medications
Reporting obligation: Reports may be required to state agencies, licensing boards, pharmacy boards, and law enforcement.
Sentinel Events and Serious Adverse Events
Certain serious adverse events may trigger mandatory reporting under federal, state, or accrediting body requirements.
- Patient suicide or attempted suicide while on service
- Serious injury related to falls or environmental hazards
- Events indicating systemic failure in care delivery
- Events requiring immediate intervention to prevent further harm
Reporting obligation: Accrediting organizations and state agencies may require notification and root cause analysis.
Failure to Report – Legal and Litigation Risk
Failure to comply with mandatory reporting requirements can independently support regulatory citations, enforcement actions, and civil liability.
- Citations for failure to protect patient health and safety
- Condition-level deficiencies and enforcement escalation
- Use of non-reporting as evidence of concealment or negligence
- Increased exposure in wrongful death and False Claims Act matters
Attorney insight: Documentation demonstrating timely reporting, escalation, and corrective action is often central to defensibility.
Mandatory Reporting Obligations in Hospice & Palliative Care Carry Elevated Risk
Hospice and palliative care providers are subject to state-specific mandatory reporting requirements involving abuse, neglect, exploitation, unexpected deaths, medication diversion, controlled substances, and patient safety events. Failures to recognize reporting triggers, meet statutory timelines, or properly document notifications can result in regulatory action, licensure exposure, and significant litigation risk. Our clinical-legal team evaluates reporting compliance against applicable state statutes and federal hospice requirements.
Submit Records for Hospice Reporting Compliance Review