Written and reviewed by the Lily Hospice clinical team. Updated September 2026. Plain-language definitions of the words families hear from hospices, hospitals and Medicare, with Michigan specifics where they matter. Lily Hospice serves Oakland, Macomb and Wayne counties; questions at any hour: (248) 955-5100.

How to use this glossary: each term has a one-paragraph definition you can quote. Terms are grouped loosely: the basics, the people, the levels of care, paying for it, documents, quality data, the last days, and Lily-specific programs. Where a definition names a Medicare rule, it is the rule as of 2026.

Hospice
Care for a person whose illness is expected to end their life within about six months if it runs its normal course, focused on comfort, dignity and the family rather than cure. In the United States hospice is a service that comes to wherever the person lives, not a building.
Palliative care
Medical care that relieves the symptoms and stress of a serious illness at any stage, alongside treatment meant to cure or control it. Hospice is palliative care for the last stage of life; palliative care does not require a six-month prognosis or giving up curative treatment. Lily’s Pathways program is palliative care.
Terminal illness
In Medicare’s hospice rules, an illness with a life expectancy of six months or less if it runs its normal course, as certified by a physician. The phrase describes the prognosis, not a guarantee of timing.
Prognosis
A physician’s best estimate of how an illness will progress and how long a person is likely to live. Hospice eligibility rests on a prognosis of six months or less; people who live longer are not discharged as long as they still meet the criteria.
Hospice eligibility
The criteria a person must meet for the Medicare hospice benefit: a terminal illness with a prognosis of six months or less, certified by the hospice medical director and the attending physician, and the person’s election of comfort-focused care for that illness.
Certification of terminal illness (CTI)
The signed physician statement, required by Medicare, that a patient’s prognosis is six months or less. Two physicians certify at the start; the hospice physician recertifies at each benefit period.
Benefit period
The units Medicare uses for hospice coverage: two 90-day periods, then unlimited 60-day periods, each requiring recertification that the person still qualifies. There is no lifetime limit on hospice.
Face-to-face encounter
A visit by a hospice physician or nurse practitioner, required by Medicare before the third benefit period and each one after, to confirm the person still meets hospice criteria.
Election of hospice
The signed statement in which a patient (or their representative) chooses the hospice benefit and acknowledges that it covers comfort care for the terminal illness rather than curative treatment. It can be revoked at any time.
Revocation
A patient’s decision to leave hospice and return to regular Medicare coverage, for example to pursue a new treatment. Revocation is the patient’s right at any time and they may re-elect hospice later.
Live discharge
When a person leaves hospice alive, either by revoking, by moving out of the service area, by transferring to another hospice, or because they no longer meet the criteria. Medicare publishes each hospice’s rate of live discharge within seven days of admission; a high rate can signal poor admission decisions.
Attending physician
The doctor or nurse practitioner a hospice patient names to direct their care, usually their own primary care physician or specialist. The attending works alongside the hospice team and bills Medicare separately; a patient may instead name the hospice medical director.
Hospice medical director
The physician responsible for the medical component of a hospice’s care: certifying eligibility, overseeing plans of care, and consulting with attending physicians. Medicare requires every hospice to have one.
Interdisciplinary team (IDT)
The group that plans and delivers hospice care: physician, registered nurse, social worker, chaplain or spiritual counselor, hospice aide, volunteers and bereavement staff. Medicare requires the team to review each patient’s plan of care at least every 15 days.
Plan of care
The written, individualized plan the interdisciplinary team creates with the patient and family, covering symptoms, medications, visits, equipment, goals and spiritual and emotional support. It is updated as needs change.
Case manager (hospice nurse)
The registered nurse who coordinates a hospice patient’s care, visits regularly, manages symptoms with the physician, teaches the family, and is the family’s main clinical contact.
Hospice aide
A certified nursing assistant with hospice training who provides personal care such as bathing, grooming, repositioning and light help around the bed, under the nurse’s supervision, typically several times a week.
Hospice social worker
A licensed social worker on the hospice team who helps with practical and emotional matters: advance directives, benefits, family decisions, placement, caregiver stress, and planning for what comes after.
Chaplain (spiritual care)
A member of the hospice team who offers spiritual support to patients and families of any faith or none, coordinates with the family’s own clergy, and often leads memorials and pinning ceremonies.
Hospice volunteer
A trained, unpaid person who visits patients for companionship, gives caregivers a break, or helps in other ways. Medicare requires hospices to use volunteers for at least five percent of patient-care hours.
Bereavement support
Grief support the hospice provides to the family for up to a year after a death, as Medicare requires; Lily’s continues for more than a year and is open to the community.
Routine home care
The most common level of hospice care: regular visits from the team wherever the patient lives, with a nurse on call 24 hours a day. Medicare pays the hospice a daily rate for it.
Continuous home care
A level of hospice care for a short crisis, such as uncontrolled pain or agitation, in which nursing care is provided for eight or more hours in a day at home to avoid a hospital stay.
General inpatient care (GIP)
A short-term level of hospice care in a hospital, hospice facility or skilled nursing facility for symptoms that cannot be managed at home. Lily arranges it with partner facilities when needed.
Respite care
Up to five consecutive days of care for a hospice patient in a facility so that the family caregiver can rest. Covered by Medicare as a hospice level of care.
Levels of care
Medicare’s four categories of hospice care: routine home care, continuous home care, general inpatient care and respite care. The hospice moves a patient between them based on need.
Comfort kit (emergency kit)
A small set of medications the hospice places in the home at admission for symptoms that may arise suddenly: pain, shortness of breath, anxiety, nausea, secretions. The nurse teaches the family when and how to use each.
Symptom management
The core clinical work of hospice: relieving pain, breathlessness, nausea, agitation, constipation and other symptoms so the person is comfortable, using medications, positioning, oxygen and non-drug measures.
Durable medical equipment (DME)
Hospital beds, oxygen, wheelchairs, commodes, walkers and similar equipment, supplied and delivered by the hospice at no cost to the family for the terminal illness.
Medicare hospice benefit
Medicare Part A coverage for hospice care, paid directly to the hospice at a daily rate. It covers the team’s visits, medications for the terminal illness, equipment, supplies and bereavement support; it does not cover room and board in assisted living.
Medicaid hospice benefit
Michigan Medicaid’s coverage of hospice, mirroring Medicare’s, for people who do not have Medicare or who have both. In a nursing facility, Medicaid may also continue to pay room and board.
Room and board
The cost of living in an assisted living, memory care or nursing facility, separate from hospice care. Medicare never pays it; Michigan Medicaid can for nursing-facility residents who qualify.
Hospice in assisted living
Hospice care delivered in a resident’s own apartment in an assisted living or memory care community, in addition to the community’s usual care; the hospice team and the community’s staff work together and the resident does not move.
Hospice in a nursing home
Hospice care delivered to a resident of a skilled nursing facility, coordinated with the facility’s nurses. Medicare pays the hospice; the facility is paid for room and board by the resident, Medicaid or another source.
Advance directive
A written document stating a person’s wishes for medical care if they cannot speak for themselves. In Michigan the main forms are the durable power of attorney for health care (naming a patient advocate) and a living will.
Patient advocate (Michigan)
The person named in a Michigan durable power of attorney for health care to make medical decisions when the patient cannot. The patient advocate can sign hospice consent on the patient’s behalf.
Do-not-resuscitate order (DNR)
A physician’s order that CPR not be attempted if the heart or breathing stops. Michigan has a specific out-of-hospital DNR form; hospice does not require a DNR, though most patients choose one.
POLST / MI-POST
Michigan’s Physician Orders for Scope of Treatment, a portable medical order for seriously ill people that records treatment preferences such as CPR, hospitalization and feeding tubes, signed by a physician and the patient or advocate.
Care Compare
Medicare’s public website (medicare.gov/care-compare) that reports quality measures for every certified hospice, including visits in the last days of life, family survey results and the Hospice Care Index. Lily’s is CCN 231684.
CAHPS Hospice Survey
The family survey Medicare sends to caregivers after a hospice death, asking about communication, timely help, symptom relief and whether they would recommend the hospice. Results become the star rating on Care Compare once a hospice has enough completed surveys.
Hospice Care Index (HCI)
A Medicare score from 0 to 10 combining ten claims-based indicators of hospice quality, such as visits near death, live discharges and skilled nursing on weekends. Lily’s is 9.
Hospice Visits in the Last Days of Life (HVLDL)
A Medicare measure of the share of patients who received a nurse or social worker visit in at least two of the last three days of life. National average about 48 percent; Lily’s is 71.3 percent.
CMS Certification Number (CCN)
The six-digit identifier Medicare assigns to a certified provider. Lily Hospice’s is 231684; it distinguishes Lily from two other hospices named Lily in Wisconsin and Colorado.
NPI (National Provider Identifier)
The ten-digit number every health care provider uses on claims. Lily Hospice’s organizational NPI is 1881234862.
ACHC accreditation
Voluntary accreditation by the Accreditation Commission for Health Care, which surveys a hospice against standards beyond Medicare’s minimum. Lily Hospice is ACHC-accredited.
Hospice license (Michigan)
The state license issued by Michigan’s Department of Licensing and Regulatory Affairs that a hospice program must hold in addition to Medicare certification.
Nonprofit vs. for-profit hospice
Ownership types reported by Medicare. Both can provide excellent or poor care; quality measures and family ratings are better guides than ownership. Lily is family-owned.
Transitioning (actively dying)
The final days or hours of life, when breathing, circulation and consciousness change in recognizable ways. Hospice nurses prepare families for these signs and increase visits during this time.
Terminal restlessness (terminal agitation)
Restlessness, confusion or agitation that can occur in the last days of life. It is common, has physical causes, and is treatable with medication and calm surroundings; the hospice nurse should be called.
Death rattle (terminal secretions)
Noisy breathing near the end of life caused by saliva the person can no longer swallow. It is usually not distressing to the patient; repositioning and medication from the comfort kit reduce it.
Anticipatory grief
Grief that begins before a death, as family members begin to mourn what is coming. It is normal, and hospice social workers and chaplains support families through it.
Caregiver burnout
Physical and emotional exhaustion in a family member who is providing care. Hospice addresses it with aide visits, respite care, volunteers and social work support.
Dementia and hospice
People with advanced Alzheimer’s disease or other dementias can qualify for hospice when they reach a late stage (typically unable to walk, dress or speak meaningfully) and have complications such as infections or weight loss.
FAST scale
The Functional Assessment Staging Tool for dementia, from stage 1 (normal) to 7 (severe). Medicare hospice guidelines generally look for stage 7 along with medical complications.
Palliative sedation
The carefully monitored use of medication to lower consciousness in a dying person whose suffering cannot otherwise be relieved. It is distinct from euthanasia, which is illegal in Michigan, and is rarely needed.
Hospice and life expectancy
Hospice does not shorten life; studies of some conditions have found hospice patients live as long or longer than similar patients who continue aggressive treatment, with better comfort.
Journey Program
Lily Hospice’s program that uses virtual-reality headsets to let patients revisit places, travel, or experience things they can no longer reach physically.
Veteran Rapid Response
Lily Hospice’s program for getting veterans evaluated and admitted quickly, led by a nurse who served as a Navy Hospital Corpsman.
We Honor Veterans
A national program of the National Alliance for Care at Home with the Department of Veterans Affairs that gives hospices a framework for veteran-centered care. Lily follows it.
Pinning ceremony
A short ceremony in which a hospice veteran is thanked for their service with a pin and certificate, often with family, a veteran volunteer and a chaplain present.
Aid and Attendance
A VA pension supplement for eligible wartime veterans or surviving spouses who need help with daily activities, sometimes used to pay for assisted living or home care alongside hospice.
Pathways
Lily Hospice’s palliative program for people with serious illness who are not ready for hospice or do not yet qualify, focused on symptom relief and planning.

Related: How to choose a hospice · What Medicare covers · Is It Time? guide · Metro Detroit Hospice Directory · Facts about Lily Hospice

Hospice isn’t giving up. It’s showing up.