How Fast Can Hospice Start in Michigan?

Written and reviewed by the Lily Hospice clinical team. Updated September 2026.

In most cases hospice can start within 24 to 48 hours of the first call, and often the same day. The steps are a phone call, a physician order certifying that the illness is life-limiting, an evaluation visit, and signed consents; a well-run hospice does all of them in one day when a family needs it to, including evenings and weekends.

What has to happen before care starts

Four things, and none of them should take long. First, someone calls. It can be a family member, a nurse at a facility, a hospital discharge planner, or the patient. Second, a physician certifies that the patient has a life-limiting illness with a likely life expectancy of six months or less if it runs its usual course; the hospice can contact the attending doctor for this, and the hospice medical director signs as well. Third, a nurse visits to evaluate, explain, and answer questions. Fourth, the patient or their representative signs the election form and consents. Equipment such as a hospital bed, oxygen and a commode is ordered at the same time and usually arrives within hours.

At Lily Hospice, the evaluation visit is usually within 24 hours of the call and admission is often the same day once the order and consents are in place. A real person answers (248) 955-5100 24 hours a day, so a Friday-evening hospital discharge does not become a Monday-morning admission.

What slows it down, and how to avoid it

The most common delay is the physician order. If your loved one’s doctor is hard to reach, tell the hospice; they will chase the order and, if needed, the hospice medical director can certify with the attending. The second delay is a hospital that wants to discharge to a specific hospice on its own timeline; you have the right to choose any Medicare-certified hospice, and saying so early keeps things moving. The third is paperwork about insurance. Medicare pays for hospice through Part A, Medicaid and most commercial plans have a hospice benefit, and none of it requires prior authorization from the family. Missing pieces should never delay an evaluation visit.

One thing that does not need to happen first: deciding. Families sometimes wait to call until they are sure. Call when you are wondering. The evaluation visit is free, carries no obligation, and is the fastest way to get clear answers.

How fast is fast enough

If a hospice tells you it will be “a few days,” ask why. Same-day or next-day admission is the norm for well-staffed hospices in metro Detroit, and pain, breathing trouble and family exhaustion do not wait. In our analysis of Medicare data for all 104 hospices serving Oakland, Macomb and Wayne counties, the ability to be present at the end varied enormously between agencies; speed at the start is often the first sign of how present a hospice will be later.

Questions families ask

Can hospice start the same day?

Yes. If the physician order and consents can be completed the same day, admission can be the same day. Lily Hospice admits same-day when a family needs it, including evenings and weekends.

Does a doctor have to refer us to hospice?

A physician must certify eligibility, but anyone can make the first call, including the family. The hospice contacts the doctor for the order.

Can hospice start in the hospital and continue at home?

Yes. Many admissions begin with a hospital discharge. The hospice coordinates transport, equipment at home and the first visit so there is no gap.

Can hospice start in assisted living or a nursing home?

Yes. Hospice comes to wherever the patient lives, including assisted living, memory care, adult foster care and skilled nursing facilities, and works alongside the facility staff.

What if we are not sure it is time?

Call anyway. The evaluation is free and carries no obligation, and if hospice is not the right fit yet, a palliative program such as Lily’s Pathways may be.

General education, not medical or benefits advice. Decisions about hospice are made with your loved one’s physician. Lily Hospice, 2125 Butterfield Dr, Suite 299, Troy, MI 48084. Medicare-certified since 2021. ACHC-accredited.

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