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What happens when a hospice patient dies at home

A death at home under hospice care is expected, and there is usually a plan. Here is what the family, the hospice nurse and the funeral home each do, and where state rules differ.

Checked against the sources listed below on October 20, 2026. General information, not legal advice. Rules differ by state; check yours.

The first call goes to the hospice

A hospice nurse and doctor are on call 24 hours a day, 7 days a week. When a hospice patient dies at home, the family follows the plan the hospice gave them, which usually starts with a call to the hospice. There is no need to move the body right away.

The hospice nurse comes to the home, confirms the death and, where the state allows, pronounces it. The family or the nurse then calls the funeral home. When your phone rings, ask:

  • The name of the person who died, the address, and any access notes such as stairs or a gate code.
  • Whether the death has been pronounced, by whom, and at what time.
  • The hospice nurse's name and phone number, and whether the nurse will wait for you.
  • Who in the family has the right to make arrangements, and how to reach them.
  • Whether the family wants time before you arrive.

Sources: [1], [2], [3]

Who pronounces death: it depends on the state

States decide who may pronounce death. Four large states as examples:

StateWhat the law says
TexasA registered nurse, advanced practice registered nurse or physician assistant may pronounce death if the written policies of the hospice allow it. A person who relies in good faith on that determination is protected from liability.
FloridaThe death of an enrolled hospice patient counts as an attended death for medical examiner purposes. The hospice must report the death to the medical examiner if anything unusual or unexpected is present.
New YorkThe Department of Health says state law does not require a physician to pronounce death; unless a local law says otherwise, anyone may.
PennsylvaniaRegistered nurses, physicians and physician assistants could already pronounce death in home hospice. Since Act 137 of 2024, a trained licensed practical nurse may also pronounce death for a hospice patient with a valid do-not-resuscitate order, and release the body to the funeral director or coroner.

In other states, ask the hospice who pronounces and check your state's vital records and funeral board rules.

Sources: [5], [6], [7], [8]

Taking the person into your care

The CDC's handbook for funeral directors notes that, with the attending physician's permission, the person who pronounces death may authorize release of the body to the funeral director. You still need the cause of death certified by the attending physician or other certifier before you file the death certificate.

  • Confirm the death was pronounced, and write down who pronounced it and the time.
  • Ask whether the medical examiner or coroner must be told. You must notify them of a death that may be from an accident, suicide or homicide, or that happened without medical attendance, unless someone already has.
  • Get the family's authorization, from the person with the legal right to make arrangements under your state's law.
  • Agree with the nurse and family on personal effects: what stays, what goes with the person, and a written list of jewelry.
  • Leave hospice equipment and medicines in the home.

Source: [4]

Medicines in the home

A hospice must have written policies on managing and disposing of controlled drugs in the patient's home, and share them with the family when those drugs are first ordered. Federal law lets trained hospice nurses and other qualified hospice employees dispose of a patient's controlled drugs on site after the death. Funeral home staff should not take or handle them.

Sources: [9], [10]

The death certificate

The funeral director usually completes the personal part of the death certificate with an informant, such as a spouse, parent, child or other relative, gets the medical certification from the person responsible for it, and files it within the state's time limit. Deadlines in five large states:

StateWho files, and whenMedical certification
CaliforniaThe funeral director registers it within 8 calendar days after death and before disposition.The attending physician or nurse practitioner, within 15 hours after the death (since July 1, 2026).
FloridaThe funeral director who first takes custody files it electronically within 5 days and before final disposition.The primary or attending practitioner, within 72 hours of receiving it from the funeral director. The local registrar may allow 5 more days.
New YorkThe funeral director files it before disposition; the death must be registered within 72 hours.The attending physician or nurse practitioner, right away (the law says forthwith).
PennsylvaniaThe funeral director completes the personal part; the report is filed within 4 days.A physician, certified registered nurse practitioner, physician assistant or dentist who attended the last illness.
TexasThe person in charge of the burial or removal files it electronically within 10 days.The attending physician, physician assistant or advanced practice registered nurse, within 5 days of receiving it.

Sources: [4], [11], [12], [13], [14], [15], [16], [17]

After the death

The hospice must offer the family bereavement support for up to a year. Tell the family how to reach it. See hospice bereavement programs, and keep the coordination checklist with each hospice you work with.

Source: [18]

Common questions

Who pronounces death when a hospice patient dies at home?

It depends on the state. In Texas a registered nurse may if the hospice's written policies allow it. In Pennsylvania a trained licensed practical nurse may for a hospice patient with a do-not-resuscitate order. Ask the hospice what applies.

Can the funeral home take the body before the doctor signs the death certificate?

Often yes. The CDC handbook notes the pronouncing person may authorize release with the attending physician's permission, but you still need the medical certification before filing the death certificate.

What happens to the patient's medicines?

The hospice handles them under its written policies. Federal law lets trained hospice employees dispose of controlled drugs on site after the death.

Sources

  1. Medicare Hospice Benefits (publication 02154) (Medicare.gov)
  2. What To Do After Someone Dies (National Institute on Aging (NIH))
  3. End-of-Life Care for People Who Have Cancer (National Cancer Institute (NIH))
  4. Funeral Director's Handbook: Death Registration and Fetal Death Reporting (2019 revision) (CDC National Center for Health Statistics)
  5. Texas Health and Safety Code chapter 671: Determination of death (671.001, 671.002) (Texas Legislature)
  6. Florida Statutes 400.6095: Patient admission; assessment; plan of care; discharge; death (Florida Legislature)
  7. Vital Statistics technical notes: pronouncement of death (New York State Department of Health)
  8. State Board of Nursing proposed rulemaking 16A-5151: LPN pronouncement of death (Act 137 of 2024) (Pennsylvania Independent Regulatory Review Commission)
  9. 42 CFR 418.106: Drugs and biologicals, medical supplies, and DME (eCFR (42 CFR Part 418))
  10. 21 U.S.C. 822(g): Disposal of controlled substances by hospice employees (U.S. Code, govinfo.gov)
  11. California Health and Safety Code 102775 and 102780: Registration of deaths (California Legislative Information)
  12. California Health and Safety Code 102800: Medical certification (operative July 1, 2026) (California Legislative Information)
  13. Florida Statutes 382.008: Death, fetal death, and nonviable birth registration (Florida Legislature)
  14. New York Public Health Law 4140: Deaths; registration (New York State Senate)
  15. New York Public Health Law 4142: Death certificate; duties of funeral director (New York State Senate)
  16. State Registrar Notice 2020-10: Medical Certification of a Report of Death (Pennsylvania Department of Health)
  17. Texas Health and Safety Code chapter 193: Death certificates (193.002 to 193.005) (Texas Legislature)
  18. 42 CFR 418.64: Core services (bereavement counseling) (eCFR (42 CFR Part 418))

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