The First 72 Hours of Hospice: From Referral to Admission
September 16, 2025
The first 72 hours of hospice run from the referral through the election and the initial assessment, which a registered nurse must complete within 48 hours after the patient elects hospice. In that window, a family meets your hospice for the first time. Get consents signed, contacts confirmed and the 24/7 number saved before anyone is in crisis.
What has to happen in the first 72 hours
Four things, in order:
- The referral is answered and the family is reached. A referral that lands at 4:45 on a Friday still needs a live answer that evening, not Monday.
- The election statement and consents are signed. Every hour these wait is an hour the admission cannot start.
- The initial assessment is completed. Under 42 CFR 418.54(a), the hospice RN completes it within 48 hours after the election, unless the physician, patient or representative asks for it sooner. The comprehensive assessment by the interdisciplinary group follows within five calendar days.
- The HOPE clock starts. The HOPE Admission assessment is part of that comprehensive assessment. If it finds a moderate or severe symptom impact, an in-person Symptom Follow-up Visit is due within two calendar days. See the HOPE Tool for hospice agencies.
Where it goes wrong
Most of the first 72 hours is spent reaching people. Intake leaves a voicemail. The family does not recognize the number and lets it ring. A nurse drives out for a signature and knocks on a door no one answers. Each miss pushes the admission back and leaves a frightened family wondering who, if anyone, is coming.
A welcome sequence that works
- Introduce your hospice before the first call. A short text from your hospice's own number: who you are, why the referral was made, and that someone will call shortly.
- Say what happens next. Give the number the intake team will call from and ask the family to save it. A known number gets answered.
- Collect contacts once. A short form for the primary caregiver, the health care decision-maker and a backup contact, so the first live call reaches the right person.
- Send consents and the election statement for e-signature. Families sign from the kitchen table, and the nurse arrives to care for the patient instead of collecting paperwork.
- Schedule the assessment visit on the first live call. Confirm the time by text.
- Give the 24/7 line, with examples. "Call us any time if breathing changes, pain is not controlled, or you are frightened." Families who know when to call, call earlier.
What to measure
- Time from referral to first live contact with the family, including after hours.
- Share of consents and election statements signed before the first visit.
- Share of initial assessments completed within 48 hours after election.
- Share of after-hours referral calls answered live.
Where QliqSOFT fits
AI Voice Agents answer referral calls at night and on weekends, capture the details, and route the caller to whoever your live on-call schedule says is covering. Quincy sends the welcome, the contact form, and the consents and election statement for e-signature by text from your hospice's number. At admission, a QR magnet on the refrigerator gives the family one scan to reach your team from then on.
Frequently asked questions
What do the first 72 hours mean in hospice care coordination?
The first 72 hours are the critical period after a hospice referral or admission, when timely communication, documentation, education, and scheduling are essential to ensure a smooth transition into care. They include the initial nursing assessment, which must be completed within 48 hours after the patient elects hospice. QliqSOFT previously published this workflow as First72Hours.
Why are the first 72 hours so important in hospice admissions?
The first 72 hours set expectations for patients and families, establish trust, complete required documentation, and prevent delays that can disrupt care delivery or cause confusion during an already emotional time.
What challenges do hospice teams face during the first 72 hours?
Hospice teams often face fragmented communication, incomplete information, delays in scheduling visits, manual paperwork, and difficulty coordinating between intake, clinical staff, and families.
What information is typically collected during the first 72 hours?
Key information includes patient demographics, clinical details, the election statement, consent and admission forms, contacts for the primary caregiver and health care decision-maker, care preferences, and scheduling information required to initiate hospice services.
How are expectations set for patients and families during this phase?
Expectations are set through structured education and consistent communication that explains what hospice care involves, what happens next, and who will be involved in care delivery. Families should also receive the hospice's 24/7 number, with examples of when to call.
How does a structured first-72-hours process support regulatory and compliance needs?
The workflow ensures required documentation, consent forms, and admission records are completed and tracked. It also tracks the initial assessment, due within 48 hours after election under 42 CFR 418.54(a), and the comprehensive assessment, due within five calendar days.
How does Quincy support hospice teams during the first 72 hours?
Quincy provides structured workflows, secure communication, automated intake steps, and coordinated escalation to help hospice teams manage admissions efficiently during the first 72 hours. The welcome, contact forms, consents and election statement go to the family by text for e-signature, AI Voice Agents answer referral calls at night and on weekends, and a QR magnet at admission gives the family one scan to reach the team.
What benefits does this approach provide to hospice care providers?
It helps reduce delays, minimize manual work, improve coordination across teams, and create a more consistent experience for patients and families during admission.
How does this process impact patient and family experience?
Clear communication, faster coordination, and fewer handoffs reduce stress for families and help patients feel supported from the very beginning of hospice care.
What key metrics can be tracked during the first 72 hours?
Metrics include referral response time, admission completion time, documentation completion rates, handoff efficiency between intake and clinical teams, and the share of initial assessments completed within 48 hours after election.
How long does a hospice have to complete the initial assessment?
Under 42 CFR 418.54(a), the hospice registered nurse must complete the initial assessment within 48 hours after the patient elects hospice care, unless the physician, patient or representative requests that it be completed sooner. The comprehensive assessment follows within five calendar days of the election.
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