Who's actually entering
your home — and
how they got there.
“Experienced team” is the most common claim on hospice websites. Frankly, it tells you almost nothing. Experience at what? How trained? Held to which standard?
The standard behind the standard.
Federal regulations set minimum credentialing standards for every clinical role at a Medicare-certified hospice — from the nurse case manager to the bereavement counselor. We meet those standards. The more useful question is what each role actually requires beyond that floor.
This page lays it out plainly: the credentials we require, the training we add, and the continuing education that keeps the team current as best practices shift. If you're evaluating us — or any hospice — these are the questions where the answer should be specific.
Hospice Nurses (RNs)
The clinical foundation of every care plan. Our RNs hold:
Active RN license in the State of Michigan, verified through the state nursing board
BSN preferred (Bachelor of Science in Nursing); ADN nurses with hospice experience also qualify
CPR certification current and verified
Specialty hospice training completed before the first solo visit — covering pain and symptom management, communication around dying, grief reactions, and the clinical patterns of decline
ELNEC training (End-of-Life Nursing Education Consortium) — the most widely adopted hospice nursing curriculum in the United States
CHPN certification (Certified Hospice and Palliative Nurse) — encouraged and supported through the Hospice and Palliative Credentialing Center
Hospice nursing isn’t a version of hospital nursing or home health nursing. The skills overlap, but the discipline is different. Different clinical judgment around symptoms hospital nurses rarely manage to this depth. Different communication — about dying, about prognosis, about what a family should expect in the next two weeks — that traditional nursing school barely touches. And the steadiness to deliver complex care in someone’s home, without the safety net of an institution down the hall.
Hospice Aides and Certified Nursing Assistants
Our aides handle the hands-on personal care that holds comfort and dignity in place — bathing, repositioning, dressing, mouth care, the daily work most families can’t manage alone. What’s required:
Completion of a state-approved nursing assistant program — a federal minimum of 75 hours of training, including at least 16 hours of supervised practical experience
Active listing on the Michigan Nurse Aide Registry in good standing — verified, not assumed
CPR certification current and verified
Hospice-specific aide training beyond the general CNA curriculum, covering end-of-life care, family communication, and the physical changes the dying body goes through
12 hours of in-service training annually per federal requirement, tracked and documented
What we add: every new aide shadows an experienced one in real homes — not in a classroom — until the supervising nurse signs off on competency. A new hospice aide doesn’t work solo on Day 1. We don’t make families train our staff for us.
Hospice Physicians
and Nurse Practitioners
Our medical directors and nurse practitioners hold:
- Active license to practice in the State of Michigan
- DEA registration for controlled substance prescribing
- Board certification in their primary specialty — internal medicine, family medicine, geriatrics, or comparable
- Hospice and Palliative Medicine certification preferred, through the American Board of Medical Specialties
The hospice physician doesn’t replace the patient’s attending doctor. They lead clinical decisions about hospice eligibility, recertification, and symptom management — and they collaborate with the patient’s primary physician throughout the care plan.
Medical Social Workers
Our medical social workers carry:
- Bachelor's or Master's degree in Social Work from a program accredited by the Council on Social Work Education (CSWE)
- Licensed Master Social Worker (LMSW) credential preferred, in line with Michigan licensure
- Specialty training in hospice and end-of-life social work — grief, anticipatory grief, complicated bereavement, family conflict around end-of-life decisions, and the financial and legal realities families navigate
- Continuing education maintained per state licensure requirements
Hospice social work isn't general counseling. It's a specialty that handles the specific pressures families face at end of life: advance directives, family conflict over care decisions, financial pressure during terminal illness, and the practical questions nobody warned anyone about until they were standing in the middle of them.
These aren't soft skills. They directly affect outcomes — when family conflict gets resolved, symptom management gets easier, because the patient isn't absorbing the household's stress.
Chaplains
Our spiritual care chaplains are professionally trained:
- Clinical Pastoral Education (CPE) — typically one to four units (each unit involves 400 hours of supervised training) through ACPE-accredited programs
- Multi-faith preparation — trained to serve patients of any faith and patients of no faith
- Continuing education in grief support, family dynamics, and ethics in end-of-life care
Hospice chaplains aren't there to convert. They're trained to meet patients where they already are — Christian, Muslim, Jewish, Hindu, Buddhist, Sikh, secular, uncertain, somewhere in between. The training is in the meeting, not the message.
Volunteers
Federal regulation (42 CFR § 418.78) requires every Medicare-certified hospice to maintain a volunteer program — at least 5% of total patient care hours must come from trained volunteers. Our volunteer program includes:
Documented orientation covering hospice philosophy, HIPAA, boundaries, communication, infection control, and family dynamics
Background check and reference verification before any patient contact
TB screening and health clearances per federal and state guidelines
Role-specific training based on assignment — direct patient companionship, vigil presence, pet therapy, music companions, bereavement support, administrative volunteers
Ongoing in-service scheduled regularly through the year
Volunteers don’t replace clinical staff. They extend the team’s reach into the spaces clinical staff can’t always fill — sitting with a patient so the caregiver can sleep, reading aloud, playing music, walking a dog, simply being present in the room.
Background Checks
and Compliance
Every clinical staff member and volunteer clears the same screening before patient contact:
State and federal criminal background checks
Sex offender registry verification
Office of Inspector General (OIG) exclusion list verification — federally required for anyone billing Medicare
License and credential verification through primary source (state boards, certification bodies)
Reference checks
Drug screening where required by role and state regulation
TB screening and immunization verification
None of these is optional. They’re how a Medicare-certified hospice has to operate. We document each step, maintain the records for audit, and re-verify on the schedules federal regulation requires. A hospice that treats any of these as a box to check rather than a standard to hold is one to watch carefully.
Continuing Education and Competency
Skills don't stay sharp on their own. Every team member completes:
Annual competency review for clinical skills, with sign-off by clinical leadership
In-service training hours meeting or exceeding federal minimums
Specialty certification tracking for staff pursuing advanced credentials (CHPN, CHPLN, ACHPN, and others)
Annual mandatory training in HIPAA, infection control, safety, and cultural competence
End-of-life communication and bereavement training refreshed annually for all clinical staff — not only chaplains and social workers, but nurses and aides too
Clinical updates as Medicare regulations, best practices, and pharmacology change
When a competency review identifies a skills gap, additional training is required before that staff member resumes the affected aspect of care. That isn’t optional either.
Onboarding and Mentorship
A new hire doesn’t walk into your home alone on Day 1. Standard onboarding includes:
Classroom orientation in hospice philosophy, our policies, federal regulations, and documentation standards
Field shadowing with experienced clinicians before any independent visits
Competency sign-off by the supervising nurse before solo practice
Mentor pairing for the first 90 days
Probationary performance review before permanent status
We don’t put new clinicians in front of families unsupervised in the first week. That isn’t how trust gets built. It isn’t how competence develops. And it isn’t how good hospices operate.
Ask the Specifics
If you’re considering hospice for a loved one in Detroit, Southfield, Troy, Warren, Sterling Heights, or anywhere across the Michigan tri-county area, the people who walk through your door matter more than any brochure. Ask any hospice about their training, credentials, and ongoing competency requirements — and expect specifics, not slogans.
Call (800) 489-7977 or reach us through our contact page. We’re happy to walk through any of this in detail.