The Medicare hospice benefit was established in 1982 to ensure that patients in the last 6 months of life have access to high-quality palliative care provided by a physician, nurse, social worker, chaplain, home health aide, and volunteer.1 Since then, the hospice industry has expanded rapidly. In 2009, approximately 1.56 million individuals used hospice compared with 1.2 million in 2005. The number of hospice programs has also increased. In 2009 there were approximately 5000 hospices in the United States compared with 4160 in 2005.1