What Certification Does a Hospice Administrator Need?

Hospices serve to ease the one transition every person must inevitably experience: end-of-life. Not everyone ends up in hospice, obviously, but many do. Each year, over one million patients receive hospice care, a short-term treatment option for those with less than six months to live. Most patients spend less than a month in hospice before passing on.

Hospice administrators—who earn an average of approximately $84,000 per year—manage hospice facilities (or equivalent home-care programs). These professionals need a wide breadth of medical and business knowledge, since their decisions impact:

• Medical services
• Business operations
• Resident life

One of the best ways to advance your career in hospice administration is to earn the appropriate certifications. In this article on hospice administrator certification programs, we will cover:

• What does a hospice administrator do?
• Earning hospice administrator certifications
• Education for becoming a hospice administrator

What does a hospice administrator do?

Hospice administrators are appointed by a hospice’s governing body, which holds legal responsibility for:

• Managing facilities
• Providing services
• Making fiscal decisions
• Driving improvements in performance and service

Governing boards set their own education and experience standards for the administrators they employ. Once hired as a hospice administrator, your job is to implement the board’s decisions and guidance day-to-day. For Game of Thrones fans, the Hand of the King comes to mind.

According to the National Hospice and Palliative Care Organization, specific job duties for hospice administrators include:

• Implementing, monitoring, and reporting on the hospice’s services
• Ensuring quality patient care
• Enforcing all local, state, and federal regulations so that the facility operates in a legal and ethical manner
• Ensuring that performance improvement and safety activities are planned and implemented
• Providing the governing body with up-to-date information on a regular ongoing basis

Hospices sometimes list this job under other titles, such as executive director. No matter the moniker, hospice administrators handle day-to-day operations of hospice and palliative care.

Earning hospice administrator certifications

One way to distinguish your resume from others is by passing the Hospice Administrator Certification (CHA) exam from the National Board for Home Care and Hospice Certification (NBHHC). According to the organization, professionals with this credential are leaders in the field who can:

• Identify trends in healthcare and its impact
• Build and coach a strong management team to position their provider agency for success
• Understand the essential elements of financial management and operating a budget
• Understand ways to monitor and improve an agency’s operational performance
• Identify and minimize broad risks of liabilities
• Understand corporate compliance programs
• Identify new practices to integrate quality improvement, financial, operational, compliance and customer service goals

According to the NBHHC, an increasing number of employers are requiring this certification, which represents a “gold level knowledge of standards.” The organization also asserts that the certification facilitates better opportunities and higher pay.

The CHA exam is comprised of four sections:

• Business operations
• Finance
• Business development
• Compliance

Exam costs include an application fee ($99) and a registration fee ($499).

Certification elligibility

Hospice administrators do not need to have a master’s degree or even a bachelor’s degree to advance in the field, but it does make things easier. The NBHHC lays out different requirements for the highest level of education each candidate might have. They are:

• Bachelor’s or master’s degree: five years or more of experience as a supervisor or manager, or at least one year as an administrator.
• Associate’s degree: seven years or more of experience as a supervisor or manager, or at least two years as an administrator.
• High school diploma: nine years or more of experience as a supervisor or manager, or at least three years as an administrator. You must also have a “diploma or professional licensure in a health-related field.”

Regardless of education, each applicant must have been in a hospice leadership position for one of the past four years to qualify.

Renewing your certification

Certifications must be renewed every four years. Qualifications include having a leadership position for at least one of the four years and earning 50 points through:

• Continuing education (minimum of 36 points for 36 credit hours; you are allowed to earn all 50 points through continuing education)
• Joining a trade association (1 point per year of membership)
• Leadership in the trade organization (.25 points for each month served)
• Writing field-specific articles (3 points per publication)
• Teaching-industry-related courses (1 point per credit hour)
• Continued certification exam work (1 point per written question or hour of item writing or hour of item reviewing)

Other hospice administration exams

The Hospice & Palliative Credentialing Center offers the Certified Hospice and Palliative Care Administrator (CHPCA) exam for those with “the equivalent of two years of full-time administrative work in a hospice or palliative setting in the three years leading up to their initial certification.”

The exam is quite similar to the NBHHC’s, and test categories include:

• Leadership and ethics
• Operations
• Fiscal management
• Human resource management
• Quality management
• Community outreach and advocacy
• Organizational integrity and compliance

Some individual states have unique certification guidelines for hospice administration. For instance, California offers the Hospice Administrator Certification Program (HACP), which is a three-day course that focuses on legal, financial, and strategic platforms to help administrators improve their skill set. The program is designed for those with at least a year of experience in hospice administration or upper-level management.

Be alert to the possibility of other required healthcare certifications. For instance, administrators in California might also need to complete the Resiential Care Facility for the Elderly (RCFE) certification or the Administrator Certification Program. One of the best ways to research your state’s potential requirements is by looking at job postings to see what (if any) certifications they mandate.

Education for becoming a hospice administrator

Every hospice has different requirements, but they often include:

• Certification
• Two or more years of health administration experience
• At least a bachelor’s degree
• Business knowledge
• Leadership and communication skills
• Registered nurse status

Many hospices require administrators to be registered nurses. This makes sense since a major part of the job description is managing the healthcare team.

Many hospice administrators decide to earn an master’s degree in order to improve either their healthcare or business administration skills. Common degrees include:

• Master of Healthcare Administration (MHA)
• Master of Healthcare Management
• Master of Business Administration (MBA) with a healthcare administration concentration
• Master’s in Palliative Care
• Master of Public Health with a concentration in health management
• Master of Jurisprudence in Healthcare Compliance

There is no “right” master’s degree for this job. If there were, it would probably be called “Master of Hospice Administration.” Every hospice looks for different qualities in a candidate, so earning experience in the field before jumping into a graduate degree is not only a requirement but can be extremely helpful to determine your intended career trajectory.

Some graduate degrees can be earned online from well-regarded schools like Boston College. The flexibility that an online program provides can be an important determining factor for those who are trying to decide which degree best suits their needs.

Hospice administration undergraduate education

The right undergraduate degree can set you up for a career in hospice administration. Appropriate degrees include:

• Bachelor of Science in Nursing
• Bachelor of Science in Health Administration

There are pros and cons to each degree. Since very few master’s programs have undergraduate prerequisites (as long as you have some professional experience in the field of the degree), earning a BSN first and gaining experience as a nurse might be advantageous. On the flip side, numerous programs help people with other bachelor’s degrees become RNs, so a BSN isn’t strictly necessary.

For those looking to gain experience as nurses before earning a bachelor’s degree, you could complete a two-year Associate’s Degree in Nursing (ADN), take the NCLEX-RN exam, which every nurse needs to pass in order to become registered, and then complete a bachelor of science at a four-year institution.

RN or no RN, bachelor’s or master’s, certification or no certification—there’s no one surefire path to a job as a hospice administrator. That said, certification can’t hurt your prospects and is almost guaranteed to improve them. If you’re serious about a career as a hospice administrator, you need to give serious consideration to pursuing the certifications discussed above.

Questions or feedback? Email editor@noodle.com