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Under the Medicare Hospice Benefit, what is the prognosis requirement that a physician must certify for a patient to be eligible for hospice care?

A life expectancy of 6 months or less if the terminal illness runs its normal course

A life expectancy of 12 months or less regardless of treatment decisions

Active cancer or end-stage organ failure with any prognosis

Any illness that has failed two lines of curative therapy

to track

2026 Statistics

Key Facts: CHP-SW Exam

Portfolio

Review Process

NASW (not a timed exam)

BSW

Minimum Degree

CSWE-accredited

3 years

Supervised Hospice Experience

Post-BSW, paid, supervised

20 CE

Hospice/Palliative CE Hours

Application requirement

$140

Application Fee (Members)

NASW / NCHPP ($350 non-members)

2 years

Credential Validity

Renew with 20 CE hours

The NASW CHP-SW credential is the BSW-level national recognition for hospice and palliative social work. Unlike exams with timed multiple-choice tests, the CHP-SW is awarded through NASW portfolio review. Eligibility requires: (1) a CSWE-accredited BSW, (2) current state social work license, (3) at least 3 years (4,500 hours) of paid, post-BSW, supervised social work experience in hospice and palliative care, (4) 20 CE hours specifically in hospice and palliative care, (5) professional references, (6) adherence to the NASW Code of Ethics and NASW Standards for Palliative and End of Life Care. Application fee is $140 for NASW or NCHPP members and $350 for non-members. The credential is valid for 2 years and renewal requires 20 CE hours in hospice/palliative topics. The advanced credential for MSW-level practitioners is ACHP-SW. Our 100 free CHP-SW practice questions help candidates master the underlying knowledge base: Medicare Hospice Benefit, the four levels of hospice care, grief theory (Kubler-Ross, Worden, Doka, Rando, Bowlby, continuing bonds, dual process), advance care planning, NASW ethics, cultural and spiritual care, pediatric/perinatal loss, Medicare Conditions of Participation, and interdisciplinary team function.

Sample CHP-SW Practice Questions

Try these sample questions to test your CHP-SW exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Under the Medicare Hospice Benefit, what is the prognosis requirement that a physician must certify for a patient to be eligible for hospice care?

A.A life expectancy of 6 months or less if the terminal illness runs its normal course

B.A life expectancy of 12 months or less regardless of treatment decisions

C.Active cancer or end-stage organ failure with any prognosis

D.Any illness that has failed two lines of curative therapy

Explanation: The Medicare Hospice Benefit (42 CFR 418.22) requires the hospice medical director and the patient's attending physician to certify that the patient has a terminal illness with a life expectancy of 6 months or less if the illness runs its normal course. Eligibility is based on prognosis, not diagnosis. The benefit is structured in an initial 90-day period, a second 90-day period, and unlimited 60-day recertification periods thereafter, each requiring physician recertification.

2Which of the following is NOT one of the four levels of hospice care defined by the Medicare Hospice Benefit?

A.Routine home care

B.Continuous home care

C.General inpatient care (GIP)

D.Skilled nursing facility custodial care

Explanation: The Medicare Hospice Benefit defines exactly four levels of care: (1) Routine Home Care, (2) Continuous Home Care (for brief periods of crisis requiring primarily nursing), (3) General Inpatient Care (GIP, for pain or symptom management that cannot be controlled at home), and (4) Inpatient Respite Care (up to 5 consecutive days to relieve the caregiver). Custodial care in a skilled nursing facility is not covered under the hospice benefit; room and board in a nursing home is the patient's responsibility.

3According to Elisabeth Kubler-Ross, which sequence best represents the five stages of grief as originally described in 'On Death and Dying' (1969)?

A.Shock, numbness, yearning, reorganization, acceptance

B.Denial, anger, bargaining, depression, acceptance

C.Avoidance, confrontation, accommodation, integration, resolution

D.Disbelief, searching, disorganization, rebuilding, transcendence

Explanation: Kubler-Ross described five stages originally observed in dying patients: Denial, Anger, Bargaining, Depression, and Acceptance (DABDA). The stages are not linear or universal, and later scholarship (including Kubler-Ross herself) emphasized that patients and families may move through them in any order, revisit stages, or skip them entirely. Modern grief theory (Worden, Bonanno, Neimeyer) has largely moved beyond stage models, but CHP-SW candidates must know the classic DABDA framework.

4William Worden's 'Tasks of Mourning' model identifies four active tasks a bereaved person must work through. Which of the following is Worden's fourth task?

A.Find meaning in the loss and construct a narrative

B.To find an enduring connection with the deceased in the midst of embarking on a new life

C.Return to full pre-loss functioning within one year

D.Replace the deceased with a new attachment figure

Explanation: Worden's Four Tasks of Mourning (most recently revised in the 5th edition) are: (1) Accept the reality of the loss, (2) Process the pain of grief, (3) Adjust to a world without the deceased, and (4) Find an enduring connection with the deceased in the midst of embarking on a new life. Worden revised Task 4 from the original 'emotionally relocate the deceased and move on with life' to reflect continuing bonds theory — the bereaved do not sever ties with the deceased but integrate that relationship into their ongoing life.

5A hospice patient in routine home care develops uncontrolled pain that has not responded to escalating opioid titration at home. The interdisciplinary team determines that intensive symptom management is needed that cannot be provided in the home. Which level of hospice care is most appropriate?

A.Continuous home care

B.General inpatient care (GIP)

C.Inpatient respite care

D.Routine home care with increased visits

Explanation: General Inpatient Care (GIP) is the Medicare hospice level designated for short-term inpatient management of pain or other symptoms that cannot be controlled in the home setting. GIP is provided in a Medicare-certified hospice inpatient unit, hospital, or skilled nursing facility with 24-hour nursing. Continuous home care is also for crisis symptom management but is provided in the home with primarily skilled nursing. Respite care is to relieve the caregiver, not for symptom control. GIP requires clear documentation of the uncontrolled symptom.

6The NASW Standards for Palliative and End of Life Care identify which of the following as a core responsibility of the palliative care social worker?

A.Prescribing and titrating opioid medications under physician supervision

B.Advocating for the patient's self-determination and informed decision-making across the illness trajectory

C.Delivering spiritual sacraments to patients when a chaplain is unavailable

D.Certifying the 6-month terminal prognosis for Medicare hospice eligibility

Explanation: The NASW Standards for Palliative and End of Life Care (originally 2004, still the foundational NASW document in this area) identify core social work responsibilities including advocacy for patient self-determination and informed decision-making, psychosocial assessment, intervention with patients and families, interdisciplinary team participation, cultural competence, and ethics. Prescribing is outside the social work scope, spiritual sacraments are the chaplain's role, and physicians (not SWs) certify prognosis.

7Which legal document specifically designates another person to make healthcare decisions on behalf of a patient if the patient loses decision-making capacity?

A.Living will

B.Durable Power of Attorney for Healthcare (DPOA-HC)

C.Do Not Resuscitate (DNR) order

D.POLST/MOLST form

Explanation: A Durable Power of Attorney for Healthcare (DPOA-HC), also called a healthcare proxy or healthcare power of attorney, designates an agent (surrogate) to make medical decisions on the patient's behalf when the patient is no longer able to do so. A living will expresses treatment preferences but does not name a decision-maker. A DNR is a physician order limiting CPR. POLST/MOLST are medical orders that translate goals of care into actionable orders but do not designate a surrogate.

8What is the fundamental distinction between a living will and a POLST (Physician Orders for Life-Sustaining Treatment) form?

A.A living will is legally binding; a POLST is only advisory

B.A POLST is a portable medical order set signed by a clinician that is actionable by EMS and across care settings; a living will is a statement of preferences

C.A POLST expires annually; a living will never expires

D.A living will requires witnesses; a POLST does not

Explanation: A living will is an advance directive — a written statement of the patient's future treatment preferences (e.g., 'I do not want CPR or mechanical ventilation if terminally ill'). It must be interpreted by clinicians in context. A POLST (or MOLST in some states) is a portable medical order signed by a physician, NP, or PA based on shared decision-making with the patient; EMS and other providers can and must follow it immediately. POLST is for seriously ill patients with a limited prognosis; living wills are for anyone.

9The hospice interdisciplinary group (IDG) required under Medicare Conditions of Participation must include, at a minimum, which four core disciplines?

A.Physician, nurse, social worker, and pastoral/spiritual counselor

B.Physician, nurse, pharmacist, and dietitian

C.Physician, social worker, home health aide, and volunteer coordinator

D.Nurse, nurse aide, social worker, and physical therapist

Explanation: Medicare Conditions of Participation for Hospice (42 CFR 418.56) require the IDG (also called the IDT) to include at a minimum: a doctor of medicine or osteopathy (hospice medical director or physician designee), a registered nurse, a social worker, and a pastoral or other counselor. Home health aides, volunteers, and therapists are additional team members but are not part of the required four-member core. The IDG collectively develops and reviews the plan of care.

10How frequently must the hospice interdisciplinary group review and update the patient's plan of care under Medicare Conditions of Participation?

A.At least every 30 days

B.At least every 15 calendar days

C.Only when the patient's condition changes significantly

D.At each recertification period (every 60-90 days)

Explanation: Under 42 CFR 418.56, the hospice IDG must review, revise, and document the individualized plan of care as frequently as the patient's condition requires, but at a minimum every 15 calendar days. The plan of care must include all services necessary for the palliation and management of the terminal illness, interventions to manage pain and symptoms, and a detailed statement of the scope and frequency of services. This is a frequent survey citation if not documented.

About the CHP-SW Exam

The CHP-SW (Certified Hospice and Palliative Social Worker) is the NASW BSW-level national credential for hospice and palliative social work. It is awarded through a portfolio review process — not a timed exam — that verifies a CSWE-accredited BSW, current state licensure, three years of supervised social work experience in hospice and palliative care, 20 CE hours in hospice/palliative topics, professional references, and adherence to the NASW Code of Ethics and the NASW Standards for Palliative and End of Life Care.

Questions

100 scored questions

Time Limit

Portfolio review (no timed exam)

Passing Score

NASW portfolio review approval

Exam Fee

$140 (NASW/NCHPP members) / $350 (non-members) (NASW)

CHP-SW Exam Content Outline

14%

Grief, Bereavement, and Loss

Kubler-Ross stages, Worden's four tasks of mourning, continuing bonds (Klass/Silverman/Nickman), dual process model (Stroebe & Schut), anticipatory grief (Rando), disenfranchised grief (Doka), ambiguous loss (Boss), complicated grief / prolonged grief disorder (DSM-5-TR), bereavement hallucinations, and attachment-informed grief theory (Bowlby, Parkes)

12%

Hospice Eligibility & Medicare Hospice Benefit

6-month prognosis certification, benefit periods (two 90-day + unlimited 60-day), face-to-face encounter requirement, LCDs for non-cancer hospice diagnoses, hospice election and waiver of curative treatment for the terminal illness, Part D interaction, debility/failure-to-thrive restrictions, and live discharge/revocation

10%

Ethics and NASW Code of Ethics

NASW Code of Ethics (Standards 1.02 self-determination, 1.06 conflicts of interest, 1.07 confidentiality, 2.09 colleague impairment), double effect, palliative sedation, VSED, medical aid in dying, mandatory reporting, post-death confidentiality (HIPAA 50-year rule), moral distress, and ethics consultation

10%

Advance Care Planning

Living wills, Durable Power of Attorney for Health Care (DPOA-HC), POLST/MOLST, DNR orders, Five Wishes, Patient Self-Determination Act of 1990, goals-of-care conversations, Respecting Choices / Conversation Project frameworks, substituted judgment and best interest standards

10%

Family Systems & Caregiver Support

Genograms, family meetings (VALUE, SPIKES), caregiver burden assessment (Zarit), dementia caregiver support, anticipatory guidance for active dying, post-death support, Ira Byock's 'Four Things That Matter Most,' dignity therapy (Chochinov), legacy work, and family conflict mediation

10%

Pain & Symptom Management (Social Work Role)

Cicely Saunders' 'total pain' framework, psychosocial and spiritual contributors to suffering, terminal restlessness/delirium assessment, palliative sedation, withdrawal of artificial nutrition and hydration, and family education on comfort medications

Cultural and Spiritual Considerations

NASW Standards and Indicators for Cultural Competence, truth-telling across cultures, familismo, Jewish/Catholic/Muslim/Buddhist/secular death customs, FICA and HOPE spiritual assessment, LGBTQ+ chosen family and end-of-life issues, veterans (We Honor Veterans), rural access, and health equity in hospice

Four Levels of Hospice Care

Routine home care, continuous home care (crisis symptom management with primarily skilled nursing), general inpatient care (GIP for uncontrolled symptoms), and inpatient respite care (up to 5 days for caregiver relief) — eligibility criteria and appropriate use of each level

Medicare Conditions of Participation

42 CFR 418 — IDG composition (MD/RN/SW/pastoral counselor), comprehensive assessment within 5 days, plan of care review every 15 days, required bereavement services for 1 year post-death, QAPI program (418.58), volunteer 5% requirement (418.78), spiritual care (418.64), and Hospice Quality Reporting Program

Interdisciplinary Team Function

IDT vs MDT, roles of physician, RN, social worker, chaplain, home health aide, volunteer coordinator, and bereavement coordinator, team meeting dynamics, shared plan of care development, collaborative decision-making, compassion fatigue and peer support

Pediatric Palliative and Perinatal Loss

ChiPPS standards, ACA Section 2302 concurrent care for children, children's understanding of death by developmental stage, sibling support, perinatal loss (miscarriage, stillbirth, neonatal death, termination for anomaly), age-appropriate communication, and memory-making interventions

How to Pass the CHP-SW Exam

What You Need to Know

Passing score: NASW portfolio review approval
Exam length: 100 questions
Time limit: Portfolio review (no timed exam)
Exam fee: $140 (NASW/NCHPP members) / $350 (non-members)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CHP-SW Study Tips from Top Performers

1Master the Medicare Hospice Benefit (42 CFR 418): 6-month prognosis certification, two 90-day + unlimited 60-day benefit periods, face-to-face encounter requirement before the 3rd period, and the hospice election waiver for curative treatment of the terminal illness

2Know the four levels of hospice care cold: routine home care, continuous home care (crisis symptom management, primarily RN, at least 8 of 24 hours), general inpatient care (GIP for uncontrolled symptoms), and inpatient respite care (up to 5 consecutive days for caregiver relief)

3Study modern grief theory beyond Kubler-Ross: Worden's four tasks (especially the revised Task 4 on enduring connection), continuing bonds (Klass/Silverman/Nickman), dual process model (Stroebe & Schut), anticipatory grief (Rando), disenfranchised grief (Doka), and ambiguous loss (Boss)

4Memorize the DSM-5-TR criteria for Prolonged Grief Disorder (12 months in adults, 6 months in children) and distinguish it from normal bereavement and from major depression

5Learn the distinctions among DPOA-HC (names a surrogate), living will (expresses preferences), POLST/MOLST (portable medical orders), DNR (limits CPR specifically), and Five Wishes (comprehensive advance directive tool)

6Study the NASW Code of Ethics Standards most relevant to hospice practice: 1.02 self-determination, 1.06 conflicts of interest, 1.07 privacy and confidentiality, and 2.09 impairment of colleagues

7Understand the hospice interdisciplinary group (IDG) composition required by 42 CFR 418.56: physician, RN, social worker, and pastoral/spiritual counselor — and the 15-day plan of care review requirement

8Know the Medicare Conditions of Participation basics: 5-day comprehensive assessment, 15-day plan of care review, at least 1 year of bereavement services (418.64), 5% volunteer hours requirement (418.78), and QAPI program (418.58)

9Study Cicely Saunders' 'total pain' concept (physical, psychological, social, spiritual) and how social workers address the non-physical dimensions of suffering

10Review Ira Byock's 'Four Things That Matter Most' (Please forgive me, I forgive you, Thank you, I love you) and Chochinov's Dignity Therapy as evidence-based legacy interventions

Frequently Asked Questions

Is the CHP-SW a timed exam or a portfolio review?

The CHP-SW is awarded through a NASW portfolio review process — not a timed multiple-choice exam. NASW reviews documentation of your CSWE-accredited BSW, current state license, three years of supervised hospice/palliative social work experience, 20 CE hours in hospice and palliative care, and professional references. Our 100 free CHP-SW practice questions are designed to help candidates master the knowledge base underlying the NASW Standards for Palliative and End of Life Care so they can practice competently and document their professional preparation.

What are the CHP-SW eligibility requirements?

The CHP-SW requires: (1) a bachelor's degree in social work from a program accredited by the Council on Social Work Education (CSWE), (2) current state social work license at the appropriate level for your state, (3) at least three years (approximately 4,500 hours) of paid, post-BSW, supervised social work experience in hospice and/or palliative care, (4) 20 continuing education hours specifically related to hospice and palliative care, (5) professional references from a supervisor and colleagues, and (6) adherence to the NASW Code of Ethics and the NASW Standards for Palliative and End of Life Care.

How much does the CHP-SW credential application cost?

The CHP-SW application fee is $140 for current NASW members or members of the National Council of Hospice and Palliative Care Professionals (NCHPP), and $350 for non-members. Renewal every two years is $95 for members and $350 for non-members. These fees are set by NASW and are subject to change — always confirm current fees on the NASW Credentials page before applying.

How is the CHP-SW different from the ACHP-SW?

CHP-SW is the BSW-level credential (Certified Hospice and Palliative Social Worker). ACHP-SW is the Advanced Certified Hospice and Palliative Social Worker credential for MSW-level practitioners. ACHP-SW requires a CSWE-accredited MSW, two years of paid post-MSW supervised hospice/palliative social work experience, and either a state license at the clinical level or an ASWB passing score. Both credentials share the commitment to the NASW Standards for Palliative and End of Life Care, but ACHP-SW validates advanced clinical competence.

How long is the CHP-SW credential valid, and how do I renew?

The CHP-SW credential is valid for two years. Renewal requires documenting 20 continuing education hours earned in hospice and palliative care topics during the credential cycle, continued state licensure, adherence to the NASW Code of Ethics and NASW Standards for Palliative and End of Life Care, and payment of the renewal fee ($95 for members, $350 for non-members). NASW will send renewal reminders before expiration.

What topics are covered in the CHP-SW knowledge base and our practice questions?

Our 100 CHP-SW practice questions cover the full content of the NASW Standards for Palliative and End of Life Care: hospice eligibility and the Medicare Hospice Benefit (6-month prognosis, benefit periods), the four levels of hospice care (routine, continuous home, GIP, respite), pain and symptom management (social work role in total pain), grief theory (Kubler-Ross, Worden, Doka, Rando, Bowlby, continuing bonds, dual process), advance care planning (POLST, DPOA-HC, Five Wishes), NASW ethics and Code of Ethics, cultural and spiritual competence, pediatric palliative and perinatal loss, family and caregiver support, Medicare Conditions of Participation, and interdisciplinary team function.

What is the NASW Standards for Palliative and End of Life Care?

The NASW Standards for Palliative and End of Life Care (originally published in 2004) define the scope of practice and competencies expected of professional social workers in this specialty. Core Standards address ethics and values, knowledge, assessment, intervention, attitude and self-awareness, empowerment and advocacy, documentation, interdisciplinary teamwork, cultural competence, continuing education, and supervision and leadership. All CHP-SW applicants must demonstrate adherence to these Standards.

What continuing education counts toward the 20 CE hour requirement?

The 20 CE hours must be in topics specifically related to hospice and palliative care — e.g., grief and bereavement, pain and symptom management, advance care planning, pediatric palliative care, cultural and spiritual care at end of life, ethics in palliative care, family dynamics in serious illness. Approved sources include ACE-approved providers, NASW chapter CE programs, NHPCO (National Hospice and Palliative Care Organization), SWHPN (Social Work Hospice & Palliative Care Network), and CAPC (Center to Advance Palliative Care). Always verify CE eligibility with NASW Credentialing before submission.