Providing expert care as a hospice case manager enables patients and families the ability to cope and work through uncomfortable symptoms and situations. It is the support that is given to families during this time that make the biggest impressions on care. Federally mandated pubic reporting requirements encourages transparency in health care quality. The CAHPS-Hospice Survey provides patients the ability to make informed decisions when choosing a provider for their care. The CAHPS-Hospice Survey is also a tool for families to use in rating their perception of care that their loved one received through the end-of-life. There is strong evidence that states, continuing education that is provided to the hospice case managers can have a direct influence on patient satisfaction scores. Education-based on patient an family expectations through the end-of-life is lacking within the organization. Hospice case managers are often able to provide guidance when confronting difficult and often painful decisions with patients and families. It is important that hospice case managers feel confident in their role to promote comfort, control pain and other symptoms, and provide support for the patient, family and those close to them at the end of life.