For both my Mom and my Dad I requested a Hospice evaluation. Yes, it had to be approved by the doctor first but it was my request. You don't have to wait on the doctor to suggest it... The doctor just has to sign off on the evaluation. Then Hospice came in and did their evaluation. They were the ones that determined acceptance. Once they accepted Mom, they notified her doctor. I had opted to use the Hospice doctor so her previous doctor sent all the records to Hospice.
If there is a reason for a medical consult the Hospice nurse comes and evaluates. If necessary the Hospice doctor will come out as well. It is then up to them to determine treatment. Mom's Hospice nurse visits with her twice a week on a regular basis. So Mom actually sees more medical personnel now than she did before... she just doesn't have to go to the ER to see a nurse or doctor