Problem: An adequate home supply of medication is crucial for hospice patients to enhance pain management, symptom control, and quality of life. An adult home hospice agency in Central Maryland identified an issue related to an increase in after-hours patient calls regarding inadequate home medication supply. The site revealed an increase in after-hours calls from zero to six calls/month in early 2023 to seven to nine calls/month at the year's end. After-hours medication calls are preventable, impacting patient care and safety, increasing costs, and disrupting staff workflow. Purpose: This quality improvement project aimed to enhance medication workflow, home medication supply, and safety for adult hospice patients by implementing a new medication reconciliation (MR) process using the Medications at Transitions and Clinical Handoffs (MATCH) program. Methods: Before the program's launch, the project lead (PL) assembled a team of stakeholders to design a successful initiative. Key tactics included defining nurses' workflow during each patient visit, adopting a new home hospice nurse job aid, and creating an EPIC build for the MR process in the electronic medical record. The initiative was monitored weekly by the PL through chart reviews and reports, evaluating data on staff adherence, after-hours medication calls, and safety events. Data were recorded in Excel on the site’s secure computer. Results: Seventy-one percent of nurses completed training on the new MR workflow. The EPIC build was successful, with an average of 93% adherence to the MR process. Medication reconciliation was performed on 2,914 eligible patients, averaging two after-hours calls and 0.5 medication safety events per week. Conclusions: The new MR process through the MATCH program improved medication management and efficiency, resulting in fewer after-hours calls and enhanced patient safety at the project site. Keywords: medication reconciliation, adult home hospice, after-hours calls for refills