Six questions to ask when choosing a hospice
From the outside every hospice looks the same. All of them are Medicare-certified, all of them have nurses, all of them say twenty-four hours. These are the questions that actually tell them apart — and two of them most agencies hope you never ask.
Almost nobody chooses a hospice calmly. It usually happens in a hospital corridor, from a list a discharge planner hands you, on the worst week of your year. You are allowed to ask questions anyway, and you are allowed to take a day.
1. At three in the morning, who actually picks up?
Every agency advertises 24/7. That is not the same as a nurse answering. Some route overnight calls to an answering service that takes a message and pages someone; you may wait twenty minutes for a call back from a person who has never met your family.
Ask them to say which it is, in plain words. “Does a nurse pick up, or does a service take a message?” The answer differs far more than the marketing does.
2. How long until someone is actually at the door?
Not “we're available around the clock” — a number of minutes. An agency covering four counties from one office is being honest when it says two hours; that may still be the right agency for you, but you should know before the night you need it rather than during.
3. Will we see the same nurse each week?
This is the difference between being known and explaining everything again. Ask how many patients each nurse carries. A specific number is a real answer; “it varies” is not. Continuity is also a safety issue — the nurse who saw your father last Tuesday is the one who will notice what changed by Friday.
4. What is the aide schedule, in hours?
Certified nursing assistant (CNA) visits are what actually lifts weight off the family: bathing, dressing, personal care. Ask how many visits a week and how long each one is. “As needed” is not a schedule, and it is the answer that most often turns into less help than you expected.
5. What does Medicare's own data say about you?
This is the question agencies do not expect, and you do not have to take anyone's word for the answer — you can look it up yourself, for free, in about two minutes.
Medicare publishes a scorecard for every certified hospice on Care Compare. Type in a town, and you can compare agencies side by side on two things that matter:
- The Hospice Care Index — ten indicators drawn from claims data, scored out of 10. It captures things families cannot see from outside, like how often nurses actually visited in the last days of life.
- The family survey (CAHPS) — what bereaved families said afterwards about communication, symptom relief and support.
Look up every agency on your list, not just the one recommended to you. For what it is worth, ours is on there too: Medicare reports Southern Utah Hospice at 10 out of 10 on the Hospice Care Index. We would genuinely rather you checked that yourself than believed us.
6. What happens to us afterwards?
Bereavement support is part of the Medicare hospice benefit, so every agency offers something. The differences are in the details: for how long, how often, and who actually does it. Ask those three things.
Ours runs for thirteen months — deliberately past the first birthday, the first holidays and the first anniversary, which are usually harder than the first week.
Two things nobody tells you
You can change agencies. If it is not working — the visits are not happening, nobody answers, the fit is wrong — you can transfer to a different hospice without losing your benefit or starting over. People do this, and it is not rude.
You do not have to take the list you were handed. A discharge planner's list is usually who they have a relationship with, not a ranking. You are free to call an agency that is not on it.
If you are making this decision this week
Call two or three agencies and ask them questions one, three and five. You will learn more in fifteen minutes than from any amount of website reading — including this one.
If you want to start with us, the number is 435-635-1001 and a nurse answers it at any hour. Ask us anything on this list. If we are not the right fit for your family, we will say so and tell you what to ask the next agency.