Choosing a Hospice in Arizona: Reading the Public Data

Why an Arizona hospice search returns so many results

Arizona has no Certificate of Need law, meaning a new hospice does not need state permission based on existing capacity before it can open and seek Medicare certification. Combined with a large population of retirees and part-year residents who moved to Arizona partly for its climate, this has produced one of the largest hospice markets in the country relative to population.

A long list is not itself a warning sign, but it does mean the burden of comparison falls on the family rather than on a licensing process that already screened out weaker entrants. Pull up Care Compare for your county, and expect to spend real time comparing CAHPS scores and live-discharge rates across a genuinely long list 1Ref 1Centers for Medicare & Medicaid Services (2024).Find Healthcare Providers: Compare Care Near You (Hospice).That Care Compare is the official public tool for comparing Medicare-certified hospices by location, including CAHPS Hospice family-experience scores. — the same method for judging hospice quality that works everywhere, just applied to more names.

What to check first when the list is long

With many similarly sized agencies to choose from, ownership and CAHPS performance are a faster filter than trying to evaluate every name individually. Nationally, family caregivers have rated for-profit hospices lower across every CAHPS Hospice domain than nonprofit hospices, and were less likely to say they would recommend them 2Ref 2Anhang Price R, Parast L, Elliott MN, et al. (2023).Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences.That family caregivers report worse care experiences across all CAHPS Hospice domains at for-profit than not-for-profit hospices, and are less likely to recommend them.; a separate analysis found problematic live discharges — a patient sent off hospice while still declining — are more common at for-profit agencies 3Ref 3Teno JM, Plotzke M, Christian T, Gozalo P (2015).Characteristics of Hospice Programs With Problematic Live Discharges.That problematic (burdensome) live-discharge patterns are far more common at for-profit than not-for-profit hospices..

In a market as large as Arizona's, that means starting by sorting for higher CAHPS scores and lower live-discharge rates, then narrowing further by calling the top few and asking each the same specific questions: who answers the phone at 3 a.m., how quickly a nurse can reach the patient's home, and how the agency handles a request to switch hospices if the fit is wrong.

Arizona's Medicaid hospice benefit through AHCCCS

Arizona's Medicaid program, AHCCCS (the Arizona Health Care Cost Containment System), covers hospice care for enrollees who qualify 4Ref 4Centers for Medicare & Medicaid Services (2024).Hospice Benefit Toolkit.That Medicaid (administered in Arizona as AHCCCS) covers hospice care for enrollees who qualify, as part of the general framing of the Medicare/Medicaid hospice benefit structure.. Arizona expanded Medicaid eligibility under the Affordable Care Act, so AHCCCS reaches a broader group of low-income adults than Medicaid programs in states that did not expand.

For AHCCCS enrollees who are also residents of a nursing facility, Medicaid generally pays a room-and-board rate to the hospice on the resident's behalf, though the exact mechanics vary by state and are worth confirming directly with the facility and the hospice 5Ref 5Centers for Medicare & Medicaid Services (2024).Hospice Payments (Medicaid).That for dually eligible nursing-facility residents, Medicaid generally pays a room-and-board rate to the hospice on the resident's behalf, and that the mechanics vary by state..

For Arizonans who need nursing-facility-level care, the state's Medicaid long-term care program, ALTCS (the Arizona Long Term Care System), determines eligibility and coordinates payment separately from a standard AHCCCS acute-care enrollment. A hospice serving an ALTCS-eligible patient works within that separate eligibility determination, so it's worth asking directly how the hospice interacts with ALTCS rather than assuming the process mirrors regular AHCCCS enrollment.

Serving a large seasonal population

Arizona's hospice agencies routinely serve patients who split the year between Arizona and another state, a pattern far more common here than in most places. That raises practical questions a hospice serving a stable, year-round population may not face as often: what happens to care continuity if a patient needs to travel or relocate mid-enrollment, and how a hospice coordinates records with a program in another state if a patient transfers.

It's a fair question to ask directly during an intake call if your family splits time seasonally, since the answer affects real continuity of care, not just paperwork. An agency accustomed to snowbird patients should be able to describe this process without hesitation; one that has never considered it may not be the right fit for a family that travels. This is also worth asking about even if your family stays put, since an agency's operational habits around scheduling and transfer paperwork reflect how often it handles this kind of transition.

Rural and tribal Arizona look nothing like the Phoenix metro

Arizona's hospice abundance is concentrated where its population is. The Phoenix and Tucson metro areas hold the large majority of the state's hospice agencies and its largest concentration of retirees. Rural counties, and the parts of the state that overlap tribal nations including the Navajo Nation, the Tohono O'odham Nation, and the San Carlos and White Mountain Apache reservations, see a much thinner hospice presence, often relying on a mix of Indian Health Service facilities, tribal health programs, and a smaller number of agencies willing to travel long distances.

A family in one of these areas should ask the same core questions as anywhere — CAHPS scores, live-discharge rate, ownership — but should also ask directly how far a hospice's staff actually travels to reach a specific community, and whether the agency coordinates with a local tribal health program or Indian Health Service facility. The answer in rural Arizona can look far more like the answer in a genuinely rural state than like the fast-growing Phoenix market the rest of this article describes.

Checking a license or filing a complaint in Arizona

The Arizona Department of Health Services licenses and inspects hospices operating in the state and is the place to check a license or file a complaint about a specific agency's care, separate from Medicare's own hospice complaint process. Asking a hospice directly whether it has had recent state findings, and how it responded, is a reasonable question during an intake call.

Given how many agencies operate in Arizona, a hospice's willingness to answer plainly, rather than deflect, is itself useful information when the field is this large. It's also worth checking how recently an agency's CAHPS results were collected, since a smaller agency's scores can shift noticeably year to year with a small sample of surveyed families. The same underlying checks apply outside Arizona too, whether it's choosing a hospice in Kansas or choosing a hospice in Rhode Island — only the size of the list changes.