Choosing a Hospice in Pennsylvania: Reading the Public Data
SavePennsylvania has dozens of Medicare-certified hospice agencies spanning dense metro corridors and wide rural counties, and quality varies more by agency than by geography. This guide walks through the specific public sources — CAHPS scores, live-discharge rates, ownership status, and the state's own licensing complaint history — that separate a well-run hospice from one coasting on its reputation.
Last updated: July 2026History
What Does Choosing a Hospice Actually Involve in Pennsylvania?
Choosing a hospice in Pennsylvania means picking among the Medicare-certified agencies licensed to serve the county where the patient lives, and Pennsylvania has dozens of them — large nonprofit health-system programs, faith-affiliated agencies, and small for-profit companies that may serve only a handful of counties. The choice usually happens fast, often within days of a terminal diagnosis or a hospital discharge, which is exactly when families have the least time to research.
The good news is that the research does not require insider knowledge. Every Medicare-certified hospice in the state reports the same standardized measures to CMS, and those measures are public. The work is knowing which three or four numbers actually predict a hospice that shows up, answers the phone, and controls symptoms — and reading them for the specific agencies serving your address, not a chain's reputation.
Filtering CMS Care Compare to Pennsylvania
Care Compare is the federal government's public tool for comparing every Medicare-certified hospice in the country, and filtering it to Pennsylvania narrows a national list down to the agencies that can actually take a referral in a given county 1Ref 1Centers for Medicare & Medicaid Services (2024).Find Healthcare Providers: Compare Care Near You (Hospice).Supports that CMS Care Compare is the official public tool for filtering and comparing Medicare-certified hospices by state and county.. Search by ZIP code rather than city name, since a hospice's certified service area rarely matches municipal boundaries.
Each result shows the same handful of fields: whether the agency is Medicare-certified, its ownership type, and links into the underlying CAHPS and claims-based measures described below. Because a single ZIP code near a county line — Bucks and Montgomery, or Westmoreland and Allegheny — can sit inside more than one agency's service area, it is worth searching from both the home address and the address of any facility, such as a nursing home or hospital, where care might actually be delivered.
Reading the CAHPS Family-Experience Score
The CAHPS Hospice Survey asks the primary caregiver of someone who died on service, months later, to rate communication, symptom management, timeliness, and whether they would recommend the hospice to others 2Ref 2Centers for Medicare & Medicaid Services (2024).CAHPS Hospice Survey.Supports the description of what the CAHPS Hospice Survey measures and how it samples caregivers of patients who have died.. It is the closest thing to a review the federal government runs, except every respondent actually used the hospice and the survey instrument is standardized nationwide.
Pennsylvania agencies range widely on these scores, and the range is worth taking seriously: a caregiver rating in the bottom quartile on getting timely help is the accumulated experience of hundreds of other families in exactly the position a new family is about to be in. Read the domain scores individually rather than an overall rating, since a hospice can score well on staff courtesy while scoring poorly on out-of-hours response — the domain that matters most at 3 a.m.
Why the Live-Discharge Rate Deserves a Second Look
A hospice's live-discharge rate — how often patients leave hospice alive rather than being cared for through death — is a signal for how a hospice enrolls and manages patients, and a pattern of live discharge close to a hospitalization has been linked to for-profit ownership and shorter stays 3Ref 3Peer-reviewed cohort study (see article) (2024).Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice.Supports that burdensome transitions after a live discharge from hospice are more likely among for-profit agencies and short stays.. It does not mean every live discharge is a red flag; conditions do stabilize.
What is worth scrutinizing is the pattern behind it. Research on problematic live discharges — ones followed quickly by a hospital admission or a hospital death — has found them meaningfully more common at for-profit hospices than not-for-profit ones 4Ref 4Teno JM, Plotzke M, Christian T, Gozalo P (2015).Characteristics of Hospice Programs With Problematic Live Discharges.Supports that problematic live-discharge patterns are documented as more common at for-profit than not-for-profit hospices., and a separate national CAHPS analysis found family caregivers report worse experiences across every measured domain at for-profit hospices, and are less likely to say they would recommend one 5Ref 5Anhang Price R, Parast L, Elliott MN, et al. (2023).Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences.Supports that family caregivers report worse experiences across CAHPS domains at for-profit hospices and are less likely to recommend them.. Ownership alone should not decide the choice, but it belongs in the comparison alongside the CAHPS numbers.
| Signal | Where to find it | What it suggests |
|---|---|---|
| CAHPS domain scores | Care Compare, per agency | Family-reported communication, symptom control, timeliness |
| Live-discharge pattern | Care Compare claims data | Enrollment and management practices |
| Ownership type | Care Compare listing | One input among several, not a verdict |
Distance and Continuous Home Care Across a State This Size
Pennsylvania stretches from the dense rowhouse blocks of Philadelphia to sparsely populated timber counties along the New York and West Virginia borders, and that geography changes what a hospice can realistically deliver. Continuous home care — periods when a hospice can staff a home almost around the clock during a bad stretch — depends on a clinician being able to reach the house quickly, and reach time is not the same in Center City as it is forty minutes past the nearest hospital in Potter or Fulton County.
A question worth asking any agency serving a rural address directly: how many miles is the farthest home they currently cover, and what is their typical response time for an urgent visit outside business hours? Two agencies with identical CAHPS scores can differ sharply on this, and it rarely shows up in the federal data at all — it has to be asked.
How Pennsylvania's Medical Assistance Program Handles the Hospice Benefit
Pennsylvania's Medicaid program, called Medical Assistance, follows the federal hospice benefit structure but administers its own rules for people who are also living in a nursing facility. For a dually eligible nursing-home resident who elects hospice, Medicaid — not Medicare — typically continues paying a room-and-board rate to the facility, passed through the hospice, and the exact rate and process vary by state 6Ref 6Centers for Medicare & Medicaid Services (2024).Hospice Payments (Medicaid).Supports how Medicaid room-and-board payment works for dually eligible nursing-facility residents electing hospice, and that the specific rules vary by state..
That detail matters because families are sometimes told, incorrectly, that electing hospice means giving up the nursing home placement, or that room-and-board billing becomes the family's responsibility. It is worth asking the hospice's admissions staff, in plain terms, how the room-and-board arrangement will work for the specific facility involved, since the mechanics run through Pennsylvania's own Medicaid administration rather than Medicare directly.
Where a Complaint Goes When the Federal Data Runs Out
Care Compare shows quality measures, not licensing history, and the two are different records kept by different agencies. Pennsylvania's Department of Health licenses the hospice agencies operating in the state and is the venue for a complaint about licensed conduct — a missed visit, an unanswered on-call line, a specific dispute over clinical judgment — that CMS's national dataset was never built to capture.
A hospice's Medicare certification and its state license are two separate standings, and a problem serious enough to matter to a family is often a state licensing matter well before it becomes a Medicare decertification. Asking a hospice directly whether it has had any state licensing actions in the past several years is a fair question, and a defensive non-answer is itself useful information.
Common questions
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Say it back
How would you explain this to someone you love?
Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.
When to Call the Hospice Nurse Line — Not Wait for the Next Visit
- —Pain or breathlessness that is not controlled between scheduled visits
- —A missed visit or an on-call line that goes unanswered for hours
- —A live discharge proposed with no clear clinical reason given in writing
- —A sudden change in the level of care that is not explained to the family
If the on-call hospice nurse cannot be reached and the person is in acute distress, call 911 and tell the dispatcher hospice is involved so paramedics know the goal is comfort, not resuscitation, unless a POLST says otherwise.
This article explains how to evaluate hospice agencies using public data; it is not medical advice and does not replace a conversation with the hospice team or the treating clinician.
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References
- 1.Centers for Medicare & Medicaid Services (2024). Find Healthcare Providers: Compare Care Near You (Hospice). Medicare.gov / Care Compare (CMS). link ✓Supports that CMS Care Compare is the official public tool for filtering and comparing Medicare-certified hospices by state and county.
- 2.Centers for Medicare & Medicaid Services (2024). CAHPS Hospice Survey. Centers for Medicare & Medicaid Services (CMS). link ✓Supports the description of what the CAHPS Hospice Survey measures and how it samples caregivers of patients who have died.
- 3.Peer-reviewed cohort study (see article) (2024). Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice. JAMA Network Open (PMC11099680). PMID 38753329 ✓Supports that burdensome transitions after a live discharge from hospice are more likely among for-profit agencies and short stays.
- 4.Teno JM, Plotzke M, Christian T, Gozalo P (2015). Characteristics of Hospice Programs With Problematic Live Discharges. Journal of Pain and Symptom Management. PMID 26004403Supports that problematic live-discharge patterns are documented as more common at for-profit than not-for-profit hospices.
- 5.Anhang Price R, Parast L, Elliott MN, et al. (2023). Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences. JAMA Internal Medicine. doi:10.1001/jamainternmed.2022.7076 ✓Supports that family caregivers report worse experiences across CAHPS domains at for-profit hospices and are less likely to recommend them.
- 6.Centers for Medicare & Medicaid Services (2024). Hospice Payments (Medicaid). Medicaid.gov (CMS). linkSupports how Medicaid room-and-board payment works for dually eligible nursing-facility residents electing hospice, and that the specific rules vary by state.
6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy