Choosing a Hospice in Vermont: Reading the Public Data
SaveVermont runs one of the strictest hospital and health-facility licensing reviews in the country, and that same Certificate of Need process applies to any new hospice, which keeps the state's hospice count small. Vermont was also an early and enthusiastic adopter of Medicaid expansion, unlike some neighboring states. Here is how Vermont's regulatory choices, its rural geography, and its older population change what the standard vetting method turns up.
Last updated: July 2026
Start with Care Compare — Vermont's list is short by design
The starting point for judging hospice quality in Vermont is the same tool used everywhere: Medicare's Care Compare, searchable by county, which lists every Medicare-certified hospice serving that area along with its CAHPS Hospice family-experience scores 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.. In Vermont, that list is short because the state runs one of the country's most comprehensive Certificate of Need programs, administered by the Green Mountain Care Board, which reviews new hospitals, nursing homes, and hospices alike before they can open.
A short list changes the arithmetic. In a state where a Care Compare search might return only a handful of agencies, comparing all of them closely is realistic in a way it isn't in a state with dozens of names, and it's worth doing precisely because there are fewer alternatives if the first agency turns out to be a poor fit.
Vermont's rural terrain shapes how fast help arrives
Vermont is geographically small but overwhelmingly rural and mountainous, with no large metro area and a road network that slows down in winter. A hospice serving a county in the Northeast Kingdom or along the spine of the Green Mountains may need meaningfully longer to reach a home during a snowstorm than the same mileage would suggest on a map.
That matters most for the hospice levels of care meant for a crisis — continuous home care and general inpatient care both depend on a clinician or a transfer reaching the patient quickly 2Ref 2Centers for Medicare & Medicaid Services (2024).Medicare-Certified 4 Levels of Hospice Care.The definitions of continuous home care for a brief crisis and general inpatient care for symptoms that can't be managed at home.. It's worth asking any Vermont hospice directly how it handles a winter emergency in a rural stretch of its service area, including whether it has a backup plan for when a mountain pass closes.
Vermont expanded Medicaid early, and its population skews older
Vermont expanded Medicaid under the Affordable Care Act, and Medicaid covers hospice care for enrollees who qualify 3Ref 3Centers for Medicare & Medicaid Services (2024).Hospice Benefit Toolkit.That Medicaid covers hospice care for people who qualify, as part of the general framing of the Medicare/Medicaid hospice benefit structure.. Vermont also has one of the oldest populations of any state, driven by years of younger residents moving away and retirees moving in, which keeps demand for hospice and other end-of-life care relatively high for the state's small overall population.
For a family without Medicare, without private insurance, and without a Medicaid category that fits, hospice for the uninsured in Vermont typically still runs through a hospice's own charity-care policy — worth asking about directly, since coverage isn't guaranteed and terms vary by agency. For Medicaid enrollees who also live in a nursing facility, Medicaid generally pays a room-and-board rate to the hospice on the resident's behalf, though the specific arrangement is worth confirming, since the mechanics vary by state 4Ref 4Centers 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..
Ownership and CAHPS still matter in a small market
Even where Vermont's Certificate of Need process has kept the hospice field small, ownership status and CAHPS Hospice scores are worth checking before calling. Nationally, family caregivers have rated for-profit hospices lower across every CAHPS Hospice domain than nonprofit hospices, and less likely to recommend them 5Ref 5Anhang 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., and problematic live discharges are more common at for-profit agencies 6Ref 6Teno 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..
Vermont's small-hospital, community-health tradition means many of its hospices are nonprofit or hospital-affiliated, but that's a pattern to verify on Care Compare for a specific agency, not something to assume outright. A short list makes checking every name's actual numbers realistic; there's little excuse not to before enrolling.
Checking a license or filing a complaint in Vermont
The Vermont Department of Health licenses and inspects hospices operating in the state and is the place to check a license history or file a complaint about a specific agency's care, separate from Medicare's own hospice complaint process. That state-level record can surface a finding that Care Compare's national quality measures don't capture.
Asking a hospice directly how it handles complaints, and whether it has had any recent state findings, is a fair question during an intake call, even in a state where word of mouth travels fast. The same checks apply identically to choosing a hospice in Iowa or choosing a hospice in Kansas; only the state agency's name and the local geography change.
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 a hospice's answers should give you pause
- —The intake team can't say who answers the clinical phone line overnight or on weekends.
- —Nobody at the agency can produce or explain its CAHPS Hospice scores or its live-discharge rate when you ask.
- —You're pressured to sign enrollment paperwork before comparing even one other agency, in a state where that comparison is realistic to do.
- —The person describing the plan of care is a marketer, not a nurse or clinician.
If the patient is in crisis and the hospice's on-call clinical line can't be reached, call 911 or go to the nearest emergency department — hospice enrollment does not replace 911 for a life-threatening emergency.
This article explains how to read publicly available hospice quality data for Vermont. It does not recommend, rank, or claim availability of any specific hospice agency, and it is not a substitute for guidance from a hospice's clinical team or the patient's physician.
References
- 1.Centers for Medicare & Medicaid Services (2024). Find Healthcare Providers: Compare Care Near You (Hospice). Medicare.gov / Care Compare (CMS). link ✓That Care Compare is the official public tool for comparing Medicare-certified hospices by location, including CAHPS Hospice family-experience scores.
- 2.Centers for Medicare & Medicaid Services (2024). Medicare-Certified 4 Levels of Hospice Care. Medicare.gov / Care Compare (CMS). link ✓The definitions of continuous home care for a brief crisis and general inpatient care for symptoms that can't be managed at home.
- 3.Centers for Medicare & Medicaid Services (2024). Hospice Benefit Toolkit. Centers for Medicare & Medicaid Services (CMS). link ✓That Medicaid covers hospice care for people who qualify, as part of the general framing of the Medicare/Medicaid hospice benefit structure.
- 4.Centers for Medicare & Medicaid Services (2024). Hospice Payments (Medicaid). Medicaid.gov (CMS). linkThat 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.
- 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 ✓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.
- 6.Teno JM, Plotzke M, Christian T, Gozalo P (2015). Characteristics of Hospice Programs With Problematic Live Discharges. Journal of Pain and Symptom Management. PMID 26004403That problematic (burdensome) live-discharge patterns are far more common at for-profit than not-for-profit hospices.
6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy