Home health, and hospice
Skilled nursing and therapy at home after a hospital stay, and end-of-life care. Both are usually paid by Medicare, which makes them a different transaction from everything else on this page.
These are the two categories where the money is not yours, and that changes what you are choosing between. You are almost always free to pick the agency — a hospital discharge planner's list is a list, not an assignment — and Medicare publishes ratings and patient-survey results for both. The catch is that Medicare's list and Oregon's list are not the same list.
Two lists, and the bigger one is the state's
Medicare certifies 51 home health agencies in Oregon. The Oregon Health Authority licenses 62. The eleven-agency difference is agencies you can hire that do not appear on Medicare's own site — which matters if you are paying privately, and does not if you need Medicare to pay, because Medicare only pays a certified agency. So: if Medicare is paying, use Medicare's list and its ratings. If you are paying, the state list is the complete one.
What to ask
1. Am I allowed to choose a different agency from the one on this discharge list?
Yes, and hospital discharge is the moment families are least likely to know it. The list you are handed is often the agencies the hospital has a relationship with, which is not the same as the agencies that are best or nearest.
A bad answer sounds like: 'This is who we work with.' That is an answer about the hospital, not about your options.
2. Is the agency owned by, or affiliated with, this hospital or this health system?
Frequently yes, and frequently fine. It is worth knowing, because it explains the shape of the list you were given.
A bad answer sounds like: Evasion. It is a matter of public record.
3. How many visits a week, by whom, and for how many weeks?
'Home health' covers a nurse twice a week and a physical therapist three times, and families routinely expect something closer to daily. Getting the number said out loud at the start prevents the disappointment that follows.
A bad answer sounds like: 'As often as she needs.' The plan of care has numbers in it; ask what they are.
4. What happens at night and at weekends?
Especially for hospice. The question that decides a family's experience is who answers the phone at 2am on a Sunday and whether anyone comes out.
A bad answer sounds like: An answering service with no on-call clinician behind it, or 'call 911' — which for a hospice patient is usually the outcome hospice exists to avoid.
5. For hospice: what does your inpatient or respite arrangement look like, and where is it?
Most hospice happens at home, and most families reach a point where it cannot for a few days. Whether that is a bed twenty minutes away or a bed in another county is a real difference at a bad moment.
A bad answer sounds like: A vague 'we can arrange something'.
6. Who is the assigned nurse, and what happens if we do not get on?
In hospice especially, the relationship with one nurse is most of the experience. Agencies will reassign; families do not know they can ask.
A bad answer sounds like: No named person.
What to check yourself
This is the half almost nobody does, and it is free. A public record answers questions no conversation will.
The agency's Medicare rating and its patient-survey results
Medicare publishes a quality-of-patient-care star rating for home health agencies and survey results for both home health and hospice, on its own comparison site. Free, and it is the only quality data in this category that is not self-reported marketing.
That the agency holds a current Oregon license
OHA publishes its licensed home health and hospice lists as PDFs, each carrying the license number, county and expiry date.
That they serve your parent's ZIP code
Home health agencies define service areas by ZIP, not by distance, and an agency twenty minutes away may not cover her street. Ask, and ask about the specific address.
What Medicare will and will not pay for here
Medicare's home health benefit requires a doctor's certification and, in most cases, that your parent is homebound. It does not pay for round-the-clock care, meals, or help with bathing alone. The gap between what it covers and what a family needs is where the private cost sits.
What should worry you
None of these is proof of anything on its own. Each one is a reason to ask one more question before you decide.
- An agency that says Medicare will cover something without wanting to see the certification.
- A hospital discharge that presents one agency as the only option.
- Hospice that cannot describe its after-hours arrangement in specifics.
- Any suggestion that choosing hospice means giving up on treating pain — it is the opposite, and an agency that leaves that ambiguity is not communicating well about the rest either.
- Pressure to sign hospice paperwork at the bedside without a family member reading it.
Where this comes from
Every legal claim on this page is a paraphrase of one of these, read on the date shown. Nothing here is our opinion about what the law requires.
- OAR 333-536-0007 — In-Home Care Agencies: Classification — The four in-home care classifications and what each may provide, quoted from the rule. Read 2026-08-12.
- OAR 333-536-0093 — Criminal Records Checks; 333-536-0065 Service Plan; 333-536-0066 Initial Visit and Monitoring — That an agency must complete a records check and fitness determination before direct client contact, and must produce a service plan with monitoring. Read 2026-08-12.
- ORS 443.370, 443.373, 443.376 — long-term care referral agents — The definition of a long-term care referral, the registration requirement, and the disclosure duties. Read 2026-08-12.
- Oregon DHS long-term care referral agent register — The public search a family uses to check an advisor. Read 2026-08-12.
- Oregon Health Authority — licensed in-home care agencies, home health agencies, hospices — 235 licensed in-home care agencies with classification and expiry; 62 licensed home health agencies; 65 hospices. Read 2026-08-12.
- CMS Provider Data Catalog — Home Health Care Agencies — 51 Medicare-certified home health agencies in Oregon, against the state's 62. Read 2026-08-12.
- Oregon DHS Licensed Long-Term Care Settings Search — Inspection reports, substantiated violations and regulatory actions per facility, refreshed every 24 hours. Read 2026-08-09.
- Oregon Department of Human Services — Carina — That the state's care-matching service is open to Medicaid, OPI and OPI-M consumers, and not to private-pay families. Read 2026-08-12.
- Oregon Office of the Long-Term Care Ombudsman — That the Ombudsman is a free, independent advocate for residents of licensed long-term care settings, and its toll-free number. Read 2026-08-12.
- Oregon DHS Long-Term Care Referral Registry — consumer resources — The state's own description of the Ombudsman's service, quoted on the touring kit. Read 2026-08-12.