When Angie Oujiri spent 15 years in home health, she noticed something that most hospice leaders miss entirely: a significant number of patients receiving home health services are actually hospice-appropriate, they’re just not ready to hear it yet.
Angie, now Director of Hospice for Vivie in Minnesota, joined the Voices of Hospice Leadership podcast to share what that realization means for hospices trying to grow census and improve care transitions.
The Emotional Barrier No One Talks About
Families facing a life-limiting diagnosis often choose home health over hospice, not because it’s the right clinical fit, but because it feels safer emotionally. Home health doesn’t carry the weight of a “death and dying” conversation. A few PT sessions feels more hopeful than signing onto a hospice benefit.
“It’s easier to not have those conversations,” Angie explains. “So people end up in home health. And they receive amazing care there, but the patient has a different need set.”
The result? Patients who could be receiving the full support of a hospice team, chaplains, social workers, medication management, 24/7 on-call, spend their final months in a care model that isn’t built for where they are.
Informed Consent Changes Everything
Angie’s core message is simple: families deserve to know their options. When clinicians take the time to explain what hospice actually covers, how visits work, and what families can expect, many patients make a different choice.
The problem is that those conversations are hard. Most clinicians aren’t trained to have them, and most organizations don’t create space for them.
The One Question That Opens Every Door
Drawing from Atul Gawande’s work, Angie recommends a simple but powerful question every clinician can start asking today: “What is most important to you right now in your life and your world?”
That question cuts through clinical complexity and gets to what actually matters , which is the foundation of any meaningful conversation about end-of-life care.
Home Health Teams Are a Referral Source You’re Ignoring
For hospice leaders, Angie’s most actionable advice is this: invest in your home health partners. They are in front of your future patients every single day.
“Give them the resources they need. A good document that outlines clinical indicators. Education on the hospice benefit. Invest in them, it will come back.”
Whether your organization has its own home health arm or partners with external agencies, building that relationship is one of the highest-leverage moves a hospice can make.
Building Something New
As Vivie expands its hospice service line into the Twin Cities metro area, Angie is helping build a program from the ground up, inside a fully integrated care organization that also offers home health, palliative care, and population health services. The advantage? Seamless care handoffs, shared EMR access, and a team that communicates in real time.
“It truly comes down to collaboration and communication,” she says. “Making sure patients and families have what they need, no matter who is with them.”
Listen to the full episode on the Voices of Hospice Leadership podcast.
