By SLC Senior Advisor Care Team · October 23, 2026
Both Type I and Type II Utah assisted living facilities may keep hospice residents. A Type II facility needs a written evacuation plan, in the service plan, for any hospice resident who cannot evacuate without significant help; a Type I facility needs an assigned, trained person on site 24/7 for each such resident. DLBC records show nine hospice-rule findings at eight local facilities, most rated high.
Why the rule exists
Utah draws its assisted living licenses around evacuation. Hospice patients often reach a point where they cannot get out of bed, let alone out of the building, on their own. Rather than force a move at the end of life, Utah's rule lets them stay, with safeguards so that a fire or other emergency does not leave them behind.
For families, that is good news: many people can finish their lives in the apartment they know, with hospice nurses and aides visiting. The safeguards are the price of that flexibility, and inspectors check them.
The two versions of the rule
| Type I facility | Type II facility | |
|---|---|---|
| Can keep hospice residents? | Yes, with physician orders and hospice in the service plan | Yes, with physician orders and hospice in the service plan |
| If the resident cannot get out alone | A trained, physically capable person assigned only to that resident, on site 24/7 | A written emergency evacuation plan for that resident |
| Limit | Such residents no more than 25% of the census | No percentage limit |
| Where it is documented | Service plan and staffing records | Integrated into the resident's service plan |
The Type I requirement is demanding, which is why some Type I homes cannot keep a hospice resident once they are bedbound. Type II facilities have more room to accommodate them.
What DLBC has cited locally
DLBC's public 36-month record for Salt Lake and Tooele county assisted living shows nine findings under the hospice rules, at eight facilities, dated between November 2023 and April 2026. Eight were rated high noncompliance and one moderate. Most carried a $200 civil money penalty; one carried $400 and one $300.
The typical finding is the one described in a 2026 citation: an inspector reviewed the file of a hospice resident who needed significant help to evacuate and found no evacuation plan. The facility then wrote the plan, and DLBC verified the correction. Facility profiles on this site list each finding with its date and correction status.
Questions to ask before hospice starts
- Is my parent's building Type I or Type II, and what does the hospice rule require here?
- If my parent cannot get out of bed alone, what is the written evacuation plan, and may we read it?
- For a Type I home: who will be the assigned person on site around the clock, and is that staff or a private companion we hire?
- How will hospice staff and facility staff divide tasks overnight?
- Will the monthly charge change because hospice is involved?
What a good evacuation plan looks like
Utah's rule does not prescribe a template, but a useful plan answers practical questions: which staff member is responsible for the resident in an emergency, how the resident will be moved (wheelchair, evacuation sled, two-person carry), which exit and route will be used, where the resident goes once outside, and how night staffing changes the plan. It should be specific to the resident's room and condition, not a copy of the building's general fire plan.
Ask to read it, and ask when it was last practiced. Plans that exist only on paper are the ones that fail.
When hospice is not the right fit in assisted living
Some residents on hospice need more hands-on care than a building can safely provide, even with the hospice team visiting. Frequent repositioning, complex symptom management overnight, or two-person transfers around the clock can exceed what a small staff can do while caring for other residents. In those cases, a nursing care facility or an inpatient hospice setting may be safer.
That decision belongs to the resident, family, hospice and facility together. Raise it early, while there is time to plan, rather than during a crisis at 2 a.m.
How Medicare fits
Medicare's hospice benefit pays the hospice for its services, medications and equipment tied to the terminal diagnosis, wherever the patient lives. It does not pay the facility's room and board. Families keep paying the facility, or the New Choices Waiver continues to pay for services for an eligible resident.
The family, not the facility, chooses the hospice. DLBC lists 28 hospice licenses with addresses in Salt Lake and Tooele counties; compare at least two, and ask about after-hours response times.
Frequently asked questions
Can someone on hospice stay in Utah assisted living?
Yes. Both Type I and Type II facilities may keep hospice residents with physician orders on file and hospice written into the service plan.
What extra rule applies in a Type II facility?
If a hospice resident cannot evacuate without significant assistance, the facility must write an emergency evacuation plan and put it in the service plan.
What extra rule applies in a Type I facility?
Each hospice resident who cannot exit alone needs a trained, physically capable person assigned only to them on site 24/7, and such residents may be no more than 25% of the census.
Does Medicare pay assisted living room and board during hospice?
No. Medicare pays the hospice for its services, not the facility's room and board.
How do I find a facility's hospice findings?
Open the facility's profile on this site or search DLBC's public records. Each finding lists the rule, such as Type II Hospice Patients, the date, the noncompliance level and whether DLBC verified the correction.
