social worker

nursing assistant

hospice nurse

community representative

Heart to Heart Hospice

Typical workday consists of anywhere from 7 to 10 patients which would be fine if they were all in one place, but considering it's a travel job, sometimes you have to drive an hour to an hour and a half between patients. The hours are from 9:00 to 5:00. You fit all that in. I truly believed that I learned one thing and one thing only hard work doesn't matter. Timeliness doesn't matter. Discipline doesn't matter. Dedication doesn't matter. Because our corporate office is in a different state management around here, gets to do whatever they want to do with no repercussions. I've watched management get rid of really good people for doing their jobs. Management has a chip on their shoulder that they can't seem to remove and yet they think that they can just ruin everybody's life because, they can. Honestly, the culture sucks. It's healthcare. Nobody likes anybody. Everybody always constantly has it worse than the other nobody's helpful and they're all out for themselves. The hardest part of the job is having to deal with staff who don't know what they're doing or how to do what they're doing because they were placed in the position they were because they knew management. The one thing I did enjoy about my job was meeting. New people, was listening to their stories, holding their hands and just being there for them. It's hospice. It's not that hard to just give a little bit of your heart and love. 

Our hospice culture emphasizes empathy, trust, and collaboration. Leadership encourages open communication and recognizes the emotional investment that hospice work requires. This support allows staff to bring both professionalism and heart to everything they do, knowing they are never alone in their efforts.
One of the greatest strengths of our organization is our amazing Executive Director. Her compassionate leadership, integrity, and vision inspire excellence throughout the team. They genuinely care about both employees and patients, fostering an environment where people feel heard, respected, and motivated. Because of this leadership, our hospice is not just a workplace, but a community built on purpose and care.

The workplace environment that Ex dir has created is one of compassionate, respectful, and supportive, creating a space where employees feel valued while providing exceptional care to patients and their families. There is a shared sense of purpose that brings everyone together, and even in difficult moments, the culture remains one of kindness, teamwork, and dignity.

I work after hours so I don’t get to see the day staff. But my executive Director will at times check in with me to see how I’m doing and she will try to schedule meetings to accommodate the after our schedule so that we can all meet up.


When I first started in 2016 it was very family oriented. Loved everyone. Unfortunately, it was a revolving door. 22 employees in and out in 6 months. Fired the ED and manager, but the ED brought in beginning of 2017 is a complete witch. She bullies one person at a time until she runs them out. That's why it continues to be a revolving door. Salary was for 43 hours per week, but consistently worked 75+ hours PER WEEK, 6-7 days PER WEEK. Carried a caseload of 18-26 patients with a max of 47 visits a week. Started my day early and could be done with visits by 6, but then would be up all hours of the night doing admissions, on call, recertification paperwork, care plans....It is a thankless job and management pushes for more and more and more. Complaints had been filed by people for bullying, intimidation, and harassment and upper management just sweeps it all under the rug. Boss says "You're on salary", yet she leaves everyday at 5 and works no weekends. Very unfortunate situation because some awesome employees have come and gone because it's so poorly run.

As a rn cm I have 5 to 7 pts I see a day. I make this schedule. Sometimes its less pts daily, just depends. I take phone calls and emails all day long from other departments and pt's families. I have a lot of compassion and love for other people. Hospice is a calling. I have learned so much as a hospice nurse. The case management part of it is a  learning process. I have done this for several years so not a big deal. I have learned that time management skills will make or break your day. You have to figure this out on a daily basis. No day is the same, which is a bonus to the job. E. D. Is amazing and supportive. Pcm is new, but kind. Have had great pcm's in the past . Management is kind and respectful. Culture wise, it is different.  We work solo most of the time. The staff communicates often and we have monthly meetings, celebrations etc to support staff. Hardest part of job is being able to have time to do the dr. Reports and visits without working at home. It is the bear in the woods of the company. Another challenge in some ways is that we lose all of our pts. We build these great kindred spirits with our pts and then lose them. Yes, it is the nature of the business, but we all have feelings we just can't  hide. There are so many things about htohh that is enjoyable. I love my nursing job

While Heart to Heart Hospice has many dedicated frontline employees who genuinely care about patients and families, my experience with corporate leadership was disappointing.

Communication from senior leadership often lacked transparency and consistency, making it difficult for local leaders and teams to effectively execute organizational goals. Decision-making frequently appeared disconnected from the realities of daily operations, creating unnecessary challenges for staff and impacting morale.

There was a strong emphasis on metrics and performance expectations, but insufficient support, collaboration, and leadership accountability to help teams achieve those goals successfully. Employee feedback was not always valued or acted upon, which contributed to a culture where concerns could be overlooked rather than addressed constructively.

Healthcare organizations thrive when leaders invest in their people, foster trust, and create an environment of open communication. Unfortunately, that was not the culture I experienced during my time with the company.

I sincerely appreciate the hardworking clinicians and support staff who remain committed to providing quality patient care despite these challenges.

Every time I go to work it's with a smile on my face because I work for the most amazing company in San Antonio. From the secretaries to Executive Director. Team work is huge in this organization. Every employee genuinely cares about each patient and each family member. If our patients or families need something we go above and beyond to make it happen. Every family I've ever spoken to has been elated about the superior service H2H has provided for their loved one.  Management, including our ED has an open door policy. We are able to discuss goals, future plans, and/or any concerns or things we need help with. New hires are taken under their wings by other employees to ensure their training is very thorough. PCMs are not only managers, but they are your friend, shoulder to cry on when losing a patient, and your side kick when needing help. Like most companies, if you work hard the company, the company will work hard for you. This is very true with H2H. We do many bonding activities and truly enjoy the company of each other. This company is so amazing I would recommend it to any of my friends looking for jobs, I know they wouldn't be disappointed. Honestly, if any of my loved ones ever needed hospice care I would ALWAYS recommend H2H.

Terrible communication between upper, middle management and staff, especially those staff in the field. Asking questions and getting any answers at all is frustrating and next to impossible. Important information that should be communicated is not communicated and staff is left to fend for themselves when dealing with clients, facilities, families. Never experienced such a poorly organized and arrogant set of administrators. This hospice company wants to excel with higher numbers and bigger profits at the expense of patient care and a burned-out team. Constantly hearing about quality nurses and support staff looking for other employment. Lots of turnover at this company. No accountability at all from management. Nurses are expected to be on call 24/7 if one of their patients dies or has an urgent need because management drags their feet on hiring more nursing personnel. Many nights a nurse IS NOT on call so everyone else has to be ready to go regardless of any personal plans. Isn't that illegal?? Not having a scheduled RN on call? The most enjoyable part of the job is a close connection with patients and families, and the satisfaction that my contributions during their suffering and pain is of some comfort.

Extremely long hours, assignments make no sense. Expect to drive over 100 miles every day, patients are randomly scattered. Charting is obsurd and takes hours. I was taught that if patients are confused, just chart what the last nurse charted. They will also ask you to write IDG notes on patients you've never seen violating HIPPA laws. They will change your entire job description, and they are constantly changing the rules. Management is manipulative, and they talk badly about staff, they also like to try and pit people against each other. They also micromanage you, yet provide no help. They are constantly looking for anything they can point out that's wrong. The hardest part of the job is they think it's appropriate to contact you 24/7 and you don't get paid for all the work you do, also being in the office is extremely stressful because of all the gossip and gaslighting. Management lacks compassion and empathy. The only enjoyable part is the patient care. 

Worked for a wonderful local hospice company that was purchased by Heart to Heart earlier this year. H2H made many promises and have followed through on none of them. They stated they wanted to keep all of our employees and keep our patient visit frequencies at the level that provided excellent care. After they took control, all of their promises went out the window and they picked off our nursing management first and then started on the RN case managers making a work environment that made it impossible to stay with much larger patient loads, less staff, more overtime without pay and more on-call responsibilities.  Forced RNCMs to do non-emergent admissions at all hours of the night and weekends expecting them to come back and work their full schedule with no time off in exchange or rest.  A wonderful company was ruined by H2H.

What is the best part of working at the company?
Caring for hospice patients and their families.

What is the most stressful part about working at the company?
Constant expectation to be on call, heavy caseload, lack of company concern for employees.

What is the work environment and culture like at the company?
Corporation was out of touch with local operations. Only nurses were valued, but even they were not highly valued. The office staff was a sub-group and often a hostile work environment for field staff that occasionally had to work in the office. The culture, established by the corporation, was numbers and profits above all else. 

What is a typical day like for you at the company?
I was happy when I was in the field working with my assigned patients and families and collaborating with most of the field staff.  I often worked from 8 AM-6:30 PM and then was called out (1-2 times per week) between 2 AM-6 AM to attend a patient's death so the nurse did not have to stay until the body was removed.

Top Job Titles	Average Salary
Social worker 2 salaries reported	$40.00 per hour
Nursing assistant 3 salaries reported	$16.33 per hour
Hospice nurse 3 salaries reported	$32.50 per hour
Community representative 1 salary reported	$65,000 per year

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