Free Resource
The After-Hours Triage Protocol Template
The structure an answering service actually needs to route a hospice or home-health call correctly at 2am — and the questions that decide urgency.
A hospice agency has to make covered services available 24 hours a day, seven days a week — that is a Condition of Participation, not a service level you choose. In practice, that means the person answering the phone at 2am has to be able to tell a routine call from one that needs a nurse right now, and route it accordingly.
Most agencies hand their answering service a one-page 'call us for emergencies' sheet and hope for the best. That is not a triage protocol. A protocol defines urgency tiers, the exact questions that sort a call into one, who gets contacted for each tier, how fast, and what gets written down.
This is a template for that document. It is deliberately generic — your medical director and clinical leadership set the actual clinical thresholds. What it gives you is the structure, so nothing critical is left undefined.
1. Start with three urgency tiers, not two
Two tiers — 'emergency' and 'not emergency' — force every ambiguous call into one bucket or the other, and ambiguous calls are most of them. Three works better: Immediate (contact on-call clinician now), Same-shift (on-call clinician calls back within a defined window), and Next business day (message queued, no callback tonight).
The middle tier is what makes the protocol usable. It gives the agent somewhere to put 'the patient is uncomfortable but stable and the family is anxious' without either waking a nurse for no reason or telling a worried family to wait until morning.
Define each tier by what the agent DOES, not by clinical severity the agent can't assess. The agent isn't diagnosing — they're matching the caller's answers to a routing rule you wrote.
2. Write the symptom questions as a decision tree the agent reads aloud
The agent should never be improvising questions. For each common after-hours reason for calling — pain, breathing change, fall, bleeding, medication question, equipment failure, death in the home — write the two or three questions that determine the tier, in the order they're asked, with the routing rule attached to each answer.
Keep each branch short. If a branch needs more than three questions to reach a routing decision, it's really a clinical assessment and the answer is 'escalate to the on-call clinician' — the agent's job there is to connect, not to keep triaging.
'Death in the home' is its own branch and it is almost always an Immediate-tier contact, but the questions are logistical (location, who is present, has a physician been notified) rather than clinical.
3. Name people and windows, not roles
'Escalate to the on-call nurse' is not actionable at 2am. The protocol needs the on-call schedule (or a link to where it lives), the contact order if the first person doesn't answer, and the maximum time the agent waits before going to the next name.
Specify what the agent does if they reach no one on the list — this is the failure mode that turns into a complaint. Usually it's: keep trying every N minutes, contact the clinical manager, and document each attempt with a timestamp.
Keep reading — no download required
The rest of this — the remaining sections, the full checklist, and the sources — opens right here on the page. One email, no PDF, no mailing list.
Rather have someone run the phones instead of writing the protocol? That's what we do.
Home Health & Hospice answering · Talk to our team
This resource references dated regulatory material. Last reviewed against its sources for the 2027-03-31 revision cycle.