Hi Westieluv - Here we are again-lol. I would say there are pros and cons to both opportunities.
The new (start-up) hospice may offer opportunity for advancement for a nurse, like yourself, with hospice experience (plus your CHPN), into something like Director, Clinical Services or Administrator, if that's something that interests you. That would give you the opportunity for the longetivity piece. The cons (I've experienced), is the growing pains with little to no orientation, minimal policies and procedures for their particular hospice yet in place, a lot of room for error (in the eyes of immediate supervisor), depending on their individual preferences of how things should be decided vs. your independent thinking as well as a lot of turnover. Smaller hospice agencies tend to pay less and more likely to attract "new" hospice nurses who need a lot of initial guidance. Sometimes when they realize what they've gotten themselves into, they leave, creating a shift in assigned patients and turnover of nurses, which impacts the patient's continuum of care.
I always enjoyed case management (PRN or otherwise), knowing that there was always an in-patient unit possibility should the patient require it for intractable pain, out-of-control medication stabilization, family crisis, etc. I'm guessing that would be an opportunity with the large, hospital-based hospice. Sometimes distance, as you know, is irrevalant since we do so much driving anyway. With the larger hospice agencies, I find they have more fine-tuned territories, and nurses are not geographically, criss-crossing so much of the time. Also, a well-established hospice agency is doing something right, if their turnover is low. Maybe that means that the current case managers are happy!
I think it boils down to what you find happiness in doing. You seem to be gifted towards hospice nursing which equals patient satisfaction. So, your personal happiness is important. Good luck in your decision. I hope this helped in some sort of way! Take care!