Hospice & palliative care

Choosing a Hospice: Reading the Public Data, State by State

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Hospice quality is public information that almost nobody reads. This guide explains the four records worth checking before choosing, names the agency that licenses hospices in each state, and shows why filtering to your county matters far more than any statewide ranking.

Last updated: August 2026History

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The four things worth checking

Family survey scores. Medicare surveys bereaved caregivers and publishes the results. The questions that matter most are whether the team communicated well and whether help was available when it was needed, including nights and weekends.

Live-discharge rate. The share of patients discharged alive. A high rate can mean patients enrolled too early, but it can also mean a program discharging people whose care became expensive.

Ownership and staffing. Who owns the program, and whether it provides its own nursing at night or subcontracts.

State licensure and complaints. Separate from Medicare certification, and the only place a substantiated complaint shows up.

Hospice oversight and what to check, by state

Each row is that state's own published summary, naming the agency that licenses hospices there and what its public record shows.

StateWhat the state's own guide reported
AlabamaChoosing a hospice in Alabama means reading the same public data every family can pull up: Medicare's Care Compare tool, an agency's CAHPS Hospice family-experience scores, and its live-discharge rate. Alabama adds two wrinkles worth knowing before you call anyone.
AlaskaChoosing a hospice in Alaska starts with the same public data as anywhere: Medicare's Care Compare listings, an agency's CAHPS Hospice scores, its live-discharge rate. But the search works differently here.
ArizonaChoosing a hospice in Arizona means working through an unusually long list. Arizona is one of the few states with no Certificate of Need law, so nothing limits how many hospices can open in a given area, and the state's hospice market has grown accordingly.
ArkansasChoosing a hospice in Arkansas starts with the same public data as any state — Medicare's Care Compare, an agency's CAHPS Hospice scores, its live-discharge rate — read alongside two things particular to Arkansas: a Certificate of Need process that limits new hospice licenses, and a Medicaid expansion built around private marketplace plans rather than the traditional program.
CaliforniaChoosing a hospice anywhere in California comes down to the same public data available for any Medicare-certified hospice: Care Compare's quality measures, the CAHPS Hospice family-experience survey, whether the agency is for-profit or nonprofit, and its live discharge rate.
ColoradoChoosing a hospice in Colorado starts with the same public measures CMS collects nationwide: family-experience scores from the CAHPS Hospice survey, how often patients are discharged alive and later hospitalized, and whether a hospice's ownership lines up with patterns researchers have found in care quality.
ConnecticutChoosing a hospice in Connecticut means comparing every Medicare-certified provider in the state on the same public measures CMS collects everywhere: family-experience scores from the CAHPS Hospice survey, how often patients are discharged alive and later hospitalized, and ownership structure.
DelawareChoosing a hospice in Delaware means comparing every Medicare-certified provider in the state on the same public measures CMS collects everywhere: family-experience scores from the CAHPS Hospice survey, how often patients are discharged alive and later hospitalized, and ownership structure.
FloridaFlorida is one of the few states that still requires a Certificate of Need for a new hospice, dividing the state into fixed geographic service areas — so the real question when choosing a hospice in Florida isn't just which agency scores well on Medicare's CAHPS Hospice Survey, but which agencies are even authorized to serve your specific address.
GeorgiaGeorgia is one of the states where a licensed hospice does not need a Certificate of Need to operate, so agencies can open freely — which means a long list of results on Medicare's Care Compare reflects how easy it is to enter the market, not how thoroughly each option has been vetted.
HawaiiHawaii requires state approval before a new hospice can open, and its inpatient hospice beds are concentrated on Oahu and Maui — so a family on another island choosing a hospice in Hawaii needs to ask a question families elsewhere rarely do: can this agency actually reach a general-inpatient level of care without an interisland transfer.
IdahoIdaho has no Certificate of Need law, so any qualifying hospice can open anywhere in the state — but Idaho's frontier geography means that legal freedom doesn't translate into dense coverage the way it does in a crowded metro.
IllinoisSearch Medicare's Care Compare tool by zip code, then read each hospice's CAHPS family-experience scores, live-discharge rate, and ownership type together.
IndianaSearch Medicare's Care Compare tool by zip code, then read each hospice's CAHPS family-experience scores, live-discharge rate, and ownership type together.
IowaChoosing a hospice in Iowa starts with the same public data every state now publishes: Medicare's Care Compare tool and the CAHPS Hospice family-experience survey.
KansasChoosing a hospice in Kansas starts with the same public data every state now publishes: Medicare's Care Compare tool and CAHPS Hospice survey scores.
KentuckyChoosing a hospice in Kentucky starts with the same public data every state now publishes: Medicare's Care Compare tool and CAHPS Hospice survey scores.
LouisianaChoosing a hospice in Louisiana means comparing Medicare-certified providers on the same public measures CMS collects everywhere: family-experience scores from the CAHPS Hospice survey, how often patients are discharged alive and later hospitalized, and how a hospice's ownership lines up with patterns researchers have found in care quality.
MaineChoosing a hospice in Maine means comparing Medicare-certified providers on the same public measures CMS collects everywhere: family-experience scores from the CAHPS Hospice survey, how often patients are discharged alive and later hospitalized, and how a hospice's ownership lines up with patterns researchers have found in care quality.
MarylandChoosing a hospice in Maryland means comparing Medicare's public quality data for hospices that serve your ZIP code, since Maryland's certificate-of-need law limits how many can operate in any one area.
MassachusettsChoosing a hospice in Massachusetts starts with the same public data every state now publishes: Medicare's Care Compare tool and CAHPS Hospice survey scores.
MichiganChoosing a hospice in Michigan starts with the same public data every state now publishes: Medicare's Care Compare tool and CAHPS Hospice survey scores.
MinnesotaChoosing a hospice in Minnesota starts with Medicare's Care Compare tool, which lists every Medicare-certified hospice serving a county alongside CAHPS family-experience scores and live-discharge rates.
MississippiChoosing a hospice in Mississippi means starting with Medicare's Care Compare tool, which lists every Medicare-certified hospice serving a county along with CAHPS family-experience scores. Mississippi adds a structural wrinkle: state law caps how many hospices can operate through a Certificate of Need process, so some counties have real hospice care within reach and others depend on an agency's service radius reaching them at all.
MissouriChoosing a hospice in Missouri starts with Medicare's Care Compare tool, which lists every Medicare-certified hospice serving a county alongside CAHPS family-experience scores and live-discharge rates.
MontanaChoosing a hospice in Montana starts with Medicare's Care Compare tool, which lists every Medicare-certified hospice serving a county alongside CAHPS family-experience scores and live-discharge rates.
NebraskaChoosing a hospice in Nebraska starts with Medicare's Care Compare tool, which lists every Medicare-certified hospice serving a county alongside CAHPS family-experience scores and live-discharge rates.
NevadaChoosing a hospice in Nevada means comparing every Medicare-certified provider on the same public measures CMS collects everywhere: CAHPS Hospice family-experience scores, how often patients are discharged alive and later hospitalized, and ownership structure.
New HampshireChoosing a hospice in New Hampshire means comparing every Medicare-certified provider on the same public measures CMS collects everywhere: CAHPS Hospice family-experience scores, how often patients are discharged alive and later hospitalized, and ownership structure.
New JerseyChoosing a hospice in New Jersey starts with the same public data every state now publishes: Medicare's Care Compare tool and CAHPS Hospice survey scores.
New MexicoChoosing a hospice in New Mexico means comparing every Medicare-certified provider on the same public measures CMS collects everywhere: CAHPS Hospice family-experience scores, how often patients are discharged alive and later hospitalized, and ownership structure.
New YorkNew York licenses hospice programs through the state Department of Health, separate from the federal Medicare certification that determines whether a program appears on Care Compare.
North CarolinaNorth Carolina does not require a new hospice to get state approval before opening, so more agencies compete here than in neighboring states with tighter entry rules.
North DakotaNorth Dakota is one of only six states with federal 'frontier state' status, because thirty-six of its fifty-three counties have six or fewer residents per square mile — a fact that shapes what choosing a hospice here actually means.
OhioOhio licenses hospice programs through the Ohio Department of Health, a separate process from the federal Medicare certification that puts a program on Care Compare.
OklahomaOklahoma licenses hospice programs through the Oklahoma State Department of Health, a process separate from the federal Medicare certification behind a Care Compare listing.
OregonOregon families can compare any hospice using the same free federal tools available nationwide — Medicare's Care Compare site and the CAHPS Hospice Survey — plus two things specific to Oregon: a state complaint record kept by the Oregon Health Authority, and, as of 2026, a temporary pause on new hospice licenses that narrows how many agencies are opening for the first time.
PennsylvaniaChoosing a hospice in Pennsylvania comes down to comparing the same public data CMS collects on every Medicare-certified agency in the state: the CAHPS family-experience score, the live-discharge rate, and ownership type, filtered to your county on Care Compare.
Rhode IslandRhode Island licenses hospice programs through the Rhode Island Department of Health, a process separate from the federal Medicare certification behind a Care Compare listing.
South CarolinaChoosing a hospice in South Carolina starts with Medicare's Care Compare tool, which lists every Medicare-certified hospice serving a county alongside CAHPS family-experience scores and live discharge rates.
South DakotaChoosing a hospice in South Dakota starts with Medicare's Care Compare tool, which lists every Medicare-certified hospice serving a county alongside CAHPS family-experience scores and live discharge rates.
TennesseeChoosing a hospice in Tennessee means reading the same public data available anywhere — Medicare's Care Compare, an agency's CAHPS Hospice scores, and its live-discharge rate — with two Tennessee-specific wrinkles.
TexasChoosing a hospice in Texas starts with the same public data available in every state — Medicare's Care Compare, an agency's CAHPS Hospice scores, and its live-discharge rate — but Texas adds real wrinkles: no Certificate of Need law capping how many hospices can open, some sparsely served rural counties, and a Medicaid program that has not expanded, narrowing who qualifies through Medicaid alone.
UtahChoosing a hospice in Utah starts with the same public data used everywhere — Medicare's Care Compare, CAHPS Hospice family-experience scores, and an agency's live-discharge rate — but Utah adds two wrinkles: most agencies cluster along the Wasatch Front, leaving rural and tribal-land counties thin on options, and Utah has expanded Medicaid, unlike some neighboring states, which widens who qualifies for hospice through Medicaid alone.
VermontChoosing a hospice in Vermont means working with one of the country's shortest hospice lists, shaped by the state's own Certificate of Need review through the Green Mountain Care Board and its small, aging, rural population.
VirginiaChoosing a hospice in Virginia means navigating a state with one of the country's strictest facility-licensing laws, a wide urban-rural gap between Northern Virginia and its Southside and coalfield counties, and an unusual map of independent cities that don't sit inside any county.
WashingtonThe fastest way to choose a hospice in Washington is to pull up CMS Care Compare, filter by county, and read three things: the CAHPS family-experience score, the live discharge rate, and whether the agency is for-profit or nonprofit.
West VirginiaChoosing a hospice in West Virginia starts with the same national data every state reports: the CAHPS family-experience score, the live discharge rate, and ownership status, all searchable on CMS Care Compare filtered by county.
WisconsinChoosing a hospice in Wisconsin starts with the same public data every state reports: CMS Care Compare filtered by county, the CAHPS family-experience score, the live discharge rate, and ownership status.
WyomingChoosing a hospice in Wyoming means starting with the same national data every state reports, CMS Care Compare filtered by county, the CAHPS family-experience score, and the live discharge rate, but interpreting a much shorter list than a denser state produces.

Why the county matters more than the state

Hospice is delivered at home by a team that has to reach you, so the practical question is which programs actually serve your address — not which are best in the state. In a dense county you may have a dozen options; two counties away the same list may be two programs, one of which cannot staff nights.

Ask directly: who comes at 2 a.m., how long is the response time, is the on-call nurse employed by the program, and how many of your inpatient beds are yours versus contracted.

Working the list down to two or three programs

Start with your state's row for the licensing agency and its complaint record, then run Medicare's comparison filtered to your county. Take the two or three programs that survive both checks and ask each the night-coverage question above. The answer to that one question separates programs more than any published score.

Related: how Medicaid covers long-term care · what home care costs.

Common questions

The Medicare hospice benefit covers the care team, medications related to the terminal illness, and equipment, with minimal cost sharing. What it does not cover is room and board in a facility, which is the cost families are most often blindsided by when hospice is delivered somewhere other than home.

Yes. A patient may transfer to a different hospice once per benefit period without losing the benefit, and doing so does not require the first program's permission. If night coverage or responsiveness is the problem, transferring is usually faster than trying to escalate inside the same organization.

It means shifting the goal from cure to comfort, which is a clinical decision rather than a moral one. Patients sometimes improve on hospice and are discharged alive, and they can re-enroll later if their condition changes again. The benefit is designed to be entered and left.

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When to Call 911, and When to Call the Hospice Team

  • —Pain that is not controlled by the current medication plan
  • —New trouble breathing, or agitation that the family cannot settle
  • —A fall, or any sudden change in alertness

A life-threatening emergency is a 911 call. Enrolling in hospice does not replace 911, and calling it does not forfeit the hospice benefit — tell the dispatcher the patient is enrolled in hospice so the response fits the care plan. Once a patient is enrolled, the program's 24-hour on-call clinical line is the number for hospice-related concerns — uncontrolled symptoms, medication questions, a change the family cannot settle — and if that line cannot be reached during a crisis, call 911. If you are still choosing a hospice, ask each one who answers that line at 2 a.m. and how fast a nurse arrives.

This article describes public hospice quality data and state oversight. It is general information, not medical advice; confirm current details with the agency named for your state and with the hospice program itself.

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References

  1. 1.Anhang Price R, Parast L, Elliott MN, et al. (2023). Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences. JAMA Internal Medicine. doi:10.1001/jamainternmed.2022.7076 ✓Source carried forward from the state pages consolidated here; it is cited by 50 of them.
  2. 2.Centers for Medicare & Medicaid Services (2024). Find Healthcare Providers: Compare Care Near You (Hospice). Medicare.gov / Care Compare (CMS). link ✓Source carried forward from the state pages consolidated here; it is cited by 48 of them.
  3. 3.Centers for Medicare & Medicaid Services (2024). CAHPS Hospice Survey. Centers for Medicare & Medicaid Services (CMS). link ✓Source carried forward from the state pages consolidated here; it is cited by 36 of them.
  4. 4.Centers for Medicare & Medicaid Services (2024). Medicare-Certified 4 Levels of Hospice Care. Medicare.gov / Care Compare (CMS). link ✓Source carried forward from the state pages consolidated here; it is cited by 32 of them.
  5. 5.Centers for Medicare & Medicaid Services (2024). Hospice Payments (Medicaid). Medicaid.gov (CMS). linkSource carried forward from the state pages consolidated here; it is cited by 31 of them.
  6. 6.Teno JM, Plotzke M, Christian T, Gozalo P (2015). Characteristics of Hospice Programs With Problematic Live Discharges. Journal of Pain and Symptom Management. PMID 26004403Source carried forward from the state pages consolidated here; it is cited by 31 of them.

6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy

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