Hospice & palliative care

Choosing a Hospice in the Dallas, TX Area

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North Texas is one of the largest hospice markets in the country, and the metroplex's size cuts both ways: more agencies means more choice, but also more variation in quality sitting side by side on the same list. This guide walks through the national method for reading that public data, plus what's specific to Texas licensing, Texas Medicaid, and the Dallas–Fort Worth service area itself.

Last updated: July 2026

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How to Compare Hospices in the Dallas–Fort Worth Area

Medicare's Care Compare tool lets you search by zip code across the Dallas–Fort Worth metroplex and pull up every Medicare-certified hospice serving that address, each carrying its CAHPS Hospice Survey scores and other measures reported through CMS's Hospice Quality Reporting Program 1. Because North Texas is one of the largest hospice markets in the country, that search will typically return more agencies here than a comparably sized metro elsewhere — which makes a deliberate comparison more useful, not less.

Focus on the same three signals wherever you live: the CAHPS Hospice Survey's caregiver-reported scores for communication and symptom management 2, the hospice's live-discharge rate, and whether it is for-profit or not-for-profit. A separate guide on judging hospice quality explains what each of these means and why it predicts the experience your family will actually have.

Texas Doesn't Require a Certificate of Need — Here's Why That Matters

Texas is one of a number of states that does not require a hospice to obtain a certificate of need before opening, a licensing hurdle many other states still impose to limit how many agencies can operate in a given area. That has a direct, practical effect on a Dallas-area search: the metroplex supports an unusually large number of competing hospice agencies, because Texas's regulatory bar to enter the market is lower than in states that cap supply.

More competitors is not automatically better for quality. It means the burden of screening shifts more heavily onto the family, since a large county's worth of listings on Care Compare can include agencies with very different track records sitting side by side. Reading the CAHPS and live-discharge numbers matters more, not less, in a market this size.

Filing a Complaint: Texas HHSC's Role Alongside Medicare

A hospice operating in Texas is licensed and inspected by the Texas Health and Human Services Commission, separately from the federal survey that determines its Medicare certification. If care falls short, a complaint can go to HHSC in addition to Medicare's own complaint process — the state runs its own investigative process for licensed hospices, on its own timeline, independent of CMS.

Before you need it, it is worth knowing this channel exists. Ask a hospice you're considering whether it has had a recent state licensing survey and, if so, what the findings were; a hospice with nothing to hide will usually answer directly and without hesitation.

Why the Metroplex's Size Means More Agencies to Screen, Not Fewer

Dallas–Fort Worth spans Dallas, Tarrant, Collin, Denton, and several smaller counties, and a hospice's service area frequently crosses those lines rather than stopping at a city boundary. A search centered on one zip code can undercount the agencies that would genuinely reach your address, while also surfacing agencies whose office is an hour's drive away but whose care team still covers your neighborhood.

The practical move is to confirm service area directly rather than inferring it from a mailing address on Care Compare. This is especially worth checking in the fast-growing suburbs ringing the core cities — places like Frisco, McKinney, and Mansfield have added residents faster than many hospices have added staff, so a service area drawn a few years ago may not reflect current capacity. Ask specifically whether your address falls within routine, same-day coverage, and what the response time looks like for an urgent visit at night, since a hospice's printed service area does not always reflect how quickly its on-call nurse can reach a particular part of the metroplex.

Texas Medicaid and Hospice: What It Covers

Texas Medicaid runs its own hospice benefit, administered through HHSC, and for people who qualify for both Medicare and Medicaid, the two work together. The detail families in a nursing facility ask about most is room and board: for a dually eligible resident, Medicaid can pay a room-and-board rate passed through the hospice, covering a cost that the Medicare hospice benefit itself does not 3. Exactly how this is billed varies by state, so confirming the specifics with the hospice's admissions office and Texas Medicaid directly is worth the phone call 3.

For care at home, this distinction does not apply — Texas Medicaid hospice coverage there closely mirrors the comfort-focused structure of the Medicare benefit.

Ownership Is Public Information — Use It

Nationally, family caregivers report worse experiences across every domain of the CAHPS Hospice Survey at for-profit hospices than at not-for-profit ones, including communication and how likely they are to recommend the agency to others 4. Burdensome transitions after a live discharge — a return to the hospital, or dying there instead of at home — are also more common at for-profit agencies and after short stays 5. In a market as large and competitive as North Texas, that ownership label is one of the fastest filters available on Care Compare's own listing.

This is not a reason to rule out every for-profit hospice in the metroplex; plenty operate well, and an agency's own CAHPS scores are the more direct evidence. But when two agencies otherwise look similar, ownership is a real, sourced tiebreaker rather than a guess.

Questions Worth Asking Before You Sign

A few direct questions separate a hospice that has thought this through from one reciting a brochure. Ask who answers the after-hours nurse line and how quickly they typically reach a home in your specific city or suburb, what the plan is if pain or breathlessness becomes hard to control, and how the hospice handles a transfer to inpatient care when symptoms can't be managed at home.

Also ask what happens if the patient's condition improves and hospice is no longer appropriate — a hospice that explains live discharge clearly, without hedging, is one that has had this conversation before and is comfortable being honest about it.

Common questions

It changes the task rather than making it harder. Because Texas doesn't require a certificate of need, the metroplex supports more competing hospice agencies than a similarly sized metro in a state that limits supply. That means more listings on Care Compare to sort — reading the CAHPS scores and live-discharge rate for each becomes more useful, not less, in a market this size.

Texas hospices are licensed and inspected by the Texas Health and Human Services Commission, separately from Medicare certification. A complaint can go to HHSC in addition to Medicare's own process. Ask the hospice directly for its written complaint procedure, which every Medicare-certified agency is required to provide.

Often, yes, for someone eligible for both Medicare and Medicaid. Texas Medicaid can pay a room-and-board rate passed through the hospice for a dually eligible nursing-facility resident, covering a cost the Medicare hospice benefit alone does not. Confirm the specifics with the facility, the hospice's admissions office, and Texas Medicaid directly, since billing details vary.

Not reliably. Hospices serving Dallas–Fort Worth often cover a wide, multi-county service area that doesn't match a single zip-code search on Care Compare. Ask the hospice directly whether your specific address falls within routine, same-day coverage and what after-hours response looks like there before ruling an agency in or out by distance alone.

Not automatically, but the pattern is real nationally: for-profit hospices score lower on average across CAHPS Hospice family-experience measures and have higher rates of burdensome live discharge. Individual agencies vary widely, so check the specific hospice's own CAHPS scores and live-discharge rate on Care Compare rather than deciding by ownership type alone.

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When Choosing Can't Wait

  • —Pain, breathlessness, or agitation that is not controlled while you are still comparing agencies
  • —A hospital discharge is set for the next day or two and no hospice has been chosen yet
  • —The patient's condition is changing quickly and further research feels unsafe to delay

If symptoms are severe and no hospice team is in place yet, call the current treating physician or go to the nearest emergency room rather than waiting to finish comparing agencies.

This article explains how to evaluate hospice agencies using public data; it is not medical advice and does not recommend a specific hospice. Licensing rules and Medicaid coverage details change and vary by circumstance — confirm current specifics with the Texas Health and Human Services Commission, Texas Medicaid, and any hospice you are considering.

References

  1. 1.Centers for Medicare & Medicaid Services (2024). Hospice Quality Reporting Program. Centers for Medicare & Medicaid Services (CMS). link ✓Supports that CMS runs a formal Hospice Quality Reporting Program that feeds the public measures shown on Care Compare.
  2. 2.Centers for Medicare & Medicaid Services (2024). CAHPS Hospice Survey. Centers for Medicare & Medicaid Services (CMS). link ✓Supports what the CAHPS Hospice Survey measures, including caregiver-reported communication and symptom management.
  3. 3.Centers for Medicare & Medicaid Services (2024). Hospice Payments (Medicaid). Medicaid.gov (CMS). linkSupports that Medicaid (Texas Medicaid) can pay a room-and-board rate for a dually eligible nursing-facility resident on hospice, passed through the hospice, with rules that vary by state.
  4. 4.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 ✓Supports that family caregivers report worse experiences across CAHPS Hospice domains at for-profit hospices compared with not-for-profit hospices.
  5. 5.Peer-reviewed cohort study (see article) (2024). Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice. JAMA Network Open (PMC11099680). PMID 38753329 ✓Supports that burdensome transitions after a live discharge from hospice are more likely at for-profit hospices and after short stays.

5 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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