Choosing a Hospice in Washington, D.C.: Reading the Public Data
SaveThe District is small enough that a single Care Compare search covers the whole jurisdiction — but that convenience hides a licensing wrinkle: a hospice can be headquartered in suburban Maryland or Virginia and still serve DC patients under a separate DC Health license. This guide explains what to check, where the district's own hospice rules diverge from a typical state's, and how to read the data before anyone signs paperwork.
Last updated: July 2026
Start with Medicare Care Compare, filtered to the District
Every Medicare-certified hospice serving Washington, D.C. is listed on Medicare's Care Compare tool, searchable by ZIP code, and the results show CAHPS Hospice Survey caregiver-experience scores alongside claims-based quality measures for each program 1Ref 1Centers for Medicare & Medicaid Services (2024).Find Healthcare Providers: Compare Care Near You (Hospice).Confirms hospices are publicly searchable and comparable on Care Compare by ZIP code, and that CAHPS Hospice Survey and quality measures are reported there.. Because the District has no counties and covers a compact area, one ZIP search realistically surfaces every hospice that could serve a District address — a simplicity most states don't share, where the same search might miss hospices two counties over.
That compactness cuts both ways. A hospice with a Care Compare listing tied to a District ZIP code is not automatically licensed by the District. Many agencies that serve DC patients are headquartered in suburban Maryland or Virginia and hold licenses in those jurisdictions first, treating the District as an extension of a regional service area. Confirming the specific licensed entity that will actually staff a home in Northwest or Anacostia is a separate step from reading its federal quality data, covered below.
DC Health licenses hospices separately from Medicare — ask to see both
The District's hospice license comes from DC Health's Health Regulation and Licensing Administration, under the Health Care and Community Residence Facility, Hospice and Home Care Licensure Act — a District law that predates the current form of the federal Medicare hospice benefit. Medicare certification and a DC Health license are two different approvals, issued by two different bodies, and a hospice needs both to legally admit and bill for a District patient.
In practice, this means two questions belong in the same phone call: is this hospice Medicare-certified (which Care Compare confirms), and is it currently licensed by DC Health for the specific address being served. A hospice that hesitates to produce a current DC license, or that answers only for its Maryland or Virginia operation, is answering a different question than the one being asked. This is not a request any family should feel awkward making — a licensed hospice keeps this documentation on hand as a matter of routine.
What the CAHPS Hospice Survey actually measures
The CAHPS Hospice Survey is a standardized questionnaire mailed to the family caregivers of patients who have died, asking about communication, symptom management, timeliness of visits, and whether they would recommend the hospice to others 2Ref 2Centers for Medicare & Medicaid Services (2024).CAHPS Hospice Survey.Describes what the CAHPS Hospice Survey measures (communication, symptom management, timeliness, willingness to recommend) and that it samples caregivers of deceased patients.. It is not a satisfaction score invented by a hospice's marketing department — it is the same federally administered instrument used everywhere in the country, which is what makes judging hospice quality by comparing two agencies' results a meaningful exercise rather than a guess.
Reading it well means looking past a single headline number. A hospice can score well on overall recommendation while scoring worse on a specific domain, such as how quickly staff responded to an urgent call — the exact domain many families care about most in a crisis. Care Compare breaks the CAHPS Hospice Survey results out by domain, not just an average, and it is worth spending the extra few minutes there before narrowing a list.
A hospice's live discharge rate, and who owns it
A hospice live discharge rate — the share of patients who leave hospice care alive rather than through death — is one of the more revealing numbers on Care Compare, because a pattern of live discharges close to the Medicare payment cap can signal a hospice enrolling patients who were never really appropriate for the benefit 3Ref 3Peer-reviewed cohort study (see article) (2024).Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice.Supports that patterns of live discharge, especially for-profit and short-stay, are associated with burdensome post-discharge transitions.. A single live discharge is often clinically appropriate, for instance when a patient's condition genuinely stabilizes; a pattern is the thing worth noticing.
Ownership is part of the same picture. National research using CAHPS Hospice Survey data has found that family caregivers report worse experiences, across every measured domain, at for-profit hospices compared with nonprofit ones, and are less likely to say they would recommend the hospice 4Ref 4Anhang Price R, Parast L, Elliott MN, et al. (2023).Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences.Supports that family caregivers report worse care experiences across CAHPS domains at for-profit versus not-for-profit hospices, and are less likely to recommend them.. That is not a rule that any specific for-profit hospice is worse — plenty run excellent programs — but it is a reason to read the actual scores for a specific agency rather than assume ownership tells you nothing.
Medicaid and the District's nursing-facility hospice patients
For a District resident who is both Medicaid-eligible and living in a nursing facility, electing hospice does not mean losing nursing-facility coverage — Medicaid continues paying room and board to the facility, passed through the hospice, on top of the Medicare hospice benefit that covers the clinical care itself 5Ref 5Centers for Medicare & Medicaid Services (2024).Hospice Payments (Medicaid).Supports that Medicaid pays a room-and-board rate, passed through the hospice, for dually eligible nursing-facility residents who elect hospice.. This dual-payment structure exists nationally, but it is worth understanding clearly in the District, where a meaningful share of Medicaid long-term-care recipients live in nursing facilities rather than in home-based waiver programs with capped enrollment.
Because of that, District families should ask directly how a hospice coordinates with a nursing facility's own staff — who administers day-to-day care, who calls the hospice nurse line, and how the two care plans are reconciled. A hospice that cannot describe this coordination clearly, for a facility it says it already serves, has not actually answered the question.
Filing a complaint or checking a hospice's inspection history
DC Health's Health Regulation and Licensing Administration is the body that inspects licensed hospices and fields complaints about care within the District, separate from the federal survey process that feeds Care Compare's quality measures 1Ref 1Centers for Medicare & Medicaid Services (2024).Find Healthcare Providers: Compare Care Near You (Hospice).Confirms hospices are publicly searchable and comparable on Care Compare by ZIP code, and that CAHPS Hospice Survey and quality measures are reported there.. A District family with a concern about a specific hospice's conduct — not just its published scores — has a district-level complaint route in addition to whatever internal grievance process the hospice itself offers.
Using that route does not require certainty that something has gone wrong. Confirming a license is active, or asking whether a complaint has been filed and resolved against a specific program, is a reasonable step before enrollment, not just after a problem. DC Health's licensing office can also confirm, in writing, whether an agency's DC license covers home hospice care at a specific address, which resolves the Maryland-or-Virginia question raised earlier without needing to take a marketing claim at face value.
The same method works in every state
None of this changes by geography — only the specific public records do. Judging hospice quality means reading a CAHPS Hospice Survey and a hospice live discharge rate the same way whether the question is choosing a hospice in Arizona or in the District, and the same Care Compare filters apply to hospice quality in Arizona, hospice quality in Arkansas, and a family choosing a hospice in Arkansas as much as they do here.
The pattern repeats reliably: hospice quality in California and the process of choosing a hospice in California rest on the same federal data as hospice quality in Colorado and choosing a hospice in Colorado, and the same is true again for hospice quality in Connecticut and choosing a hospice in Connecticut. What changes state to state is the licensing agency's name, the Medicaid rules layered on top, and — as in the District's case — whether the hospice on a family's shortlist is actually licensed where the family lives.
Common questions
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Say it back
How would you explain this to someone you love?
Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.
Before enrolling a District hospice
- —the hospice cannot produce a current DC Health license for the address where care will actually happen, or answers only for a Maryland or Virginia office
- —the hospice cannot describe how its on-call nurse line is staffed overnight and on weekends
- —the hospice pressures same-day enrollment or discourages contacting DC Health or reviewing Care Compare first
If a hospice patient in the District is in acute physical distress and the hospice's on-call nurse line does not respond, calling 911 for immediate help is appropriate — enrolling in hospice does not prevent emergency responders from being called.
This article is educational and does not replace guidance from a hospice's admissions or clinical staff, from DC Health, or from a treating physician.
References
- 1.Centers for Medicare & Medicaid Services (2024). Find Healthcare Providers: Compare Care Near You (Hospice). Medicare.gov / Care Compare (CMS). link ✓Confirms hospices are publicly searchable and comparable on Care Compare by ZIP code, and that CAHPS Hospice Survey and quality measures are reported there.
- 2.Centers for Medicare & Medicaid Services (2024). CAHPS Hospice Survey. Centers for Medicare & Medicaid Services (CMS). link ✓Describes what the CAHPS Hospice Survey measures (communication, symptom management, timeliness, willingness to recommend) and that it samples caregivers of deceased patients.
- 3.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 patterns of live discharge, especially for-profit and short-stay, are associated with burdensome post-discharge transitions.
- 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 care experiences across CAHPS domains at for-profit versus not-for-profit hospices, and are less likely to recommend them.
- 5.Centers for Medicare & Medicaid Services (2024). Hospice Payments (Medicaid). Medicaid.gov (CMS). linkSupports that Medicaid pays a room-and-board rate, passed through the hospice, for dually eligible nursing-facility residents who elect hospice.
5 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy