Hospice & palliative care

Choosing a Hospice in Florida: Reading the Public Data

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Florida runs one of the largest hospice markets in the country, but state law still gates who can open a new one and where it can operate — a legacy of Certificate of Need regulation most other big states dropped years ago. This guide walks through what that means for a Florida family's search, on top of the same federal quality data every state shares, including two genuinely Florida-specific risks: hurricane continuity of care and snowbird record transfers.

Last updated: July 2026

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Florida still requires a Certificate of Need for hospice

Florida is one of a small number of states that kept Certificate of Need (CON) regulation for hospice even after its broader 2019 deregulation of most other health services, and the state's Agency for Health Care Administration divides Florida into a fixed set of geographic hospice service areas. A hospice's CON only authorizes it to enroll patients who live inside its assigned area, which means the agencies appearing in a Care Compare search are not necessarily all competing for the same household the way they might in a state without this system.

This matters for how a family should read a search result list. Two hospices can both show up for a single ZIP code near a service-area boundary, but only one may actually be authorized to admit a patient on a given street. Before comparing quality scores, it is worth confirming that an agency's CON service area genuinely includes the address where care will happen — a step most other states' families never have to think about.

What the CAHPS Hospice Survey and Care Compare show inside a service area

Every Medicare-certified hospice operating in Florida is listed on Medicare's Care Compare tool, which reports CAHPS Hospice Survey results — a standardized survey of family caregivers covering communication, symptom management, timeliness of visits, and willingness to recommend — alongside claims-based quality measures 12. Judging hospice quality this way works the same in Florida as anywhere else in the country; the instrument doesn't change by state, only which agencies are eligible to answer for a given address.

Once a family has narrowed the list to hospices actually authorized to serve their service area, the CAHPS Hospice Survey domain scores are the place to spend real time. A hospice with a strong overall recommendation rate can still lag on a specific measure, like how quickly staff responded to symptom crises overnight — often the exact thing a family cares about most.

Live discharge rate and ownership, in the country's third-largest hospice market

Florida's hospice patient volume is among the highest of any state, and that scale includes a large number of for-profit programs. 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 recommend them 4 — a pattern that is not a verdict on any single Florida agency, but a reason to check ownership alongside scores rather than assume a familiar name means a particular quality level.

A hospice live discharge rate is worth reading the same way. Patterns of live discharge concentrated near the Medicare payment cap, especially at for-profit and short-stay-heavy programs, have been linked to more burdensome transitions back to hospital care after discharge 3. A single live discharge is often clinically appropriate; a consistent pattern across many patients is the signal to notice.

Hurricane season and continuity of home hospice care

Florida's hurricane season runs roughly June through November, and a home hospice plan that works on an ordinary week can fail during a mandatory evacuation order — medications, oxygen equipment, and a dying patient may all need to move together on short notice. This is a genuinely Florida-specific question that families in most other states never have reason to ask.

Before choosing a hospice, it is reasonable to ask directly how the agency handles a storm: whether it has a written continuity-of-care or evacuation-support plan, how it reaches patients who lose cell service or power, and whether it coordinates with shelters that accept hospice-level medical needs. A hospice that has never been asked this question before is not automatically unprepared, but one that cannot describe any plan at all is worth a second look.

Snowbird patients and hospice election across state lines

Florida's large seasonal population means it is common for a patient to split the year between a Florida address and a home state elsewhere — a pattern that raises real continuity-of-care questions when a hospice election happens in one location and the patient later travels. Hospice benefits and enrollment are tied to a specific certified provider, not portable in the way a Medicare card is.

A Florida hospice serving a snowbird patient should be able to explain what happens if the patient returns north mid-benefit-period: whether records transfer cleanly to a hospice in the other state, whether there's a gap in coverage during the move, and who coordinates that handoff. Asking this before the season changes, rather than during a medical crisis, gives a family more room to plan.

Checking a hospice's Florida license and inspection history

Florida's Agency for Health Care Administration, through its Bureau of Health Facility Regulation, licenses and inspects hospices operating in the state — a state-level process separate from the federal Medicare certification survey that feeds Care Compare's public quality measures. The agency's consumer-facing Florida Health Finder tool lets a family look up a specific hospice's licensure status and inspection history directly.

This state-level check answers a different question than CAHPS scores do: not how caregivers rated their experience, but whether regulators have found and cited specific deficiencies. A hospice can have a decent survey score and still carry an open inspection finding, or vice versa — reading both records, not just one, is the more complete picture before enrollment.

The same method works in every state

None of this changes by geography — only the specific state layer on top does. Judging hospice quality through a CAHPS Hospice Survey and a hospice live discharge rate works the same way whether the question is hospice quality in Delaware or hospice quality in Florida, and a family choosing a hospice in Delaware reads the identical Care Compare filters as one choosing a hospice in Georgia.

The same holds moving further down the list: hospice quality in Georgia and hospice quality in Hawaii rest on the same federal data as choosing a hospice in Hawaii, choosing a hospice in Idaho, hospice quality in Idaho, hospice quality in Illinois, and choosing a hospice in Illinois. What changes state to state is the licensing agency's name, whether Certificate of Need gates entry the way it does here, and the Medicaid rules layered underneath.

Common questions

Not necessarily. Florida's Certificate of Need system assigns each hospice a fixed geographic service area, and an agency can only enroll patients living inside it. A Care Compare search by ZIP code can return hospices near a service-area boundary that aren't actually authorized to admit a patient at a specific address, so confirming service-area coverage is a needed first step in Florida.

This depends on the individual hospice's continuity-of-care plan, which is worth asking about before enrollment. A prepared hospice can describe how it relocates medications and equipment, keeps contact with patients who lose power or cell service, and coordinates with shelters equipped for hospice-level medical needs during a storm.

Hospice election is tied to a specific certified provider, not automatically portable between states. A hospice serving a seasonal patient should be able to explain how records transfer to a new hospice in the patient's other home state and whether there is any gap in coverage during that handoff, which is worth asking before travel plans firm up.

Florida's Agency for Health Care Administration, through its Bureau of Health Facility Regulation, licenses and inspects hospices statewide, and its Florida Health Finder tool lets the public look up a specific agency's licensure status and inspection findings — a separate check from the CAHPS Hospice Survey scores shown on Medicare's Care Compare.

Not automatically, but the pattern is worth knowing. National research has found family caregivers report worse experiences across CAHPS Hospice Survey domains at for-profit hospices on average, and are less likely to recommend them, compared with nonprofit hospices. That is a reason to check a specific agency's actual scores rather than assume ownership alone settles the question.

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Before choosing a Florida hospice

  • —the hospice cannot confirm its Certificate of Need service area actually covers your address
  • —the hospice has no described plan for continuing care during a hurricane evacuation order
  • —the hospice cannot describe how its on-call nurse line is staffed overnight and on weekends
  • —the hospice pressures a same-day enrollment decision or discourages checking Florida Health Finder first

If a hospice patient in Florida 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 Florida's Agency for Health Care Administration, or from a treating physician.

References

  1. 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. 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. 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. 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.

4 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

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