Hospice & palliative care

Choosing a Hospice in the Los Angeles, CA Area

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Los Angeles families can use Care Compare and the CAHPS Hospice survey the same way anyone in the country does, but the local picture has its own shape: California licenses hospices separately from Medicare, has paused new hospice licensing statewide to slow fraud, and Los Angeles County has been the center of that growth, which makes checking a specific hospice's record matter more here than almost anywhere else.

Last updated: July 2026

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Start With Medicare's Care Compare Tool

Medicare's Care Compare website lets anyone search Medicare-certified hospices by ZIP code and see the same quality measures CMS collects nationwide, including CAHPS Hospice family-experience results and claims-based utilization data 1. It is free, requires no account, and is the right first stop before comparing anything else about a hospice serving the Los Angeles area.

Care Compare pulls from the Hospice Quality Reporting Program, the system CMS built to require every Medicare-certified hospice to submit data or face a payment penalty 2. That data includes CAHPS Hospice results and claims-based measures like live discharge. None of this settles which hospice is the right fit. It sets out what to check before deciding, and in a county with an unusually large number of Medicare-certified hospices to search through, that checking step matters more than it would almost anywhere else in the country.

California Requires Its Own Hospice License, Separate From Medicare

Every hospice operating in California must hold a state hospice license from the California Department of Public Health's Licensing and Certification Program, in addition to federal Medicare certification. That's a separate approval process from the one CMS runs, and it's the one a family would contact for a state-level licensing complaint about a Los Angeles-area hospice.

California's licensing and certification records, including inspection findings and substantiated complaints, are public information held by the state, distinct from the federal CAHPS and Care Compare data. Checking both, the state licensing history and the federal quality measures, covers more ground than either one alone, and in Los Angeles County specifically, the state's own licensing history has carried extra weight given the scrutiny described below.

Los Angeles County Has Drawn State Scrutiny Over Rapid Hospice Growth

California paused issuing new hospice licenses under a state law aimed at slowing a rapid, fraud-linked rise in the number of hospice agencies, a pattern investigators traced heavily to Los Angeles County. State reviewers found a wave of newly licensed hospices with few or no actual patients, raising concerns that some existed mainly to bill Medicare rather than to provide care.

That history doesn't mean every hospice in Los Angeles County is suspect; long-established, well-regarded programs operate throughout the county and the wider metro. It does mean the county's hospice landscape has had more of this kind of activity than most of the country, which is a reason to lean harder on the public data described here — CAHPS scores, live-discharge patterns, and a hospice's own licensing and inspection history — rather than assuming any newly listed name on Care Compare is established or actively caring for patients.

What the CAHPS Hospice Survey Actually Measures

The CAHPS Hospice Survey is a standardized questionnaire CMS mails to the primary caregiver of patients who died under hospice care, usually a few months afterward, asking about communication, help with pain and other symptoms, timeliness of care, training for family caregivers, and whether they'd recommend the hospice to others 3. It is retrospective, drawn from someone who was actually present.

Because it's retrospective, a single family's CAHPS answers describe one patient's experience, not a promise about how any other patient's illness will go. Care Compare reports these as aggregated scores across a hospice's recent respondents, and a hospice that is too new to have collected enough surveys yet may not have a published score at all — itself worth noticing, especially given how many new hospices have entered the Los Angeles market in recent years.

Why Live Discharge and Ownership Show Up in the Research

Being discharged alive from hospice isn't inherently a red flag; some patients stabilize and no longer meet the terminal prognosis. But researchers have flagged a pattern worth knowing: patients discharged alive from hospice are more likely to be hospitalized, readmitted, or die in a hospital shortly afterward, and these burdensome transitions are more common at for-profit hospices and after unusually short stays 4.

A separate national analysis of the CAHPS Hospice survey found that family caregivers reported worse experiences, across every measured domain, at for-profit hospices compared with nonprofit ones, and were less likely to say they'd recommend the hospice to others 5. Ownership status alone doesn't settle the question for any one Los Angeles hospice, but in a county where new for-profit agencies have opened quickly, checking ownership alongside CAHPS scores and licensing history is a reasonable way to narrow a long list.

Vetting Matters More in a Market This Large

Because Los Angeles County supports one of the largest concentrations of Medicare-certified hospices anywhere in the country, families here face a longer list to sort through than almost anywhere else. That size, combined with the state's own concerns about rapid, fraud-linked growth, makes checking each hospice's public record less optional than it might feel in a smaller market.

Before narrowing to a final choice, it's worth confirming a hospice's CAHPS score exists and looks complete, checking its live-discharge pattern, confirming its state license is current and free of substantiated complaints, and asking directly how it delivers the higher levels of care CMS defines for every certified hospice — continuous home care, general inpatient care, and inpatient respite care 6. A hospice that can answer clearly and specifically, rather than in generalities, is telling a family something the public data alone can't.

Common questions

Yes. California requires every hospice to hold a state hospice license from the Department of Public Health's Licensing and Certification Program, separate from federal Medicare certification. That state license is the one a family would check, or file a complaint against, for a licensing or care-standard concern about a specific Los Angeles-area hospice.

State investigators found a rapid, fraud-linked rise in the number of newly licensed hospices in California, concentrated heavily in Los Angeles County, some with few or no actual patients. That led the state to pause issuing new hospice licenses. It doesn't mean every Los Angeles hospice is suspect, but it's a reason to check a hospice's licensing history and CAHPS record closely rather than assuming a new name is established.

A missing or incomplete CAHPS score usually means a hospice hasn't been operating long enough to accumulate enough survey responses to publish. That's not automatically disqualifying, but it does mean there's less public data to lean on, so checking the hospice's state licensing history and asking direct questions about staffing and after-hours coverage matters more than it would for an established program.

A higher score is a reasonable tiebreaker, not a guarantee. CAHPS scores are averages built from family surveys collected months after a patient's death, covering a limited number of respondents, and they say nothing about how a specific hospice would handle a specific patient's symptoms. The score works best alongside live-discharge data, ownership, and licensing history.

Routine home care is the day-to-day level most hospice patients receive, wherever they live. General inpatient care is for short-term, intensive symptom management that can't be handled at home, provided in a hospital, hospice facility, or skilled nursing setting until symptoms are controlled. Continuous home care and inpatient respite care cover a brief home crisis and a caregiver's break.

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When to Escalate Beyond Comparison Shopping

  • —a hospice's on-call clinical line goes unanswered, or reaches only voicemail, during a symptom crisis
  • —pain, breathlessness, or agitation that isn't addressed within the response time the hospice promised in writing
  • —a hospice cannot produce a current state license or explain a gap in its CAHPS or inspection history

If a hospice patient is in acute distress and the hospice's 24-hour clinical line cannot be reached, call 911 and tell the dispatcher the patient is enrolled in hospice care.

This article explains how to read public hospice-quality data for the Los Angeles area; it does not replace guidance from a hospice's own clinical team or 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 ✓Supports that Los Angeles-area families can search and compare Medicare-certified hospices by ZIP code on publicly reported quality and CAHPS measures.
  2. 2.Centers for Medicare & Medicaid Services (2024). Hospice Quality Reporting Program. Centers for Medicare & Medicaid Services (CMS). link ✓Supports the existence and structure of the Hospice Quality Reporting Program as the data source behind Care Compare for every Medicare-certified hospice, including those in Los Angeles County.
  3. 3.Centers for Medicare & Medicaid Services (2024). CAHPS Hospice Survey. Centers for Medicare & Medicaid Services (CMS). link ✓Supports what the CAHPS Hospice Survey is, who it samples, and which domains it measures.
  4. 4.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 patients discharged alive from hospice face higher rates of hospitalization, readmission, or hospital death, and that this is more common at for-profit hospices and after short stays.
  5. 5.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 domains at for-profit hospices compared with nonprofit hospices.
  6. 6.Centers for Medicare & Medicaid Services (2024). Medicare-Certified 4 Levels of Hospice Care. Medicare.gov / Care Compare (CMS). link ✓Supports the definitions of the four Medicare hospice levels of care.

6 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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