Hospice & palliative care

Choosing a Hospice in Michigan: Reading the Public Data

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Michigan families can compare hospices on CMS's Care Compare site and read CAHPS survey results, the same national tools used everywhere, but Michigan-specific facts matter too: the state licenses hospice agencies and hospice residences separately, both require Certificate of Need approval, and the rural Upper Peninsula faces access challenges the denser Lower Peninsula doesn't share.

Last updated: July 2026

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How Do You Start Choosing a Hospice in Michigan?

Start with the same national data every family can use — Medicare's Care Compare tool and CAHPS Hospice survey scores — then add what's specific to Michigan: a licensing system that distinguishes a home-based hospice agency from a bedded hospice residence, a Certificate of Need review that covers both, and a geography split across two peninsulas with very different population densities. The method for judging hospice quality is national; how hospice care is organized and reached in Michigan is not.

That split matters most for a family weighing a home-based hospice against one that also operates a residential unit, since Michigan licenses and regulates those two things somewhat differently, a distinction covered in more detail below and worth raising directly during an initial call.

Who Licenses Hospices in Michigan

Michigan's Department of Licensing and Regulatory Affairs, through its Bureau of Community and Health Systems, licenses hospices in two separate categories: a hospice agency, which delivers care wherever a patient lives, and a hospice residence, a bedded facility that requires its own license and per-bed fee on top of the agency license. Both categories also require federal Medicare certification to bill for care.

That two-track system means a single hospice organization operating both a home-based program and a residential unit is actually carrying two distinct state licenses, each inspected and surveyed on its own, which is worth knowing when checking a specific program's licensing status.

Michigan's Certificate of Need Rules for Hospice

Michigan has required a Certificate of Need for major health projects since 1972, administered today by an eleven-member, governor-appointed Certificate of Need Commission that develops and revises the specific review standards on a rotating schedule — and hospice programs, including new hospice residences, fall under that review. A completed CON approval is generally required before a new hospice agency or residence license application can move forward.

For a family, this doesn't affect the day-to-day quality of an existing hospice, but it does explain why hospice capacity in Michigan tends to grow through a formal state process rather than simple market entry, and why openings can be uneven across the state.

Hospice Access Across Michigan's Two Peninsulas

Michigan is split into two peninsulas connected by a single bridge, and the Upper Peninsula is far more rural and sparsely populated than the Lower Peninsula's Detroit-to-Grand-Rapids corridor, which changes what hospice access realistically looks like depending on where a family lives. A hospice based in a small Upper Peninsula community may cover a much larger service area than one based near a major Lower Peninsula hospital system.

That's a reasonable thing to ask about directly: which of the four Medicare-defined levels of hospice care a specific agency can deliver locally, and how far a transfer to general inpatient care might mean traveling if a symptom crisis happens at home 1.

Hospice Coverage Under Michigan Medicaid

Michigan Medicaid covers hospice care for eligible members, most of whom are enrolled through one of the state's contracted Medicaid Health Plans rather than traditional fee-for-service Medicaid, while the hospice benefit itself still follows the same federal structure used nationally — electing hospice means choosing comfort-focused care over curative treatment for the terminal illness.

For a Michigan Medicaid member living in a nursing facility, Medicaid pays the hospice a room-and-board rate for that stay, commonly around 95 percent of what the facility would otherwise receive directly 2, regardless of which Medicaid Health Plan the member happens to be enrolled with.

Reading a Hospice's Public Quality Record

Every Medicare-certified hospice serving Michigan reports quality data anyone can look up for free on CMS's Care Compare website 3, including CAHPS Hospice Survey results, which ask family caregivers of patients who died on hospice about pain and symptom management, communication, timeliness, and whether they'd recommend the program to others 4. None of it requires a phone call or a sales pitch to access.

The full method for reading these numbers — what a strong versus weak profile looks like, and how much weight to give a small number of completed surveys — lives in Gale's guide to judging hospice quality; in Michigan, the same lookup applies whether the hospice is based in Detroit or a small Upper Peninsula town, and results are refreshed on a regular public reporting schedule rather than left to go stale.

What Ownership and Live-Discharge Rates Signal

Nationally, family caregivers report a meaningfully better hospice experience — across pain control, communication, and timeliness — when the hospice is not-for-profit rather than for-profit 5, and problematic live discharges, where a patient leaves hospice alive under circumstances that look more like a business decision than a clinical one, are documented as more common at for-profit hospices 6. Both facts are public record, worth checking alongside a hospice's CAHPS score.

That pattern doesn't settle which specific Michigan hospice is the right fit — it describes thousands of agencies nationally, not a verdict on any single program — but it's a reasonable second filter once a hospice's own quality data is in hand.

If You're Coordinating Care Across State Lines

Some families researching hospice in Michigan are simultaneously coordinating care for a relative somewhere else. The lookup tools don't change from state to state — only the licensing rules and Certificate of Need posture do — so the same approach applies to hospice quality in Texas, hospice quality in Utah, hospice quality in Vermont, hospice quality in Virginia, and hospice quality in Washington.

A hospice's state license — or, in Michigan, its agency and residence licenses — along with its Certificate of Need history and complaint record are the pieces that don't transfer from one state's page to the next, which is why this guide covers Michigan on its own.

Common questions

Yes. Michigan issues a hospice agency license for home-based care and a separate hospice residence license, with its own per-bed fee, for a bedded facility. An organization offering both is holding two distinct state licenses, each surveyed on its own, in addition to federal Medicare certification.

Yes. Michigan has run a Certificate of Need program since 1972, administered by a governor-appointed commission, and hospice agencies and residences fall under that review. A completed CON approval is generally required before a new hospice license application can proceed.

For most hospice patients with Medicare Part A, the hospice benefit covers team visits, medications related to the terminal diagnosis, equipment, and the levels of care described in this article, with little to no cost-sharing for most services — though room and board in a nursing facility is generally not covered unless Medicaid also applies.

Yes. Enrolling with one hospice is not permanent — a patient can revoke the hospice benefit or transfer to a different Medicare-certified hospice, and it's reasonable to ask a prospective agency directly how a transfer would work before deciding, especially if the concern is about communication rather than the clinical care itself.

The Department of Licensing and Regulatory Affairs' Bureau of Community and Health Systems oversees hospice agency and residence licensing, surveys, and complaints in Michigan. CMS's Care Compare site is the fastest starting point for national quality and CAHPS survey data on any hospice licensed to serve the state.

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When Choosing Can't Wait

  • —the patient appears to be actively dying (irregular or labored breathing, mottled skin, unresponsiveness) and no hospice is enrolled yet
  • —uncontrolled pain, severe breathlessness, or agitation with no clinician currently involved
  • —a new medical crisis — a fall, chest pain, a seizure — in a person not yet on hospice
  • —a family caregiver in a remote area who no longer feels safe or able to manage care alone

A person in acute physical crisis needs 911 or the nearest emergency room regardless of where a hospice search stands; once a hospice is chosen and admission begins, its own on-call nurse line, staffed 24 hours, becomes the first call for pain and symptom changes.

This article explains how to read Michigan's public hospice-licensing and quality data; it is not medical or legal advice and does not replace guidance from the patient's physician, a hospice intake team, or a local Area Agency on Aging.

References

  1. 1.Centers for Medicare & Medicaid Services (2024). Medicare-Certified 4 Levels of Hospice Care. Medicare.gov / Care Compare (CMS). link ✓The four Medicare-defined hospice levels of care, used to explain what Upper Peninsula access gaps affect specifically.
  2. 2.Centers for Medicare & Medicaid Services (2024). Hospice Payments (Medicaid). Medicaid.gov (CMS). linkHow Medicaid pays room-and-board for dually eligible nursing-facility residents on hospice, at roughly 95 percent of the facility rate.
  3. 3.Centers for Medicare & Medicaid Services (2024). Find Healthcare Providers: Compare Care Near You (Hospice). Medicare.gov / Care Compare (CMS). link ✓That consumers can publicly compare Medicare-certified hospices, including those serving Michigan, on quality and experience data.
  4. 4.Centers for Medicare & Medicaid Services (2024). CAHPS Hospice Survey. Centers for Medicare & Medicaid Services (CMS). link ✓What the CAHPS Hospice Survey measures: pain/symptom help, communication, timeliness, overall rating, willingness to recommend.
  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 ✓That family caregivers report better hospice experiences across domains at not-for-profit versus for-profit hospices nationally.
  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 26004403That problematic (burdensome) live-discharge patterns are more common at for-profit than not-for-profit hospices.

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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