How We Rank and Rate Hospices

Local Hospice Guide is a directory of every Medicare-certified hospice in the country, built entirely on official government data. We do not invent ratings, sell placement, or rank hospices by who pays us. Every number on a provider's page comes from the U.S. Centers for Medicare & Medicaid Services (CMS), and we tell you plainly where each figure comes from and when data is missing.

What we use

• Family-survey results (CAHPS Hospice Survey). The headline figure on each provider is the share of families who say they would recommend the hospice, drawn from CMS's standardized survey of bereaved families. Learn what this means in what "families would recommend" really means.
• Hospice Care Index (HCI). A single CMS quality indicator built from ten care measures — see what the Hospice Care Index is.
• Quality measures such as the share of patients visited in the last days of life, and where care is delivered (home, nursing facility, inpatient).
• Size (average daily census) and conditions served.
• Ownership type (for-profit, non-profit, or government) and years in operation, from CMS enrollment data — available for most, but not all, providers.

Where each figure actually comes from

We think families deserve to know the source of every number, not just the number. Here is the provenance of what you see on a provider page.

How to read our pages

We don't reduce a hospice to one made-up "score." Instead we surface the real CMS measures side by side so you can weigh what matters to your family. A hospice marked "Not yet rated" simply hasn't had enough family surveys for CMS to publish a score — it is not necessarily worse, and is common for newer or smaller agencies. Our guide on reading CMS Care Compare walks through each measure.

Why some fields are blank

A blank is information, not an error. CMS suppresses figures when an agency has too few completed surveys or too few cases to publish a statistically reliable number. That happens most with small and newly certified hospices. We label these honestly rather than guessing or averaging in a placeholder, because inventing a number would be worse than showing none. If a field is blank on our page, it means CMS did not publish it — full stop. When you encounter blanks, lean on direct questions and references instead, as described in how to choose a hospice provider.

What we do NOT do

• We do not fabricate ratings, reviews, or statistics. Where CMS hasn't published a figure, we label it missing rather than guessing.
• We do not show consumer "star reviews" we can't verify — hospice quality here is grounded in CMS survey data, not anonymous web reviews.
• We do not sell ranking. Listings reflect the data, not payment.

Why ownership and transparency matter

Research has linked ownership structure to differences in utilization and some quality patterns, so we show it openly — but we encourage you to judge each agency on its own CMS measures, not its tax status alone. Combine our data with the questions in how to choose a hospice provider.

How our data complements your own homework

Our pages are a fast, honest starting point, not the whole decision. The most reliable choices come from pairing the published data with things only a conversation reveals: how the agency answers a 2 a.m. call, how quickly a nurse reaches the home in a crisis, whether the same aide returns each visit, and how the team handles your loved one's specific diagnosis. Use our numbers to build a shortlist, then call each provider and ask the same questions so you are comparing like with like. The data narrows the field; your questions pick the winner.

Frequently asked questions

Do hospices pay you to rank higher?

No. Placement and the figures shown are driven entirely by official CMS data. We do not sell ranking or accept payment to move a provider up the list.

Why does a hospice say "Not yet rated"?

It means CMS has not published enough family surveys or cases to report a reliable score, which is common for newer or smaller agencies. It is not the same as a low score and should not be read as one.

Are these the same numbers I'd see on Medicare's Care Compare?

Yes — we build from the same official CMS source files, then present them side by side. If you want to confirm anything, you can cross-check it on Medicare's own Care Compare tool.

Why don't you show patient reviews like other sites?

Because we cannot verify anonymous online reviews, and hospice is too consequential to rate on unverifiable opinions. We rely on CMS's standardized, audited family survey instead.

How often is the data updated?

CMS refreshes its public hospice data periodically, and we rebuild from the latest available files. Figures can lag real-world changes, so always confirm current details with the agency directly.

Does a for-profit hospice automatically rate worse here?

No. We show ownership type openly because research links it to some utilization and quality patterns, but we do not penalize an agency for its tax status. Good and poor providers exist in every ownership category, so we ask you to judge each one on its own CMS measures and your own questions.

Can I trust a hospice with strong scores but few surveys?

Treat it as a promising but thin signal. A high rate built on a small number of surveys is less stable than the same rate built on many. Use it to keep the agency on your shortlist, then verify with references and direct questions about staffing and after-hours coverage.

How to weigh the measures for your situation

No single measure should decide everything, and the right emphasis depends on your loved one's needs. A few branches help:

• If symptoms are hard to control — weight the experience scores on getting timely help and the visits-in-the-last-days measure, which signal a team that shows up when it matters.
• If you are caregiving largely alone — prioritize after-hours responsiveness and the would-recommend rate, then confirm by phone how nights and weekends are staffed.
• If the diagnosis is uncommon — look at conditions served and size, then ask directly about the agency's experience with that illness.
• If a key figure is blank — do not penalize the agency automatically; substitute questions and references for the missing data, especially with a smaller or newer provider.

Our editorial standards for high-stakes health content

Because hospice decisions are high-stakes, we hold this guide to a strict standard: we cite verified federal rules where they exist, we describe clinical eligibility as a physician's judgment rather than a checklist families apply themselves, and we never present a placeholder where a real number belongs. Eligibility thresholds that vary by region (such as functional and performance scales) are described as physician guidance, not national pass/fail rules. When we are uncertain, we say so and point you to the authoritative source rather than guessing.

What to do next

• Build a shortlist from our pages, noting each agency's would-recommend rate, HCI, and any blanks.
• Cross-check anything important against Medicare's official Care Compare tool.
• Call your top two or three and ask the same after-hours, staffing, and crisis-care questions.
• Decide on the whole picture — data plus conversation — not one number alone.

Data freshness and limits

CMS refreshes its public hospice data periodically, and we rebuild from the latest available files. Figures can lag real-world changes, and family-survey scores reflect past care, not a guarantee of your experience. Always confirm current details directly with a hospice. When you're ready, compare Medicare-certified hospices near you.