Not all hospice providers are the same. Learn how to compare hospice quality, find reliable information, and ask the questions that matter before choosing a hospice.
Choosing a hospice may be one of the most important decisions you make for someone you love. It can also be one of the most difficult.
Often, families are introduced to hospice during a hospitalization or after a physician recommends a change in the focus of care. There may be little time to research options, and most people have never had to choose a hospice before.
You may be given a list of hospice providers without knowing how they differ or what makes one better suited to your family’s needs.
The good news is that there are reliable resources to help you make an informed decision.
Do All Hospices Provide the Same Care?
All Medicare-certified hospices must meet federal requirements for providing hospice services. These include nursing care, physician oversight, medications and equipment related to the terminal illness, social work services, spiritual support, and other services based on the patient’s needs.
However, meeting the same basic requirements doesn’t mean every hospice provides the same experience.
Hospices may differ in how frequently staff visit, how quickly they respond to urgent needs, how well they communicate with families, and how effectively they provide support during the final days of life.
These differences matter.
A family caring for someone at home needs to know not only what services are available, but how reliably those services will be provided when they are needed.
Does It Matter Whether a Hospice Is For-Profit or Nonprofit?
Hospice providers may operate as either for-profit or nonprofit organizations. Both types can provide high-quality, compassionate end-of-life care. A hospice’s ownership structure alone does not determine the quality of care. Families should focus on the services offered, responsiveness, communication, and how well the hospice meets the needs of the patient and family.
Step 1: Find Hospice Providers in Your Area
A useful place to begin is the National Hospice Locator.
This free resource allows families to search for hospice providers in their area and compare them using publicly available information.
One particularly helpful feature is its hospice quality score. Rather than simply listing hospices by size or location, the National Hospice Locator uses Medicare data to help identify providers that perform well on several measures of quality.
The scoring system considers factors such as:
- Visits during the final days of life: How consistently hospice staff provide in-person support when patients and families may need it most.
- Staffing and patient visits: How much direct care hospice staff provide.
- Different levels of hospice care: Whether the hospice has provided services for patients requiring more intensive care, inpatient symptom management, or respite care.
- Family satisfaction: Whether families who received hospice services would recommend that provider.
- Organizational stability and accreditation: Additional information about the hospice’s history and oversight.
The National Hospice Locator combines these and other measures into a numerical score.
According to its October 2025 scoring methodology, hospices scoring 84 or higher ranked among the top 20% nationally.
An important caution: This is an independent scoring system developed by Hospice Analytics, not an official Medicare rating. It can help identify hospices worth considering, but it should not be the only factor in your decision.
A lower score may sometimes reflect missing information rather than poor care. Likewise, a high score does not guarantee that every family will have the same experience.
Think of the score as a starting point for asking better questions.
Step 2: Compare Hospices Using Medicare’s Care Compare Website
Another valuable resource is Medicare Care Compare.
This is the federal government’s official website for comparing Medicare-certified healthcare providers, including hospices.
You can search by location and review information about individual hospice agencies.
Some of the most useful information comes from surveys completed by family caregivers after a loved one’s death.
These surveys ask about experiences such as:
- Communication: Did hospice staff explain things clearly, listen to concerns, and keep families informed?
- Timely help: Did families receive assistance when they needed it, including during evenings, weekends, and holidays?
- Pain and symptom management: Did the hospice provide adequate help with pain, breathing difficulties, anxiety, and other symptoms?
- Caregiver training: Did families receive the information and instruction they needed to care for their loved one?
- Respect and dignity: Did the hospice team treat the patient with compassion and respect?
These are particularly meaningful measures because they reflect the experiences of people who actually received hospice services.
Not every hospice will have publicly reported results for every measure. Some may not have enough survey responses to produce reliable ratings.
When comparing providers, look for patterns rather than relying on any single number.
What Is the New HOPE Assessment?
Medicare has introduced a new hospice assessment called HOPE (Hospice Outcomes and Patient Evaluation), which began October 1, 2025.
HOPE is designed to collect more detailed information about patients’ conditions and care needs throughout their hospice experience, including symptoms and changes that may require additional attention.
Unlike assessments focused primarily on information collected at admission and discharge, HOPE includes assessments during the course of hospice care.
Over time, information collected through HOPE is intended to support quality measurement and help improve hospice care.
Families do not need to understand the technical details of HOPE when choosing a hospice, but it is useful to know that Medicare continues to develop ways to evaluate the quality of care patients receive.
For additional information, visit the Centers for Medicare & Medicaid Services’ Hospice Quality Reporting Program.
Step 3: Talk With the Hospices You Are Considering
Online ratings can help narrow your choices, but they cannot answer every question.
Once you have identified two or three hospices, consider calling them and asking to speak with an admissions nurse or representative.
You can also request an informational visit before deciding whether to enroll.
Here are some questions worth asking.
1. What happens if we need help in the middle of the night?
Hospices must provide access to care around the clock, but the way they respond to urgent calls may differ.
Ask whether a nurse is available to come to the home at night, on weekends, and during holidays. Ask how urgent calls are handled and what families should expect if symptoms suddenly worsen.
2. How often will a nurse visit?
Ask how nursing visits are scheduled and how the frequency of visits changes as your loved one’s condition changes.
A good hospice should be able to explain how the care plan is individualized and adjusted when needs increase.
3. Who will teach us how to care for our loved one?
For families providing care at home, this is especially important.
Ask who will teach you how to give medications, assist with personal care, recognize changes in condition, and respond to symptoms such as pain, agitation, or difficulty breathing.
Also ask what happens if you forget something or need additional instruction.
You should not be expected to remember everything after a single conversation.
4. What happens if symptoms become difficult to manage at home?
Most hospice care is provided wherever the patient lives. However, some situations require more intensive support.
Ask what additional services are available during a crisis, including continuous home care or inpatient hospice care when medically appropriate.
Find out where inpatient care would be provided and how those arrangements are made.
5. What support is available for family caregivers?
Hospice care is intended to support both the patient and the family.
Ask about hospice aide visits, social workers, spiritual care, emotional support, respite care, and bereavement services.
Be specific about the help your family needs, particularly if you are caring for someone at home with limited assistance.
Step 4: Pay Attention to How the Hospice Communicates
Numbers and ratings are important, but your interactions with a hospice can also tell you something about its approach to care.
When speaking with a hospice representative, consider:
- Do they listen carefully to your concerns?
- Do they explain things in language you understand?
- Are they willing to answer difficult questions?
- Do they explain what hospice will provide—and what it will not?
- Do they ask about your loved one’s wishes and your family’s circumstances?
Be cautious if you feel pressured to make an immediate decision without having your questions answered.
A good hospice should recognize that families need clear information, realistic expectations, and time to understand their choices whenever circumstances allow.
What If a Hospital or Doctor Recommends a Particular Hospice?
Your physician, hospital discharge planner, or social worker may recommend a hospice based on their experience working with local providers.
These recommendations can be valuable, especially when they come from professionals familiar with the quality of care different hospices provide.
However, you generally have the right to choose which Medicare-certified hospice will care for you or your loved one, subject to availability and coverage requirements.
You do not have to select a hospice simply because it appears first on a hospital’s list or because someone recommends it.
You can ask why a particular hospice is being recommended and compare it with other providers.
What If We Choose a Hospice and Are Unhappy With the Care?
Choosing a hospice is an important decision, but it is not necessarily permanent.
If you have concerns, begin by discussing them with the hospice nurse, clinical manager, or administrator. Many problems can be resolved through communication and changes to the care plan.
If concerns persist, Medicare beneficiaries generally have the right to change hospice providers once during each hospice benefit period.
Before making a change, speak with the hospice you are considering so that care can be coordinated without unnecessary interruptions.
A Simple Way to Begin
If you are trying to choose a hospice, you do not have to become an expert in hospice quality measures.
Start with these three steps:
- Search the National Hospice Locator to identify local hospices and review their quality scores.
- Visit Medicare Care Compare to review publicly reported quality measures and family caregiver experiences.
- Speak directly with two or three hospices and ask about nursing visits, after-hours support, symptom management, and caregiver education.
You may not have time to conduct an extensive search, and that is understandable. Even a few well-chosen questions can help you make a more informed decision.
The Bottom Line
The quality of hospice care matters—not only for the person receiving care, but also for the family members who will be supporting them.
Reliable information is increasingly available to help families compare hospice providers. Yet no rating system can fully capture the experience of caring for someone during the final chapter of life.
The goal is not simply to find the hospice with the highest score. It is to find a hospice that provides skilled, compassionate, responsive care and helps your family feel informed and supported.
At Partner for Care, we believe that families deserve access to understandable information throughout the hospice journey. Choosing a hospice is one of the first opportunities to ask questions, understand your options, and become an informed partner in your loved one’s care.