How to Tell If a Hospice Is Good

To tell if a hospice is good, read the public data Medicare already collects on it: the family-experience star ratings from the CAHPS Hospice Survey, the quality measures that track whether the hospice does the right things at admission, its ownership type, and any complaint or inspection history. No single number decides it, but together they draw an honest picture you can read in an afternoon.

This can feel like a lot to absorb when you have days, not weeks, to decide. You do not need to become an expert. This guide walks through each signal in plain English, what it does and does not tell you, and where to find it, so you can read a hospice's public scorecard the way a careful family member would. It is the companion to our general how to choose a hospice checklist: that one is the step-by-step to-do list, and this one is the deeper look at reading the numbers behind it.

Start with the family-experience star ratings

The clearest consumer signal is the star rating, and it is worth knowing exactly what it measures. Medicare's hospice star rating comes from the CAHPS Hospice Survey, which CMS developed and administers to capture the experiences of patients who died while receiving hospice care and their informal primary caregivers, meaning the bereaved family members who lived it, according to CMS. In other words, the score is the collected voice of families who came before you.

The survey has 47 questions, and Medicare publicly reports eight measures drawn from it (CMS). Two that many families weigh heavily are Getting Timely Help and Willing to Recommend this Hospice, but each measure answers a question you may be asking yourself right now:

Measure	What it tells you in plain English
Getting Timely Help	Did help arrive when the family needed it, day or night?
Help for Pain and Symptoms	Did the team get on top of pain and hard symptoms?
Communication with Family	Did the hospice keep the family informed and answer questions?
Treating Patient with Respect	Was the patient treated with dignity?
Emotional and Spiritual Support	Did the family get emotional and spiritual support?
Training Family to Care for Patient	Did the team show the family how to help at home?
Rating of this Hospice	The family's overall 0-to-10 score
Willing to Recommend this Hospice	Would the family recommend this hospice to others?

A consistently high rating across many surveys is a genuinely good sign. But read it as an experience score, not a clinical grade: it reflects how families felt they were treated and supported, which is meaningful but different from a direct medical measurement. As of July 2026, CMS refreshes this public data periodically as new survey results come in (CMS), so a profile you check today reflects the most recent published cycle.

What the quality measures actually check

Alongside the family survey, Medicare collects quality measures that track whether a hospice does the right clinical things, drawn from a standardized assessment the hospice completes for each patient and from Medicare claims (CMS). These are process measures: they do not grade the outcome of an individual's care, they check whether important steps happened.

The most useful one to understand is the comprehensive assessment at admission. It checks seven care processes that should happen when someone is admitted, including asking about the patient's treatment preferences, addressing spiritual and existential concerns, and screening and assessing physical symptoms such as pain and shortness of breath (dyspnea), according to a study in Innovation in Aging. Put simply, it asks: did the hospice sit down at the start and find out what this person needs and wants?

The same research shows why the measure is worth a look. On average, hospices performed a comprehensive assessment for about 70 percent of patients, while the lowest-performing 5 percent of hospices did so for 30 percent or fewer, and comprehensive pain assessment was the element hospices completed least often (Innovation in Aging). A hospice that reliably does the basic assessment for nearly everyone is showing you something about how it operates. As of July 2026, CMS reports these under its Hospice Quality Reporting Program, and the underlying assessment tool, called HOPE, replaced the older Hospice Item Set on October 1, 2025 (CMS), so the newest data reflects that transition.

Ownership is one input, not a verdict

Every Medicare profile lists an ownership type: nonprofit, for-profit, or government. It is fair to want to know it, and the research is real, but it is one input, not a verdict.

Here is what the data actually says. In national CAHPS data covering April 2017 to March 2019 (653,208 caregivers across 3,107 hospices), family caregivers reported worse experiences at for-profit hospices than at not-for-profit hospices on every measure, and 31.1 percent of for-profit hospices scored 3 or more points below the national average, compared with 12.5 percent of not-for-profit hospices, according to a study in JAMA Internal Medicine. A more recent JAMA analysis of 2021 to 2022 data found that hospices owned by private equity firms and publicly traded companies scored lowest on all eight CAHPS measures, about 2.86 points below not-for-profit hospices, which scored highest (JAMA).

But the same research is just as clear that ownership is not destiny. About 21.9 percent of for-profit hospices scored well above the national average, and the authors concluded that families should not treat profit status as a proxy for quality, and should instead be guided by a specific hospice's reported care experiences and quality indicators (JAMA Internal Medicine). Many for-profit hospices are outstanding and long established. So use ownership as context that tells you whether to look a little harder, then let a specific hospice's own ratings and answers decide. Our nonprofit vs for-profit hospice guide walks through this in more detail.

Look up complaints, inspections, and deficiencies

Ratings tell you about the good; the survey and complaint record tells you about the floor. Every Medicare-certified hospice is periodically inspected, and you can view its inspection and quality data on Medicare's Care Compare by searching the hospice by name or ZIP code. For the full complaint and deficiency history, and to report a concern, your state survey agency is the authoritative source.

It helps to know how common problems are, so a single finding does not frighten you out of proportion. An HHS Office of Inspector General review found that over 80 percent of hospices had at least one deficiency during 2012 to 2016, about one-third received complaints from beneficiaries or families, and over 300 hospices (18 percent) had at least one serious deficiency or a substantiated severe complaint in 2016, with the most common problems being poor care planning, mismanaged aide services, and inadequate assessments, according to HHS-OIG. What you are looking for is not a spotless record, which is rare, but a pattern of serious or repeated problems.

Two more things are worth carrying with you. First, families have the right to be free from abuse, neglect, and other harm, and should report concerns to the hospice and the state survey agency; a companion HHS-OIG report flagged barriers that keep families from filing complaints, and weak enforcement, as problems. Second, OIG's hospice oversight page notes that most Medicare hospices have at least one deficiency and warns that the public Hospice Compare data does not provide a full picture of a hospice's quality, while flagging the rapid growth in the number of new hospices as an oversight concern. That growth is why, as of July 2026, CMS has placed newly enrolling hospices in Arizona, California, Nevada, and Texas under a period of enhanced oversight that took effect July 13, 2023 (CMS). None of this means avoid new or for-profit hospices. It means a hospice that is very new, aggressively marketed, or reluctant to answer plain questions is a hospice to verify a little more carefully.

A missing rating is not a red flag

This is the point families most often get wrong, so it is worth saying plainly: a hospice with no star rating is not a bad hospice. Medicare only publishes a public star rating once a hospice has collected a minimum number of completed family surveys over the reporting period, according to CMS. A hospice that is new, small, or serves a community less likely to return a mailed survey simply may not reach that threshold yet.

So when you see "not enough survey data yet" on a profile, read it literally. It means there are too few completed surveys to publish a rating, and often nothing more than that the hospice is newer or smaller. Treat a blank rating as missing information to fill in with a phone call and the quality measures above, never as a warning sign. If two hospices both serve your address and one has strong ratings while the other has none, the ratings are a reasonable tiebreaker, but they do not replace the questions in our questions to ask a hospice list, and they never replace a conversation.

How HospiceAtlas puts this data in front of you

Reading these signals one by one on separate government sites is a lot to ask of anyone in the middle of a hard week. That is the whole reason HospiceAtlas exists. When you enter your ZIP code on the homepage, you see every hospice whose Medicare service area covers your address, and each profile pulls together the same public data described here: the CAHPS star ratings, the quality measures, and the ownership type, drawn directly from the official CMS provider data and updated each quarter.

We are careful to show this data honestly, including where it is missing, because hospice is comfort-focused care meant to bring peace and dignity at the end of life, as MedlinePlus describes it, and families deserve a clear picture rather than a sales pitch. Exactly how we source, match, and update each figure, and what our verification badges do and do not cover, is written out on our methodology page. Start from the hospices that actually serve your home, read their scorecards with the context above, then call the two or three that fit. That order, service area first and then the data and then a phone call, is how you tell a good hospice from the rest without losing days you do not have.

Find hospices that serve your ZIP code