Nonprofit vs For-Profit Hospice

Nonprofit and for-profit hospices are both Medicare-certified and must meet the same federal standards, so ownership type is not itself a measure of quality. Most hospices in the United States are now for-profit. Federal data shows some population-level differences by ownership — in length of stay, margins, and discharge patterns — but none of it decides whether a specific hospice is right for your family.

What "nonprofit" and "for-profit" actually mean

Ownership type describes how a hospice is organized financially, not how well it cares for patients. A for-profit hospice is owned by a company or investors and can distribute profits to its owners. A nonprofit hospice reinvests any surplus into its mission and is often connected to a hospital, a faith community, or a local charitable organization. Some hospices are government-owned, such as those run by a county or a public health system.

Whatever the ownership, every Medicare-certified hospice must meet the same federal Conditions of Participation and is surveyed against the same rules. Ownership changes who ultimately receives any financial surplus; it does not change the standards a hospice is held to.

How US hospices break down by ownership

Hospice began largely as a nonprofit, volunteer-driven movement, but the field has changed. According to MedPAC's March 2026 report to Congress, about 82% of Medicare-certified hospices were for-profit in 2024, with roughly 16% nonprofit and about 2% government-owned. In raw counts, that was 5,497 for-profit, 1,070 nonprofit, and 130 government hospices.

That majority is recent and still growing. MedPAC reports that the number of for-profit hospices grew about 5% in 2024, and that between 2019 and 2023 for-profit providers grew roughly 11% per year while nonprofits declined about 2% per year. Market entry of for-profit providers has driven nearly all of the sector's growth for more than a decade. One nuance matters for families: for-profit hospices tend to be smaller on average, so although they were about 82% of providers in 2024, they furnished care to roughly 60% of Medicare hospice patients.

What research does — and doesn't — say about ownership

Federal data and peer-reviewed research document several differences associated with ownership type. These are averages across thousands of providers, not statements about any individual hospice, and some reflect real differences in the patients each type tends to serve. As of July 2026, the most current federal figures come from the MedPAC report cited throughout this section.

Length of stay

In 2024, the average lifetime length of stay was longer at for-profit hospices (120 days) than at nonprofit hospices (71 days), MedPAC reports. Part of that gap reflects patient mix: for-profit hospices admit more patients with conditions such as dementia and other neurological diseases, which follow longer, less predictable courses than cancer. A longer stay can mean a family got support earlier, which is often a good thing. The gap does narrow but persists within a diagnosis — for neurological conditions, MedPAC found average stays of 194 days at for-profit versus 129 days at nonprofit hospices in 2024.

Live discharges

A live discharge — a patient leaving hospice while still alive — is sometimes exactly right: the person stabilizes, improves, or chooses to pursue treatment again. MedPAC notes, however, that unusually high live-discharge rates can signal quality or program-integrity concerns. A peer-reviewed study in the Journal of the American Geriatrics Society, available through the NIH and using Medicare data from 2005–2011, found that after adjusting for patient and geographic differences, for-profit hospices had higher live-discharge rates (about 20–21%) than nonprofit hospices (about 15–16%). That study reflects an earlier period, so it describes a historical pattern rather than today's individual providers.

Margins and quality scores

Medicare margins differ by ownership, largely because of how Medicare pays. MedPAC found the aggregate Medicare margin in 2023 was about 13.7% for for-profit hospices and about −1.3% for nonprofit hospices. Because Medicare pays a daily rate, longer stays tend to be more profitable, which is part of why length-of-stay and margin patterns move together. On quality, the evidence is mixed and modest: MedPAC cites analyses finding nonprofit hospices somewhat more likely to be high performers on the CAHPS family-caregiver survey, though sector-wide caregiver ratings are broadly similar.

Why ownership alone can't tell you about one hospice

Every figure above is an average. Averages describe a population; they do not predict the experience of one family with one hospice. There are excellent for-profit hospices and struggling nonprofit ones, and vice versa. The differences researchers find are real but modest, and they are shaped by patient mix, local markets, and payment design as much as by ownership itself.

Treating ownership as a verdict would mislead you in both directions — steering you away from a strong for-profit provider nearby, or toward a nonprofit that happens to be a poor fit. Ownership is context, not a conclusion.

It also can't capture the things families tell us matter most in the moment: how quickly a hospice responds when symptoms flare, how clearly the team communicates, whether a nurse can get to the home at 2 a.m., and how well the staff supports a caregiver who is frightened and exhausted. Those qualities vary hospice by hospice, and a label on a spreadsheet cannot tell you which provider will show up well for your family.

Why we show ownership on every profile

HospiceAtlas displays each hospice's ownership type — drawn from the CMS Provider Data Catalog — on every profile, right next to its quality measures. We do this for transparency, not to tilt you toward one type. Medicare itself publishes an ownership field for every certified hospice; the CMS data dictionary lists the possible values as For Profit, Non-Profit, Government, Combination Government & Non-Profit, or Other.

Ownership is one honest data point among several. Seeing it plainly, alongside survey scores and service details, lets you weigh it yourself rather than have it hidden or spun.

What to look at instead

Because ownership can't rank providers for you, the more useful comparison is a hospice's own record and how it answers your questions. When you compare hospices, look at the family-caregiver survey scores where they exist, the levels of care offered, and how clearly the team explains what it will and won't do.

Two companion guides help here: how to choose a hospice walks through the quality signals that matter, and questions to ask a hospice gives you a printable list to bring to the conversation. Use ownership as background; use those questions to decide.

Compare hospices that serve your address. Enter your ZIP code to see every Medicare-certified hospice covering your neighborhood — with ownership type and quality data side by side, built on public Medicare (CMS) data, so you can weigh both for yourself.

Find hospices near you →