Medicare's Care Compare tool lists Medicare-certified hospices and shows how each one did on a set of measures. There are two main parts. One is a survey of family members and friends who cared for a patient who died in hospice, summarized as a star rating. The other is a set of three measures about the care patients got, built from hospice records and Medicare claims.
Both are useful, and both have limits.
Where the ratings come from
Every hospice that gets Medicare payments has to report quality data to Medicare. Care Compare publishes the results on medicare.gov, and the same data can be downloaded from data.cms.gov. Each hospice page shows the date the data was last updated, and a link called "Get current data collection period" shows which months the figures cover.
The family caregiver survey
The star rating comes from the CAHPS Hospice Survey (Consumer Assessment of Healthcare Providers and Systems), which Care Compare calls the Family caregiver survey. It goes to a sample of the family members or friends who cared for patients who died in hospice, several months after the death.
The survey asks about five areas of care and two overall questions:
| Measure | What family caregivers reported |
|---|---|
| Communication with family | How often the team kept them informed, explained things clearly and listened |
| Getting timely help | Whether help came as soon as they needed it, including evenings, weekends and holidays |
| Treating patient with respect | Whether the patient was treated with dignity and respect, and the team really cared |
| Emotional and spiritual support | Support during hospice care, and in the weeks after the death |
| Help for pain and symptoms | Whether the patient got the help they needed for pain, breathing trouble, constipation, and anxiety or sadness |
| Rating of this hospice | How they rated the hospice from 0 (worst) to 10 (best) |
| Willing to recommend this hospice | How likely they'd be to recommend it to friends and family |
Each percentage is the share of caregivers who gave the most positive answer. CMS adjusts the scores for differences in patients and in how the survey was taken (mail or phone). Care Compare shows the national and state averages next to each score.
What the star rating means
The Family caregiver survey rating turns the survey results into 1 to 5 stars. More stars mean better quality care, as measured by this survey.
Medicare says a 1-star rating doesn't mean you'll get poor care from that hospice. It means hospices with more stars did better on these particular measures.
The stars are relative. CMS recalculates the cut points between star levels every six months, so a hospice with the same scores could land in a different star group at the next update. Scores update every quarter; stars update every other quarter.
CMS revised the survey for patients who died from April 2025 on. During the changeover, which runs from the May 2026 update through the November 2027 update, the star rating is based on seven measures instead of eight.
Why many hospices have no star rating
A hospice needs at least 75 completed surveys over the eight-quarter reporting period to get a star rating. CMS says a rating based on fewer surveys isn't reliable enough to tell hospices apart. A hospice under that number has no star, though its survey percentages may still appear. On the page, this shows as "The number of cases is too small to report Star Ratings."
Some hospices have no survey results at all. Hospices with fewer than 50 eligible patients and caregivers in a year can apply for an exemption, and a hospice certified during the year is exempt for that year. Care Compare marks these "Results aren't available for this reporting period."
Medicare is clear on what a missing rating means: the hospice didn't have enough surveys for a meaningful rating, and it doesn't mean something is wrong with the hospice.
The quality of patient care measures
Care Compare shows three measures in this section:
- Assessment at admission. The share of patients who got all seven checks when they started hospice, such as being asked about pain, shortness of breath, their treatment preferences and their beliefs and values.
- Visits in the last days of life. The share of patients who were visited by a registered nurse or medical social worker on at least 2 of their final 3 days.
- Hospice Care Index. A score from 0 to 10 built from ten indicators in Medicare claims, including gaps in nursing visits, nursing visits on weekends, discharges followed by a hospital stay, and spending per patient. A hospice earns one point for each indicator where it meets the standard. Hospices with fewer than 20 discharges over two years don't get a score.
The page also shows the conditions the hospice treated most, where it gave care (home, assisted living, nursing facility and so on) and whether it provided any level of care beyond routine home care. Care Compare notes that a 0% at a site doesn't mean the hospice can't give care there, and that a small hospice may simply not have had patients who needed other levels of care.
The reporting period
Each measure uses a different window. For the August 2026 update, CMS lists these:
| Information | Covers |
|---|---|
| Family caregiver star rating and survey scores | Patients who died October 2023 to September 2025 |
| Assessment at admission | Patients discharged October 2024 to September 2025 |
| Visits in the last days of life and Hospice Care Index | Medicare claims for care January 2023 to December 2024 |
So the newest figures describe care given about a year ago, and the claims measures go back more than three years.
What the ratings can't tell you
The ratings don't show who is on staff now, how quickly the hospice answers the phone at night in your area, or which nurse would visit. The survey only reaches families of patients who died in hospice. It leaves out patients who died within 48 hours of admission and families who asked not to be contacted.
They're a starting point for questions to ask the hospice. Medicare suggests using them alongside other information and talking them over with the patient's doctor.
Frequently asked questions
Is a hospice with no star rating a worse choice?
Not on that basis. Medicare says a missing rating means there weren't enough surveys for a meaningful rating, not that something is wrong.
Why did a hospice's star rating change when its scores barely moved?
Stars are set by comparing hospices with each other. CMS recalculates the cut points every six months, as old survey quarters drop out and new ones come in, so the same score can fall into a different star group.
Can I see the data behind Care Compare?
Yes. CMS publishes the hospice data sets, including the survey scores and footnotes, on data.cms.gov, where anyone can download them.
Sources
- Medicare Care Compare: Family caregiver survey rating for hospice agencies
- Medicare Care Compare: Hospice levels of care
- CMS: CAHPS Hospice Survey
- CMS: Hospice quality reporting, current measures
- CMS: Hospice public reporting, key dates for providers
- CMS CAHPS Hospice Survey: Star Ratings frequently asked questions (July 2025)
- Data.cms.gov: Data dictionary for hospice data on Care Compare