The Best Hospice Care Services for 2020

Find the best end-of-life care for your loved one

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First Look

An estimated 1.4 million patients receive care from a hospice organization each year, according to the Centers for Disease Control and Prevention (CDC). Hospice provides an opportunity for those nearing the end of their life to receive medical, mental health, and spiritual support that helps keep them out of the emergency room and at their home or an inpatient hospice facility. Hospice services also frequently extend to a person’s family, including respite for caregivers and bereavement support services.

To qualify for hospice care under Medicare, a person must meet the following criteria:

  • A hospice doctor and a person’s primary care doctor (if applicable) must certify that a person is terminally ill and expected to live six months or less.
  • A person must agree to receiving care that aims to make them more comfortable instead of curing their condition.
  • A person must sign a statement in which they choose hospice care and, sometimes, discontinue other curative treatments.

Private insurance companies also may offer hospice benefits. They may have different, but often similar, requirements for qualifying for the service.

There are more than 4,300 hospice care agencies in the United States, each of varying sizes. Understandably, the sheer number can make selecting a hospice organization for yourself or a loved one very daunting. If a person already lives in a nursing home facility or is hospitalized, they may receive special hospice care from trained hospice personnel that work within that facility, which may also affect hospice care agencies available to you or a loved one.

We researched and reviewed more than 30 hospice care services with a nationwide presence of 14 or more states to select the best hospice services that offer unique services, have received national recognition for their levels of care, and provide care that is at or exceeds Medicare’s standards for hospice best practices. Keep reading to find out more about each of these companies.

Our Top Picks

Encompass Health: Best Overall

Encompass Health

Encompass Health

Pros
  • Winner of several national customer and employee satisfaction awards

  • 83 hospice locations in the United States, including Puerto Rico

  • Medicare- and Medicaid-certified agency

Cons
  • Website lacks educational and service-based information

  • Not offered in 11 states

Encompass Health is a Birmingham, Alabama-based company founded in 1984. The company underwent a name change in 2018 (it was formerly called HealthSouth). Encompass Health currently offers services in 39 states as well as Puerto Rico and has 83 hospice locations. The company does not currently offer services in Alaska, Hawaii, Michigan, Minnesota, Montana, Nebraska, New York, North Dakota, Vermont, Washington, or Wisconsin.

The company provides hospice services to those with a variety of end-stage conditions, including dementia, cancer, liver disease, kidney disease, and more. Its care team includes a medical director, doctors, registered nurses, hospice aids, social workers, volunteers, and more.

We selected Encompass Health as best overall for hospice because several trusted national organizations recognized it as a top-performing hospice. Strategic Healthcare Programs (SHP), one of the largest benchmark organizations for hospice in the nation, awarded Encompass Health’s Hospice in Rainbow City, Alabama, its Top Performing Agency award for 2019. SHP cited this hospice location as having the top overall score for hospice caregiver satisfaction. Encompass also had three facilities perform in the top 5% of scores, and four locations rank in the top 20%.

Modern Healthcare, a healthcare business and policy publication, also selected Encompass Health as one of 2019’s Best Places to Work in Healthcare based on employee satisfaction surveys. That was the eighth appearance for Encompass Health on the publication’s list.

The Encompass Health national website is light on education and information and instead mostly serves as a landing page for interested parties to enter their ZIP code and find information about hospice programs in their area. However, each hospice program does have its own website that lists services offered. It also features accessible phone services that are continuously staffed. You can make a care inquiry on the hospice page of Encompass Health's website and a member of the Encompass Health team will reach out to you regarding its services.

Encompass Health is certified by the Centers for Medicare & Medicaid Services (CMS), so it accepts both Medicaid and Medicare for payments. According to its website, it is also in-network with many private insurance plans.

Kindred Hospice: Best for Seniors on Medicare

Kindred Hospice

Kindred Hospice

Pros
  • Hospice Payment Options page clearly outlines Medicare payment information

  • 24/7 phone line with registered nurses

  • Specialty programs for veterans, memory care, and cardiopulmonary care

Cons
  • Hospice landing page makes it difficult to find other sub-pages

  • Does not list states served, must search by ZIP code

Kindred is a large post-acute care company that operates long-term care hospitals and also offers hospice services. It is based in Louisville, Kentucky, and was founded in 1985. According to LexisNexis, Kindred is the second- largest hospice provider with 3.13% of the hospice market share. However, it does not list the states its hospice programs serve—instead, you must search by ZIP code to see if it serves your location. Some of its inpatient hospice locations include Austin, Texas; Atlanta, Georgia; Detroit, Michigan; and the Norfolk-Portsmouth-Newport News, Virginia metropolitan area.

Navigability is less of a strength for the Kindred Hospice site. The hospice landing page didn’t feature any links where we could receive further information or education—we had to go to the site map to find more information. It does list a toll-free registered nurse helpline that operates 24 hours a day, seven days a week. Kindred also offers an online chat service from its website.

The section about hospice payment options was clear and succinct regarding Medicare benefits and what services Medicare would and would not cover. For example, the Kindred site listed four requirements for Medicare fully covering hospice care and the variety of services it could provide under Medicare’s hospice benefit, including doctor services, nursing care, dietary counseling, hospice aide services, and music, pet, or massage therapies (availability depending on location).

Medicare is a significant source of payments for hospice organizations. An estimated 1.49 million Medicare beneficiaries received hospice care in 2017, according to the National Hospice and Palliative Care Organization.

Kindred has several specialty hospice services listed on its website, including those for veterans, memory care programs, and a cardiopulmonary program for those with an end-stage heart or lung condition. On the Medicare Hospice Compare site, Kindred’s programs performed consistently higher than the national averages, including 100% compliance on patients who received at least one visit from a care provider in the last three days of life (the national average is 82.4%).

HCR ManorCare/Heartland: Best for Private Pay

Heartland Hospice

Heartland Hospice

Pros
  • Accepts Medicare, Medicaid, managed care, and private pay insurances

  • Offers grants to help families with additional expenses that insurance does not cover

  • Unique “Tuck-In Call” program provides peace of mind

Cons
  • Provides hospice care in 27 states

  • Name varies by area—may be HCR ManorCare or Heartland

HCR ManorCare is the parent company for its hospice division, Heartland. These divisions provide care in 27 states. HCR ManorCare was founded in 1959 in Toledo, Ohio, but did not open hospice services until decades later. According to LexisNexis, it is the third top hospice provider in the country, with 2.32% of the hospice market share. Some hospice locations may be called HCR ManorCare while others are called Heartland Hospice, which can lead to some confusion.

It offers a variety of services for hospice patients and families, including pain management, spiritual support, medications, medical equipment, patient education, and bereavement services. One unique offering is its “Tuck-In Calls” program, in which a member of the staff calls the patient or a family member in the evenings to check on their day and ensure everything is in order for their evening, comfort, and rest.

While HCR ManorCare accepts Medicare and Medicaid payments and, therefore, most patients can receive hospice services free of charge, it also accepts private and managed care insurance. The insurance companies will vary based on the location served. As part of its services, Heartland will check and confirm a patient’s benefit coverage to describe potential out-of-pocket costs associated with hospice. These may include costs for provider care, medications, room and board, and medical equipment. According to Debt.org, Medicare pays an average of $153 a day for hospice care, a number which may be similar to what a person’s private insurance pays. Although there is little data on private pay benefits for hospice, many private insurance companies cover hospice because it tends to be less expensive than the costs of seeking emergency care and inpatient care as a person nears the end of their life. 

Some private insurance companies designate certain Medicare organizations as “preferred providers.” For this reason, it’s important to check with your private insurance company to find out if you must choose from a select number of hospice providers.

On the financial side, it also has a Heartland Hospice Memorial Fund, designed to relieve the financial burden that can come with caring for a terminally ill family member. According to HCR ManorCare’s website, it has made more than 5,000 grants to help pay for household bills, travel costs, and even sponsoring children to attend grief camps to help in their bereavement process.

Both HCR ManorCare and Heartland Hospice received awards from Strategic Healthcare Programs (SHP) for their services. Five of their facilities were named in the top 5% to 20% of hospice caregiver satisfaction surveys.

Amedisys: Best National Presence/Chain

Amedisys

Amedisys

Pros
  • Offers specialized end-stage dementia program

  • 111 agencies received top honors for quality benchmarks

  • Medicare-approved hospice provider

Cons
  • Not offered in 12 states

  • Must search customer service contacts by state

Amedisys is the fourth-largest hospice services company in the United States, according to analytics firm LexisNexis. The company has been in operation since 1982 and has inpatient hospice locations and offers home hospice services. According to its website, it is a Medicare-approved hospice provider, and Medicare covers 100% of hospice costs with Amedisys.

Amedisys offers hospice care in 38 states, excluding Alaska, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, North Dakota, Utah, Vermont, and Wyoming. It does not list a nationwide customer service line on the website, so you’ll need to use its website to search for individual locations and contact information.

In 2019, 111 Amedisys agencies received “SHPBest Awards” from Strategic Health Programs, one of the nation’s largest hospice benchmark associations. Three Amedisys hospice centers were awarded the SHP “Premier Performer” award for ranking in the top 5% for quality and patient satisfaction. Amedisys also outperforms the national average in several Medicare Hospice Item Set (HIS) measures, including high marks for their intake assessment and for patients receiving a visit from a licensed health care professional within the last three days of life.

The Amedisys hospice care team includes a medical director, nurse, hospice aide, social worker, chaplain, bereavement counselor, and volunteers. Services and professionals utilized depend on your loved one’s individual needs.

Amedisys offers a specialized end-stage dementia program through its hospice services. Doctors and nurses in this program are specially trained in caring for those with dementia. Examples include providing activity lap pads to decrease agitation, special training for comforting baths and personal care, and training in non-verbal pain and behavior assessments.

Compassus: Best for Caregiver Support

Compassus

Compassus

Pros
  • Hospice guide available in multiple languages

  • Support for families even after their loved one has passed

  • Payment education section features paying for hospice with Medicare Advantage

Cons
  • Available in 29 states

  • Most education available on state-specific pages, not landing page

Compassus is a hospice service company based in Nashville, Tennessee, that opened its first hospice in 1979. It serves 159 locations in 29 states. It is a Medicare- and Medicaid-approved hospice and also accepts private insurance plans. It also features information on its website about how hospice benefits work with Medicare Advantage.

Compassus offers several patient support programs that make it stand out for helping grieving families. This list includes Life Review, in which volunteers help a hospice patient create a DVD or journal for families as a keepsake. It also offers a Veteran to Veteran program, where military veterans act as companions or visitors to a hospice patient, pet therapy (varies by location), and a Bereavement Program where volunteers place phone calls to friends or loved ones after the passing of a hospice patient to check in on them and their well-being. It also offers virtual grief support groups and specialized support programs for adolescents and teenagers going through a loss. We also liked its “Along the Final Journey” hospice guide for families, which features a hospice starter kit in several different languages. These kits are very helpful for families starting hospice discussions with loved ones and other family members.

The Compassus website is best navigated by putting in your ZIP code to obtain information on local branches. It’s tough to find information about services, payments, and other basic information on the national page of the site. It does have a toll-free referral phone line that's continuously staffed if you prefer to find your local branch in this manner.

VITAS Healthcare: Best for Breadth of Services

VITAS Healthcare

VITAS Healthcare

Pros
  • Specialty services, including Paw Pals pet visits

  • Largest market share of hospice organizations

  • 24/7 telecare services

Cons
  • Only offered in 14 states and the District of Columbia

Although VITAS Healthcare operates in only 14 states and the District of Columbia, the company has the largest market share of all hospice organizations, according to LexisNexis. For 2019, VITAS Healthcare had 4.50 percent of the national hospice market share. The company has been in operation since 1978 and employees nearly 12,000 professionals that care for more than 19,000 patients on a daily basis.

VITAS offers both at-home and inpatient hospice care. Its website lists a variety of services, both for hospice patients and their families. These include 24/7 telecare services through the organization’s Care Connection Center, which is staffed with licensed clinicians who can respond to around-the-clock requests for information and consultations. It also offers respite care for caregivers, home medical equipment arrangements, and an “intensive comfort care” program where a hospice team member can remain in a person’s home for 24 continuous hours when a patient is experiencing a heightened level for health needs.

Other specialized programs VITAS Healthcare offers includes specialized training in caring for those of the Jewish faith, music therapy, veterans care, and Paw Pals pet visits from hospice pet volunteers.

Several national organizations have recognized VITAS Healthcare for its use of technology in caring for patients—its mobile app won the “Best Social Impact” award at the 2019 Mobile User Experience Awards and “Best Technology-Enabled Process Improvement Project” at the 2018 Process Excellence Network Awards.

What Are Hospice Care Services?

Hospice care services are what a person may utilize if they no longer intend to seek treatments that will cure their illness, such as cancer. Typically, a person may start to receive hospice services when they are determined by a medical professional to have about six months or less to live. However, a person can go into hospice care and then be taken off of it if their condition improves. 

According to the American Cancer Society, several studies indicate hospice care isn’t started soon enough.

Hospice care services are intended to support a person’s mental, physical, and sometimes spiritual health through the end of their life. Ideally, hospice care allows them to spend their final months and weeks as comfortable as possible and on their own terms. While hospice care is most commonly delivered at home, a person may also receive hospice care services at an inpatient facility, such as an extended-care or inpatient hospice center.

What Types of Care Does a Hospice Service Typically Provide?

Hospice services may include some combination of the following services:

  • Coordination of care: A hospice team will help to coordinate care for a person, such as with a doctor, pharmacist, spiritual care advisors, or other medical professionals. This team can ensure a person has the equipment, medications, and care services they need to be as comfortable as possible.
  • Symptom control: This may include pain management medications or other medications and therapies to reduce a person’s discomfort.
  • Family meetings: A hospice organization can appoint a nurse or social worker who can communicate with a person’s family regarding a person’s care and outlook. This person may also be a source of support for family members experiencing significant stress levels related to their loved one’s illness.
  • Respite care: Hospice care services can help reduce some of the caregiver responsibilities for loved ones. Sometimes, this includes a short-term stay in an inpatient hospice facility.
  • Spiritual care: If desired, a person may seek the services of spiritual advisors or counselors who can help a person reflect on their life and assist with any desired religious ceremonies (such as last rites).

Hospices may offer additional services based on the individual company and a person’s care needs.

Does Insurance Cover Hospice Care?

Several insurance policies and plans cover hospice care. Examples of these include:

  • Medicare: This is a federal government-funded program for those ages 65 and older and those with disabilities and certain medical conditions, such as end-stage renal disease and amyotrophic lateral sclerosis. 
  • Medicaid: Medicaid is a federal/state partnership whose coverage levels vary by state. Medicaid services are provided based on need—individuals with lower incomes may qualify.
  • Department of Veterans Affairs: VA benefits include those for hospice care.
  • Private insurance: Many private insurance companies offer a hospice benefit. How much this benefit pays may vary based on the policy type.

If you or a loved one does not have insurance, hospice companies may be able to offer free or reduced-cost services. These companies may receive grants or community support to be able to provide hospice care. 

Is a Visiting Nurse the Same as a Hospice Nurse?

When a hospice nurse comes to a person’s home, they may be considered a visiting or home health nurse. However, not all home health nurses are hospice nurses. Hospice nurses provide care to those who are at the end of their lives. Home health nurses may provide care to a person who needs nursing services, such as wound care, drawing blood samples, or performing other skilled nursing services.

Hospice nurses are trained in caring for those who are near the end of their life. This training is often practical, on-the-job experience and extra education they may pursue or that their company offers.

How Long Does Hospice Care Last?

The average length of time Medicare patients enrolled in hospice received services was 76.1 days in 2017. Some people receive hospice care for a longer time and some receive it for less. Doctors or patients themselves cannot fully predict the end of their life—but they can make a best estimate of how long a person may have to live, and help to keep them comfortable.

How We Chose the Best Hospice Care Services

We reviewed more than 30 hospice care services before narrowing our selections down. Selection criteria included considerations of the company itself, including length of time in operation, hospice market share, and locations served in the United States. We reviewed satisfaction rankings and benchmarks from Medicare, employee satisfaction, and customer satisfaction results. Finally, we considered services offered, website navigability, and customer service accessibility.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. “Hospice care.” Accessed October 4, 2020.

  2. Medicare.gov. “Hospice care.” Accessed October 9, 2020.

  3. Strategic Healthcare Programs. “SHPBest 2019 hospice caregiver satisfaction award winners list.” Accessed October 2, 2020.

  4. Encompass Health. “Encompass Health named to Modern Healthcare’s Best Places to Work in Healthcare for 2019.” Accessed October 2, 2020.

  5. "Top 100 Hospice and Home Health Report." Lexisnexis.com.

  6. National Hospice and Palliative Care Organization. “NHPCO Facts and Figures.” Accessed October 1, 2020.

  7. Debt.org. “Hospice costs and end-of-life options.” Accessed October 9, 2020.

  8. The Cochrane Database of Systemic Reviews. “Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers." Accessed October 10, 2020.

  9. American Cancer Society. “What is hospice care?” Accessed October 1, 2020.

  10. American Cancer Society. “How and where is hospice care provided and how is it paid for?” Accessed October 1, 2020.