Notes

Hospices listed by CMS in each state, 2023 to 2026

Version 1.0 · published August 17, 2026 · computed from the public CMS hospice quality releases of May 24, 2023, May 22, 2024, May 21, 2025, May 20, 2026. Counts and rates on this page are product-computed from CMS-published files, which are linked at the foot. Download the table as CSV.

On May 13, 2026 CMS imposed a six month nationwide moratorium on new Medicare enrollment of hospices, citing growth in the number of hospices in a handful of states that was not matched by growth in the number of patients. Basically, this means that CMS simply stopped approving any new hospice organizations for enrollment for six months. The notice names four states — Arizona, California, Nevada and Texas — and counts them two different ways: how many hospices were enrolled, and how many newly enrolled in a year. Neither is the same as the count shown on this page. This page gives every state with at least 25 listed hospices, through the most recent release, so the changes CMS describes can be checked against the public data by anyone, not just us.

What the data shows

Six things show up in the table. Most line up with the account CMS gives in its notice. One, Texas, moves the opposite way from what that account would lead you to expect, and the reason turns out to be the two different ways of counting rather than any disagreement about what happened. To be clear, throughout this section, statements about fraud and about what caused a number to move are CMS's, not ours, and they are attributed. The counts and rates here simply describe what the public files record; they cannot by themselves establish why a figure changed, and nothing on this page is a finding about any individual hospice.

Two of the four states CMS acted on first have stopped growing. California peaked at 1,997 listed hospices in the 2025 release and has fallen to 1,857 — a decline of 140 from that peak, although still 478 above 2023. Arizona did something smaller, and later: 219 at peak in the 2025 release and 216 now, still 37 above 2023. The two are not the same shape. California fell. Arizona stopped climbing and has held about level since. Neither is anywhere near back to where it started. All four states — Arizona, California, Nevada and Texas — were placed under what CMS calls a provisional period of enhanced oversight. CMS reports roughly 670 hospices went to medical review under it and 122 were revoked. CMS puts that revocation rate at 18% and compares it to a general provider revocation rate of 1 to 3%.

California has also had its own licensing freeze throughout the period. CMS notes in the same document that California enacted legislation in 2021 placing a moratorium on new hospice licenses, still in force, and credits it with much of the fall in new California enrollments. (The footnote making that point says “new HHAs”, home health agencies, while pointing at the table of hospice enrollments. We read it as an accidental slip for hospices, since that is the table it cites, and note it here.) So California has two candidate explanations running over the same period, and from the publicly accessible data it simply cannot be stated which one did the work. One, or the other? Possibly both? Arizona doesn't have a state law like this, so if you wanted a potentially cleaner read on what oversight alone does, Arizona is closer to it. Note that CMS's point here is about new enrollments, while the fall this page measures is in hospices listed in a quality release. Those are different counts, and the next section sets out why.

Texas looks like a contradiction and is not. Texas was the fourth oversight state, and CMS reports its new enrollments fell hard, from 164 in 2023 to 67 in 2025. The count on this page went the other way: 760 listed hospices in 2023 and 939 now, an increase of 179 and the second largest in this table. Both are true at the same time. A hospice enrolls in Medicare first and turns up in a quality release later, so a year with fewer new enrollments can still be a year when the listed count climbs, as hospices that enrolled earlier finally appear. Texas is the clearest case on this page of why the two counts should never be used to check one another.

Nevada did not follow suit. Nevada was also one of the four oversight states, and it has still grown in every release, from 71 to 132 — up 86%, the largest proportional increase of any state above the 25-hospice line. CMS writes that this growth “potentially reflects a shifting of some fraudulent hospice activity” away from California and Arizona. What the public listings establish is a bit narrower: the number of listed hospices in Nevada continued to rise across the same releases in which California's fell and Arizona's leveled off. The listings cannot confirm that or rule it out. All they show is that Nevada kept rising in the same releases where California fell and Arizona stopped growing.

Ohio and Georgia show the same direction of growth. The same notice says CMS expanded its oversight program to both states in 2025, citing hospices operating from a single location in Ohio, and an increase in Georgia larger than the increase in beneficiaries. It also notes that neither state had historically been treated as high risk. In the public listings, Georgia has the fifth largest absolute increase in this table, and Ohio the seventh largest; Georgia 220 to 247, Ohio 141 to 163. Both are increases of a couple dozen hospices, an order of magnitude below California's, which is worth keeping in mind, because CMS's notice names Ohio and Georgia in the same paragraph as California. The listings corroborate the increases CMS describes, from a different file than the one CMS cites. They do not speak to CMS's characterization of the cause.

The national live-discharge rate rose, but not every state did. The national pooled rate went from 14.77% to 16.08% across these releases. Underneath it the states split, with 23 of the 39 below rising and 16 falling or holding flat. The national figure moves with the large states and with which hospices exist to be counted. It does not describe a typical state. Both rate columns are given for that reason, because a state rate only means something against the national rate for the same release, and the national line is a yardstick. Do not read it as a trend that every state is riding.

Where our numbers and CMS's differ, and why

CMS's notice counts enrolled hospices by calendar year. This page counts hospices listed in a quality release. Both are right; they are not the same quantity, and Nevada makes the gap visible:

A hospice can be enrolled in Medicare and not yet appear in a quality release, so the enrolled count is larger and moves earlier. The two series should not be expected to reconcile, and neither should be used as a check against the other. They do not even cover the same stretch of time, which is one more reason not to read one as a test of the other. Please note also that neither of these is the count behind the rate columns: a hospice can be listed here and still have the two discharge counts suppressed, which is what the coverage column measures.

Every state with 25 or more listed hospices

Ordered by absolute change in listed hospices, 2023 to 2026. The rate columns are each state's pooled live-discharge rate, which is calculated by taking (live discharges) divided by (live discharges plus decedents), over the hospices in that state for which CMS published both counts. Coverage is the share of that state's listed hospices behind its 2026 rate; read it before comparing one state's rate with another's.

How this was computed

The count is the number of distinct CCNs in each release for which CMS published at least one measure value. That is narrower than every CCN the file mentions: a hospice can appear in the release with every one of its measures suppressed, and those are not counted here, because a row of blanks tells you nothing about a hospice and would turn the count into a tally of file entries instead of measurable hospices. The difference is substantial — in the 2026 release the file names 6,852 distinct CCNs and 6,312 of them have at least one published value — so if you recompute from the raw file and get the larger number, this is why. The live-discharge rate is computed for each hospice as live discharges ÷ (live discharges + decedents), using the two CMS-published denominators, and then pooled across the state by summing numerators and denominators. A hospice for which CMS suppressed either count is excluded from the rate entirely; it is never counted as a zero. States with fewer than 25 listed hospices in the most recent release are omitted, because a change of two or three facilities produces a percentage that reads as a trend and is not one. We picked that floor. CMS has no such threshold. Kentucky sits just under it at 23 in all four releases, and New Hampshire has climbed to 23 in the most recent one, so the line excludes two states that are a hospice or two from clearing it.

What this does not show

These are the most important limits on the table above, and they should be read before the numbers are quoted anywhere.

• How CMS defines a live discharge. It comes from the patient's discharge status code on the claim. Transfers to another hospice do not count, and neither do death nor continued enrollment in the hospice. Everything else besides these does count, revocations included. This is why these rates run slightly below CMS's own number, which accounts for all reasons, published in its Hospice Monitoring Report. Comparing the two directly would be wrong, since they're measuring two different things by definition.
• Coverage varies a lot, and not randomly. CMS suppresses counts for hospices below its reporting threshold, so what's missing from a state's rate is usually the newest and smallest hospices. Nevada and California, the two fastest growers, have the two lowest coverage figures in the table: Nevada at 73.5% and California at 73.5%. Oklahoma, which grew 11%, sits at 96.1%. The relationship is a tendency and not a rule; Washington grew 27% and still has 95.7% coverage, but where the pattern holds, you're really seeing a state's primarily established hospices, not the newest ones.
• The two rate columns count different hospices. Each rate covers the hospices that had a computable rate in that release, and the membership changes from one release to the next. California's listed count moved by hundreds between these releases, and Nevada's rose 86%, so part of what moves a state's rate is simply which hospices existed at each end. In the fast growing states, that alone could explain the whole shift; no change in behavior required, just more hospices existing at the end of the window than the beginning.
• Enrolled vs. listed. CMS's own notice puts the number of enrolled hospices at approximately 7,000, a figure CMS itself rounded. It counts a larger set. See the reconciliation above for why the two don't match.
• Why a count drops. A hospice can leave a release because it closed, because it was revoked, because it stopped meeting the reporting threshold, etc. This data cannot tell these apart, and the difference matters a lot for what the number actually means.
• A rising live-discharge rate isn't proof of anything on its own. It is one measured quantity. Live discharge is often appropriate; a patient may stabilize, or revoke the benefit to seek treatment. The rate rose nationally across these releases, so a state that rose is not necessarily an outlier.
• The measurement windows overlap. This one applies to the rate columns; the hospice counts are a snapshot of each release, not a window. Each release names its own measurement window, and consecutive windows share quarters. The 2026 release covers calendar 2023 and 2024; the release before it covers calendar 2022 and 2023, so both of them count 2023. Four releases are not four independent years, so read the gap to the national figure rather than the raw line on its own.

A note on the ownership data

The obvious companion question is how many hospices changed hands recently — the moratorium blocks re-enrollment for a change in majority ownership within 36 months of initial enrollment or the last such change, so recent transactions matter. The public change-of-ownership file cannot answer it.

We checked. In the April 2024 file, calendar year 2023 showed 38 transactions. In the April 2026 file, the same year shows 95. The file backfills heavily, so the most recent two years always seem to be understated at the moment you look at them. Rows also disappear: 2020 fell from 78 to 70 across the same two snapshots. Anyone computing “hospice M&A is down sharply since 2023” from the current file will get a result that is an artifact of when they looked.

We will not be publishing that number for that reason.

Sources, citation and corrections

• CMS Provider Data Catalog — hospice care datasets, releases of 2023-05-24, 2024-05-22, 2025-05-21, 2026-05-20.
• 91 FR 27946 — CMS notice announcing the nationwide hospice enrollment moratorium, effective May 13, 2026.
• CMS Hospice Monitoring Report, April 2026 edition — CMS's own live-discharge figure, which counts all reasons including transfers between hospices.
• CMS Hospice All Owners, quarterly snapshots, including the change-of-ownership files discussed above.
• This table as CSV — the same rows, with the hospice counts behind every rate.

Suggested citation. Hospice Metrics, “Hospices listed by CMS in each state, 2023 to 2026”, version 1.0, August 17, 2026. https://hospicemetrics.net/notes/hospice-counts-by-state

Corrections. Every figure on this page can be recomputed from the linked files. If you check one and it disagrees with ours, tell us: we will correct it and say on this page what changed and when, or we will show our working. Versions are numbered. The number moves when a definition changes. New CMS data on its own does not move it. The same method produces the state figures in a full report; the methodology sets out the definitions in more detail.