Hospice Quality

Background

The federal administration's focus on curbing fraud, waste, and abuse has unveiled exploitative hospice practices across the nation. In December 2025, Ohio was added to a list of 6 states in CMS's Enhanced Oversight Program, and hospices are now included in nationwide and statewide moratoriums. 

Ohio has 185 hospices, with 1 in 4 opening in the last 5 years - a 16.5% increase that is largely concentrated in urban areas. While the state has been accommodating new providers to increase access to care, rapid market entry is a nationally recognized indicator of potential bad actors entering the space. This data, combined with questionable ownership structures, high live discharge rates among some providers, and data that points to more hospices than the Ohio market warrants, raises red flags for LeadingAge Ohio members. 

Read more about the State of Ohio's Hospices here. 

LeadingAge Ohio hospice members are taking the lead to strengthen hospice program integrity in Ohio and recommend the following: 

Passage of House Bill 945

With recommendations from LeadingAge Ohio hospice members, Representatives Andrea White and Bill Roemer introduced House Bill 945 to amend Ohio's hospice licensure practices. Governor DeWine's fraud prevention initiatives are a start to address bad practices in the state. This legislation goes further to create lasting change to prevent poor operators from entering the state while also increasing transparency and disclosure for existing programs by, among other factors:

• Instituting a 6-month moratorium on new hospice providers or changes of ownership.
• Increase the frequency of hospice license renewal to annually from every 3 years, allowing the state to monitor hospice compliance more closely.
• Requiring established office space with visible signage and operational infrastructure.
• Prohibiting change of ownership prior to 5 years following initial licensure. Bad actors in other states frequently changed ownership as a mechanism to game the system.
• Requiring submission of out-of-state performance history for hospice applicants.
• Limiting hospice administrators and medical directors to one hospice, except under certain circumstances, such as for rural areas.
• Requiring criminal background checks for administrators, medical directors, and owners.
• Enhancing provisions for which a hospice licence may be denied, revoked, or suspended.  

Increased Transparency for Consumers

The award-winning Long Term Quality Navigator website helps Ohioans find nursing home or assisted living care. LeadingAge Ohio requests that the Ohio Department of Aging add hospices to the navigator to help consumers compare providers and make informed decisions. 

Updates

House Bill 945 has its first hearing in the House Health Committee - June 3, 2026

House Bill 945 is amended into the SHIELD Act, House Bill 795 - June 3, 2026

Resources

State of Ohio's Hospices - Coming Soon

 Press Release June 3, 2026

LeadingAge Ohio-Backed Hospice Integrity Bill Introduced in House

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