The State of Hospice in Metro Detroit, 2026

An original analysis of Medicare Care Compare data for every hospice serving Oakland, Macomb and Wayne counties. Published by Lily Hospice, Troy, Michigan, September 2026. Free to cite with attribution.

Summary

104 Medicare-certified hospices now list Oakland, Macomb or Wayne County in their service area, and 73 of them claim all three. A third of them (37) were certified in 2020 or later, so the typical hospice a metro Detroit family is offered today is younger than many of the people it cares for. Quality is uneven and mostly invisible: only 53 of the 104 have a published family-caregiver rating, and on the measure that matters most to families, the share of patients visited by a nurse or social worker in the last three days of life, hospices in the region range from 6.5% to 93%, with a median of 60.9%. Twenty-one hospices fall below the national average of 48.3%. In short, the choice of hospice in metro Detroit matters far more than most families are told, and the information to make it well has been sitting in a federal database no one reads.

Key findings

  • Crowded and new. 104 hospices serve the three counties; 70 are based inside them. 37 were certified in 2020 or later and 34 since 2021 alone. Only 26 date from before 2000.
  • Mostly for-profit. 63 report for-profit ownership, 13 non-profit, 5 “other,” and 23 (almost all newer agencies) report no ownership type to Medicare at all. At least 17 names belong to multi-location brands (Compassus, Gentiva, Heartland, Elara Caring, Heart to Heart, Optimal Care, Beacon, St. Croix, Residential and others).
  • Presence at the end varies enormously. Among the 85 hospices with enough data, the share of patients visited in the last three days of life runs from 6.5% to 93.0%. The middle half of hospices sit between 48.8% and 70.3%. Seven hospices are below 30%. Twenty-two are at or above 70%.
  • The Hospice Care Index hides more than it shows. 60 of 89 scored hospices earn a 9 or 10 out of 10, because the index only penalizes the bottom tenth on each of its ten parts. A 9 or 10 is table stakes, not a distinction. A 7 or below (13 hospices) is a warning.
  • Half the market has no family rating. 51 hospices have no published CAHPS star rating, usually because they are too new or too small to have accumulated enough completed surveys. Of the 53 that do: six are rated 5 stars, 14 are rated 4, 30 are rated 3, and three are rated 2. The median share of caregivers who would “definitely recommend” their hospice is 82%, ranging from 61% to 98%.
  • Nursing time is thin. The median hospice provides 12.4 minutes of nurse care per routine home care day, and 8.0% of its skilled nursing minutes on weekends. Families should ask directly how often a nurse will come and what happens on a Saturday.
  • Early discharges are common at some agencies. The median hospice discharges 7.6% of its live discharges within seven days of admission; the highest is 33.3%. High early-discharge rates can signal admissions that should not have happened.
  • Only five hospices cover essentially all of all three counties (80% or more of the ZIP codes in each): Hospice of Southeastern Michigan, Henry Ford Hospice, Beaumont Hospice, Seasons Hospice & Palliative Care of Michigan, and Residential Hospice. Most others serve a patchwork, which is why a hospice recommended by a hospital in Dearborn may not actually cover a home in Romeo.

What this means for a family choosing today

Three things. First, ask every hospice for its last-three-days visit rate and its family survey rating, and if the answer is “we don’t know,” look it up yourself on Care Compare or in our Metro Detroit Hospice Directory, which lists all 104. Second, confirm the hospice actually serves your ZIP code rather than your county; the service-area gaps are real. Third, treat a 9 or 10 Hospice Care Index as the minimum and put more weight on the visit rate, the family rating, and who answers the phone at night. Our checklist for choosing a hospice in metro Detroit walks through the rest.

Where Lily Hospice sits

We publish this report as one of the 104, not as a referee. Lily Hospice, Troy, ranks 20th of 85 on the last-three-days visit measure at 71.3%, against a regional median of 60.9% and a national average of 48.3%; ninth among the 70 hospices based in the three counties. Our Hospice Care Index is 9, our early-discharge rate is 3.2% against a regional median of 7.6%, and we do not yet have a published family survey rating because, at our size, Medicare has not received enough completed surveys to publish one. Our nurse-minutes and weekend-minutes measures are below the regional median, which we treat as work to do rather than a footnote. All of our numbers are on our quality scores page.

Method and sources

Data: Centers for Medicare & Medicaid Services Provider Data Catalog, hospice files “General Information,” “Provider Data,” “Zip Data,” and “Provider CAHPS Hospice Survey Data,” downloaded September 9, 2026. Reporting periods: Hospice Care Index and visit measures, January 2023 to December 2024; CAHPS survey, October 2023 to September 2025. Inclusion: Michigan-certified hospices listing five or more ZIP codes in Oakland, Macomb or Wayne County, or based in one of the three counties; ZIP codes mapped to counties with a public crosswalk. Medians and ranges are computed only across hospices with a reported value. We do not risk-adjust or rank beyond what CMS publishes. The underlying table is available as a CSV download. Corrections: (248) 955-5100.

Suggested citation: Lily Hospice, “The State of Hospice in Metro Detroit, 2026,” September 2026, based on CMS Care Compare data. lilyhospice.com/state-of-hospice-metro-detroit-2026/

See also: Hospice in Michigan: key numbers for 2026, with sourced state and national figures and Medicare payment rates.

Hospice isn’t giving up. It’s showing up.