Hospice Video Statistics

Key takeaways

1. Hospice nurses and clinicians posting as themselves made 62.9% of the on-topic videos among YouTube’s most-viewed hospice, hospice nurse and end-of-life results and drew 64.4% of their views; hospice providers’ own channels drew 0.9% (our read, Nov 6, 2026). (Mark Studios) See details
2. On the ‘end of life’ search, 110 of the 200 most-viewed results were songs, games and other off-topic videos, with 85.6% of that list’s views. (Mark Studios) See details
3. MedPAC counted 6,706 hospices in Medicare in 2024, 5,497 of them for-profit; about 1.82 million beneficiaries used hospice, and 52.9% of Medicare decedents did. (MedPAC) See details
4. The median Medicare hospice stay was 19 days in 2024 and the average 99.6 days; stays over 180 days took $17.5 billion of Medicare hospice spending. (MedPAC) See details
5. 910 hospices first joined Medicare in 2021 and 248 in 2025 (our count from CMS’s Provider of Services file, active and terminated hospices). (Mark Studios) See details
6. CMS lists 6,327 active certified hospices; Florida has 1.25 per 100,000 residents 65 and older against 9.79 nationally, and 28.9% of its rated hospices have 4 or 5 family-survey stars against 60.1% of rated hospices nationally (our calculation). (Mark Studios, CMS) See details
7. The face-to-face visit before a hospice recertification may be done by two-way audio-video telehealth through December 31, 2027. (CMS) See details
8. The “80% of Americans want to die at home” figure comes from a Stanford training page that cited no study; KFF’s survey of U.S. adults found 71 percent. (Stanford, KFF) See details

Who makes the most-viewed hospice videos on YouTube?

Hospice nurses posting as themselves made 62.9% of the on-topic videos among the most-viewed hospice, hospice nurse and end-of-life videos on YouTube on November 6, 2026, and drew 64.4% of their lifetime views (our count). We read YouTube's own view-sorted search results for 'hospice', 'hospice nurse' and 'end of life', the first four pages of results for each, through the YouTube Data API with no country filter, and classified every channel by hand from its own title, description and video text. The three lists held 440 unique videos from 198 channels, with 1,660,358,639 lifetime views in all. 103 videos were in two or more lists and 32 in all three. The 'hospice' list held 186 unique videos, and 87 of them were also in the 'hospice nurse' list.

How much of YouTube's 'end of life' search is about dying?

Less than half of it. 110 of the 200 most-viewed YouTube results for 'end of life' on November 6, 2026 were songs, games, motivation shorts and other videos with nothing to do with dying, and they drew 85.6% of that list's views (our count). Across all three lists, off-topic videos were 25.9% of the 440 videos and drew 69.6% of the views, and 98 of the 198 channels were off-topic. Music videos alone drew 57.7% of all the views; the most-viewed video in the sample was the Traveling Wilburys' 'End Of The Line', with 208,524,364 views. The rest of this section counts only the 326 on-topic videos, which had 504,408,554 views in all; the median one had 528,802 views.

How much of hospice YouTube comes from a few nurses?

Most of it. Three hospice nurses' channels, Nurse Hadley, Hospice Nurse Julie and Hospice Nurse Penny, posted 199 of the 326 on-topic videos on November 6, 2026 and drew 63.6% of their views (our count). Nurse Hadley, the channel of Hadley Vlahos, a registered nurse near New Orleans and author of 'The In-Between', drew 33.8% of the on-topic views on its own, and its videos in the sample had a median of 1,663,456 views. Hospice Nurse Julie posted 120 of all 440 videos, more than any other channel, and had 743,000 subscribers, against 724,000 for Nurse Hadley. Hospice Nurse Penny, a certified hospice nurse, posts almost only shorts: 97.3% of her videos in the sample ran 60 seconds or less.

In all, 7 channels were run by individual nurses or clinicians, and 5 of them stated a credential such as RN, CHPN, nurse practitioner or board-certified physician in their own text; we did not check any licence. In the 'hospice nurse' list these channels posted 86.2% of the videos and drew 87.4% of the views. In the 'hospice' list they drew 62.3% of the views, and among the on-topic 'end of life' results Hospice Nurse Julie alone drew 30.5%. The ten biggest channels drew 82.4% of all on-topic views, and 23.6% of on-topic titles named a nurse.

How many hospice providers' own videos make the lists?

Very few. Hospice and palliative care providers' own channels posted 5 of the 440 videos on November 6, 2026 and drew 0.9% of the on-topic views (our count): Legacy Hospice, Care Dimensions, Dignity Hospice, the UK charity Marie Curie and Aastha Hospice in Lucknow, India, with 4,630,380 views between them. Only one of them placed itself in the United States in its own text: Care Dimensions, a nonprofit hospice in Massachusetts, whose story of a family's pediatric hospice care had 526,865 views. Adding two health systems' hospice videos (Corewell Health and Spectrum Health Lakeland) and the trade association NHPCO, organisations in hospice care drew 1.1% of on-topic views. Government agencies, universities, training providers, health systems and associations as a group drew 0.6%, and titles explaining what hospice is, or how it differs from palliative care, drew 0.2%.

Do Florida hospices appear, and how active are their own channels?

No Florida hospice appeared in the search sample. Only one channel behind the 440 videos placed itself in Florida in its own text, the Jacksonville station First Coast News, whose story 'A beautiful death: how hospice turned heartbreak to hope' had 754,338 views, and 0 channels placed themselves in Palm Beach, Broward or Martin county (our count, November 6, 2026). Channels whose country setting was the United States posted 69.0% of the on-topic videos and drew 67.8% of their views.

We also read five hospice organisations' own channels, found from links on their homepages: VITAS Healthcare, which says it serves 15 states and the District of Columbia, Florida among them; Trustbridge, serving Palm Beach and Broward counties; Treasure Coast Hospice, serving Martin and St. Lucie counties; Chapters Health System of Temple Terrace, Florida; and Compassus. Together they posted 31 videos in the year to November 6, 2026, with a median of 89 views, and the most-viewed of them had 1,715 views (our count). They had 4,286 subscribers between them, and 0 of their videos were in the search sample. VITAS had the most subscribers, 2,670; Trustbridge had 137. Treasure Coast Hospice's uploads had a median of 150.5 views, 81.8% of Chapters Health's uploads ran 60 seconds or less, and Compassus posted 3 videos.

What are the most-viewed hospice videos about?

Two subjects lead: what dying looks like, and what dying people see. 13.2% of on-topic titles on November 6, 2026 were about what to expect or the signs that death is near, such as the actively dying phase, the death rattle or end-stage disease, and 36 of those came from nurses' and clinicians' own channels; they drew 9.1% of on-topic views (our count, a regex on titles with every match read by hand). Titles about deathbed visions, angels, terminal lucidity or what dying patients see were 11.3% of on-topic videos but drew 19.1% of the views, with a median of 1,371,825 views. Several are interviews with the hospice physician Christopher Kerr; what his studies measured is set out in the evidence and myths sections.

59.5% of on-topic titles used the word hospice or palliative. 12 titles named grief, bereavement, a memorial or a last goodbye, 9 were about dying with dementia or Alzheimer's, and 11 were about near-death experiences or the afterlife; 7 near-death-experience and afterlife channels had videos in the sample, mostly interviews with hospice nurses. Religious and spiritual channels posted 7 videos, and 10 faceless, compilation or re-post channels appeared. Caregivers, families and patients telling their own stories drew 5.5% of on-topic views.

Media is the second voice. Media, TV, news, documentary, podcast and entertainment channels made 20.9% of on-topic videos and drew 23.0% of their views. News channels posted 23 videos, and 7 titles were about hospice fraud, from Los Angeles fraud arrests to an exposé by the YouTuber Nick Shirley. 14 titles were full documentaries or documentary episodes, such as FRONTLINE's 'Being Mortal'.

How long and how new are the most-viewed hospice videos?

Short videos carry half the views. Videos of 60 seconds or less were 35.0% of the on-topic videos on November 6, 2026 and drew 51.0% of their views (our count). The median short had 1,032,401.5 views, against 420,553 for longer videos. Videos over 20 minutes, mostly documentaries and podcast interviews, were 13.5% of on-topic videos and drew 7.1% of the views.

Most are recent: 54.9% of on-topic videos were published in 2024 or later, 11.3% before 2020, and 73 in the year before our read. YouTube's made-for-kids flag was set on 1 video in the whole sample, an off-topic fan-art video, and YouTube's altered or synthetic content field was absent from all of them (our read of videos.list part=status).

How many families have talked about end-of-life wishes?

About a third: 32% of U.S. adults said in 2018 that they had talked with someone about their wishes for end-of-life care, while 92% said such a talk is important (The Conversation Project). The Conversation Project, a nonprofit advocacy initiative of the Institute for Healthcare Improvement, paid Kelton Global to poll 1,004 nationally representative adults aged 18 and older from January 25 to 28, 2018 (survey release). That leaves a gap of 60 percentage points between what people value and what they have done (our calculation). It is still the project's newest national survey.

Willingness is not the barrier. In the same 2018 poll, 95% of adults said they would be willing to talk about their wishes (The Conversation Project), and 53% said they would feel relieved if a loved one started the conversation (survey release).

Has the conversation gap closed since 2013?

Barely. The Conversation Project's first national survey, released in September 2013, said only 30 percent of U.S. adults had talked about their end-of-life wishes (2013 release). Kelton ran it in two online waves, the first among 1,067 adults in July 2013 and the second among 1,006 in August and September (2013 release). In 2018 the project restated that baseline as 27 percent and reported a five-point rise (2018 release). The two figures come from the same survey owner and disagree, so this page keeps both. Measured against the 2013 release itself, the share rose 2 percentage points by 2018, which is inside the polls' margins of error (our calculation).

The 2013 poll also asked why people wait. The top reason was that it is not something they need to worry about at this point in life, given by 29% of those who had not talked about their own wishes (2013 release). Yet 48% of adults said they would welcome a loved one asking and be relieved to discuss it (2013 release). Among people who had held the conversation before a loved one died, 63% said they felt better knowing they were honoring that person's wishes (2013 release).

The project's own tools have spread widely. It says its Conversation Starter Guide has been downloaded over 795,000 times, in all 50 states and more than 160 countries (The Conversation Project). It does not say over what period.

How many Americans have written down their end-of-life wishes?

About a third: 35% of U.S. adults told the Pew Research Center in 2013 that they had put their end-of-life treatment wishes in writing, formally or informally, up from 16% in 1990 (Pew Research Center). That is a rise of 19 percentage points over 23 years (our calculation). Pew polled 1,994 adults by landline and cell phone from March 21 to April 8, 2013 (Pew). In the same survey, 37% said they had given a great deal of thought to their wishes for medical treatment at the end of life (Pew). Pew has not repeated the survey since, so these are baselines rather than current figures.

How many family caregivers need help with end-of-life decisions?

14% of U.S. family caregivers of adults said in late 2024 that they needed more help or information on making end-of-life decisions (AARP and NAC). The figure comes from Caregiving in the US 2025 by AARP and the National Alliance for Caregiving, which counted 63 million U.S. adults providing ongoing care in the past year (AARP), 59 million of them caring for someone 18 or older (AARP). Applied to those 59 million, the 14% share points to roughly 8.3 million caregivers who want help with end-of-life decisions (our calculation, a rough scale estimate).

Ipsos fielded the survey from August 6 through October 14, 2024 (AARP and NAC). It has 6,858 completed surveys of caregivers, most from Ipsos' probability-based KnowledgePanel and the rest from an opt-in sample (AARP and NAC). Planning is often missing: 38 percent of caregivers of adults say no long-range plans for finances, health care decisions or living arrangements exist for the person they care for (AARP and NAC).

Do family caregivers learn from video or use it to check in?

Rarely for training, more often for checking in. Among caregivers who were trained for medical or nursing tasks, 4% named online videos as a source, far behind nurses, in Caregiving in the US 2025 (AARP and NAC). But 25 percent of caregivers had used an app, video, wearable or other remote monitoring to check on the person they care for, up from 13% in 2020 (AARP and NAC).

How many families use hospice at the end of life?

1.91 million Medicare beneficiaries were enrolled in hospice for at least one day in 2024, according to Facts and Figures 2025 from the National Alliance for Care at Home, a trade association for hospice and home care providers (National Alliance for Care at Home). That was 4.4% more than in 2023 (Alliance). The Alliance formed when NHPCO and the National Association for Home Care & Hospice affiliated, effective July 1, 2024 (Alliance), so its Facts and Figures continue the NHPCO series. Of the 2024 enrollees, 1.3 million died in hospice (Alliance). That leaves about 0.61 million who did not die in hospice that year, a group that includes people discharged alive and people still enrolled at year end (our calculation).

53.1% of all Medicare decedents in 2024 were enrolled in hospice when they died, the Alliance reports (Alliance). MedPAC, counting slightly differently, puts the 2024 share at 52.9%. Use differs by race and ethnicity: 55.8% of White Medicare decedents used hospice (Alliance), against 40.5% of Black decedents (Alliance) and 41.2% of Hispanic decedents (Alliance). Those are gaps of 15.3 and 14.6 percentage points (our calculation).

Heart and circulatory conditions were the most common principal diagnosis, at 29.8% of 2024 hospice stays, ahead of neurovascular conditions and cancer (Alliance). Medicare paid hospices $28.2 billion for 2024 care (Alliance), up 10.1% on 2023 (Alliance). That works out to about $14,764 per enrollee, averaged across short and long stays (our calculation).

How many Medicare-certified hospices are there?

CMS's Provider of Services file for the third quarter of 2026 lists 6,327 active Medicare-certified hospices (CMS). The same file holds 9,372 hospice records in all, counting those whose certification has ended (CMS). CMS's Care Compare site, refreshed in August 2026, lists 6,669 hospices (CMS Care Compare), and CMS's Medicare enrollment file of September 2026 holds 5,690 hospice enrollments (CMS). The three files count different things (certification numbers, listed providers, enrollment records), so they do not match.

The National Center for Health Statistics, which builds its hospice figures from CMS records, counted 5,200 hospices in 2020 (NCHS) and 5,800 in 2022 (NCHS FastStats), a rise of 11.5% in two years (our calculation). NCHS put the number of hospice patients at 1.8 million in 2022 (NCHS FastStats).

Which states have the most hospices?

California has 1,583 active Medicare-certified hospices (CMS) and Texas 1,045 in CMS's Q3 2026 Provider of Services file (CMS). Together they hold 41.5% of the U.S. total (our calculation). Georgia has 262 (CMS), Arizona 224 (CMS) and Nevada 160 (CMS).

Measured against older residents, the gap is wider. Nationally there are 9.79 active hospices per 100,000 residents aged 65 and older (our calculation from the POS file and Census Bureau 2025 estimates). Nevada has 26.70, California 22.94, Texas 22.18 and Arizona 14.25 (our calculation). These ratios count hospice certification numbers, not patients served or staff.

How many hospices does Florida have?

Florida has 67 active Medicare-certified hospices in CMS's Q3 2026 Provider of Services file (CMS), 1.1% of the U.S. total (our calculation). It ranks 26th among the states for hospice count though it has the second-largest population aged 65 and older (our calculation). Care Compare lists 61 Florida hospices (CMS Care Compare). NCHS counted 50 in Florida in 2020 (NCHS). Florida requires a state certificate of need to open a hospice, which limits how many can operate.

Florida has 1.25 hospices per 100,000 residents aged 65 and older, against 9.79 nationally (our calculation), using the Census Bureau's county estimates, which sum to 5,346,788 Floridians aged 65 and older on July 1, 2025 (our calculation). Its hospices are large instead. Florida hospices served 161,607 Medicare beneficiaries in fiscal 2024 (CMS), second only to California's 192,492 (CMS) and ahead of Texas's 157,549 (CMS). That is 8.9% of all U.S. Medicare hospice users (our calculation). The median Florida hospice served 1,728 Medicare beneficiaries that year, against 123 for the median U.S. hospice and 49 in California (our calculation from CMS's post-acute care and hospice file). In CMS's provider data the median Florida hospice had an average daily census of 252 patients in 2024, against 30 nationally and 12 in California (our calculation). The median Florida hospice lists 74.5 ZIP codes served, against 39 nationally (our calculation from the Care Compare ZIP file).

How many hospices serve Palm Beach, Broward and Martin counties?

CMS's Q3 2026 Provider of Services file lists 3 active Medicare-certified hospices in Palm Beach County (CMS), 5 in Broward County (CMS) and 1 in Martin County (CMS). The three counties hold 13.4% of Florida's hospices (our calculation). Miami-Dade County has 9 (CMS). The file places each hospice at its main address; a hospice serves a wider area than its home county.

Per 100,000 residents aged 65 and older, Palm Beach County has 0.73 hospices, Broward 1.27, Martin 1.79 and Miami-Dade 1.75 (our calculation). The Census Bureau estimates 410,721 residents aged 65 and older in Palm Beach County (Census Bureau), 393,083 in Broward (Census Bureau), 55,871 in Martin (Census Bureau) and 513,808 in Miami-Dade (Census Bureau), all on July 1, 2025.

What share of hospices are for-profit?

Of active Medicare-certified hospices with a stated ownership type, 82.9% are proprietary (for-profit) in CMS's Q3 2026 Provider of Services file (our calculation). In Florida the share is 52.1% (our calculation). It is 95.7% in California, 95.9% in Texas, 93.5% in Arizona, 97.5% in Nevada and 89.5% in Georgia (our calculation). The ownership field is blank or "Other" for about a sixth of U.S. hospices, so these shares leave those out.

Other CMS files give similar answers. In the September 2026 enrollment file, 4,518 hospice enrollments are proprietary (CMS), 79.4% of the total (our calculation); in Florida 36 are (CMS), 55.4% of the state's enrollments (our calculation). Care Compare labels 3,775 hospices For-Profit (CMS Care Compare), 56.6% of the list, but leaves ownership blank for almost a quarter (our calculation). NCHS put the for-profit share at 70.4% in 2020 (NCHS) and 75.6% in 2022 (NCHS FastStats); its 2020 estimate for Florida was 34% (NCHS).

CMS's hospice ownership file flags owners that are private equity companies. 5.5% of hospice enrollments list at least one direct owner with that flag (our calculation). That is a floor: private equity firms often hold hospices through holding companies, which the file records under other owner types.

How many new hospices join Medicare each year?

New hospice certifications more than doubled during 2020-2022 and then fell. Counting every hospice record in CMS's Q3 2026 Provider of Services file by the year it first joined Medicare, including hospices later terminated, 317 joined in 2019, 491 in 2020, 910 in 2021 and 941 in 2022 (our calculation). The count fell to 450 in 2023, 281 in 2024 and 248 in 2025 (our calculation).

California drove the surge. 609 California hospices joined Medicare in 2021, 66.9% of the national total that year (our calculation); in 2025 only 20 did (our calculation). Texas added 61 in 2025, Nevada 35 and Florida 5 (our calculation). Of hospices still active, 37.7% nationally first joined Medicare in 2020 or later, 59.4% in California, 73.1% in Nevada and 32.8% in Florida (our calculation).

Exits have risen as entries fell. 519 hospice certifications ended in 2025, 314 of them in California, and 481 ended in the first nine months of 2026, 357 in California (our calculation from termination dates in the POS file).

Which hospices were named in CMS's Special Focus Program?

In December 2024 CMS published a first Hospice Special Focus Program cohort of 50 hospices it had scored as poor performers (CMS, archived). California, Texas and Georgia held 60.0% of the cohort, and no Florida hospice was on it (our calculation from CMS's archived list). CMS stopped the program for 2025 effective February 14, 2025 (CMS), and its page still showed no later cohort when we checked on November 6, 2026.

How many people use Medicare hospice, and what does Medicare pay?

1,817,315 Medicare beneficiaries received hospice care in fiscal 2024, according to CMS's post-acute care and hospice utilization file (CMS). Medicare paid $27,688,802,062 for that care (CMS), covering 145,750,506 days (CMS). That is 80.2 days and $15,236 per user (our calculation).

Florida hospices received $2,547,887,249 from Medicare in fiscal 2024 (CMS) for 13,002,156 days of care (CMS): 80.5 days and $15,766 per user (our calculation). These are fee-for-service Medicare claims; hospice patients not on Medicare are not counted.

How many nurses and social workers do hospices employ?

NCHS estimates 108,400 full-time-equivalent nursing and social work employees in U.S. hospices in 2022 (NCHS). Registered nurses made up 48.6% of them, with aides and social workers making up most of the rest (NCHS). The estimate comes from CMS cost reports and does not count chaplains, volunteers or office staff.

How many nurses, aides, social workers and chaplains work in hospice and home health?

About 1.8 million people. BLS's Occupational Employment and Wage Statistics (OEWS) survey counted 1,789,480 wage and salary jobs in U.S. home health care services (NAICS 621600) in May 2025 (BLS OEWS). That industry holds most freestanding hospices, but it also holds every home health agency, and BLS does not split the two. Hospices run by hospitals and nursing homes are counted in those industries instead. So the figures in this section are shared context for the hospice workforce, not a count of hospice staff.

Inside that industry, home health and personal care aides held 1,079,060 jobs (BLS OEWS), 60.3% of the total (our calculation). Registered nurses held 198,180 (BLS OEWS), or 11.1% (our calculation), and licensed practical and vocational nurses held 80,990 (BLS OEWS).

Two occupations point most clearly to hospice work, because Medicare requires every hospice team to include a social worker and a spiritual or pastoral counselor. Home health care services employed 26,430 healthcare social workers (BLS OEWS), 14.1% of the 187,630 in the whole U.S. economy (BLS OEWS) (our calculation). They also employed 10,920 clergy (BLS OEWS). That is 19.1% of the 57,200 clergy with wage and salary jobs in the U.S. (BLS OEWS) (our calculation). Home health agencies do not usually hire chaplains, so most of these jobs are likely hospice chaplains; BLS does not label them that way.

Across all employers, registered nurses held 3.4 million wage and salary jobs (3,379,720) in May 2025 (BLS OEWS), and home health and personal care aides held 4.3 million (4,305,810) (BLS OEWS). These counts leave out the self-employed and caregivers paid directly by a family.

What do hospice and home health nurses, aides, social workers and chaplains earn?

Registered nurses in U.S. home health care services earned a median $84,930 a year in May 2025, per BLS OEWS (BLS OEWS). That is less than the $97,550 median for registered nurses across all employers (BLS OEWS), most of whom work in hospitals. Aides in the industry earned a median $36,230 (BLS OEWS), 71.1% of the $50,980 median for all U.S. occupations (BLS OEWS) (our calculation).

Social workers and clergy in the industry earned slightly more than their peers elsewhere. Healthcare social workers in home health care services had a median of $70,680 (BLS OEWS), $2,800 above the $67,880 median for the occupation across all industries (BLS OEWS) (our calculation). Clergy in the industry had a median of $61,210 (BLS OEWS), against $60,810 for all clergy (BLS OEWS).

OEWS medians cover wage and salary workers only and are not adjusted for hours, so part-time aide work pulls the aide figures down.

How many hospice-type workers are there in Florida and in Palm Beach, Broward and Martin counties?

Florida had 229,940 registered nurses with wage and salary jobs in May 2025, across all employers (BLS OEWS), at a median $84,190 a year (BLS OEWS). The state had 10,520 healthcare social workers (BLS OEWS), with a median of $64,820 (BLS OEWS), and 90,170 home health and personal care aides (BLS OEWS).

BLS publishes these counts by metropolitan area, not by county. The Miami-Fort Lauderdale-West Palm Beach metro, which covers Palm Beach and Broward counties as well as Miami-Dade, had 61,670 registered nurses (BLS OEWS) at a median $91,380 (BLS OEWS), and 3,440 healthcare social workers (BLS OEWS). The Port St. Lucie metro, which covers Martin and St. Lucie counties, had 5,310 registered nurses (BLS OEWS) and 2,180 home health and personal care aides (BLS OEWS). These are counts across all employers, not only hospices.

How fast are hospice nursing, social work and aide jobs expected to grow?

BLS Employment Projections expect aide jobs to grow fastest. Home health and personal care aides held 4,677,100 U.S. jobs in 2025, counting the self-employed (BLS OOH). Registered nurses held 3.5 million jobs (3,465,400) and are projected to grow 6 percent over the same decade (BLS OOH). Healthcare social workers held 194,800 jobs and are projected to grow 8 percent (BLS OOH). BLS's social worker profile notes that some healthcare social workers specialize in hospice and palliative care.

For the industry as a whole, BLS projects employment in home health care services (621600) to grow 18.6 percent from 2025 to 2035 (BLS). Projections do not separate hospice from home health.

How often are hospice and home health workers injured on the job?

Less often than the average worker, on paper. Employers in U.S. home health care services (NAICS 6216) recorded 1.6 nonfatal injury and illness cases per 100 full-time workers in 2024, per BLS's Survey of Occupational Injuries and Illnesses (BLS SOII). All private industry recorded 2.3 (BLS SOII). The survey counts only what employers log, and BLS does not publish a separate rate for hospice.

How much revenue does hospice care bring in, according to the Census Bureau?

U.S. employer establishments earned $31.1 billion from home hospice (end of life) care services in 2022, per the 2022 Economic Census, the Census Bureau's full count of businesses every five years (Census). Establishments in home health care services (NAICS 621610), the industry that holds most freestanding hospices, earned $30.0 billion of it (Census), or 96.4% (our calculation). Hospitals and nursing homes earned most of the rest.

Hospice care made up 26.3% of all revenue in the home health care services industry in 2022 (Census), whose total revenue was $114.2 billion (Census). The same industry earned a further $832.0 million from residential facility hospice care, meaning care in a hospice's own inpatient or residential unit (Census). The Census figures count revenue by product line, from employer establishments only. They do not count Medicare-certified hospices; CMS's own counts are in the hospices section of this page.

The 8,321-establishment count in that row is the number of locations that reported any hospice revenue. Spread across them, home hospice care brought in an average of $3.6 million per location in 2022 (our calculation).

How much hospice revenue is earned in Florida?

Florida establishments in home health care services earned $2.6 billion from home hospice care in 2022, 31.3% of the industry's revenue in the state, per the 2022 Economic Census (Census). That is 8.8% of the industry's U.S. hospice revenue (our calculation). The industry's total Florida revenue was $8.4 billion (Census).

Few Florida locations report hospice revenue, and each is large. Florida requires a certificate of need before a new hospice program can open, which holds the number of providers down. Spread across the Florida establishments that reported the line, home hospice care averaged $16.8 million each in 2022, against $3.6 million nationally (our calculation).

How many home health and hospice establishments are there in the U.S.?

BLS's Quarterly Census of Employment and Wages (QCEW) counted an annual average of 54,978 private home health care services establishments (NAICS 6216) in 2025 (BLS QCEW). This industry code covers home health agencies and most freestanding hospices together, so the count is shared context, not a count of hospices. The industry employed an annual average of 1.8 million people (1,803,516) in 2025 (BLS QCEW), up 19.0% from 1.5 million (1,515,130) in 2019 (BLS QCEW) (our calculation).

The Census Bureau's County Business Patterns counted 40,762 home health care establishments with paid employees (NAICS 621610) in 2023 (Census CBP). QCEW is built from unemployment-insurance filings and CBP from business tax and survey records, so the two counts differ. Census Nonemployer Statistics counted 441,716 home health care businesses with no paid staff in 2024 (Census NES), up from 412,098 in 2023 (Census NES). Most are self-employed caregivers rather than hospices. In 2023 there were about 10.1 of them for every establishment with employees (our calculation).

How many home health and hospice jobs are in Florida and in Palm Beach, Broward and Martin counties?

Florida had an annual average of 4,769 private home health care services establishments in 2025 (BLS QCEW), employing 90,630 people (BLS QCEW). Employment rose 13.9% from 79,541 in 2019 (BLS QCEW) (our calculation), slower than the national rise. County Business Patterns counted 3,476 Florida establishments with employees in 2023 (Census CBP).

The three counties together had 18,674 private home health care services jobs in 2025, about a fifth of Florida's total (our calculation). Palm Beach gained jobs between 2019 and 2025 while Broward and Martin lost them. QCEW counts jobs covered by unemployment insurance, so self-employed caregivers are not included.

Who pays home health and hospice providers, and how much do they spend on advertising?

Medicare is the biggest payer. In 2022, fee-for-service Medicare paid U.S. home health care services establishments $53.9 billion, 47.2% of the industry's revenue, per the 2022 Economic Census (Census) (our calculation). Census does not publish payer shares for the hospice product line on its own; the Medicare section of this page has MedPAC's hospice spending figures.

The industry spends little on paid advertising. U.S. home health care services with employees spent $485.5 million on purchased advertising and promotional services in 2024, per the Census Bureau's Annual Integrated Economic Survey (Census AIES), out of revenue of $132.5 billion (Census AIES). That is 0.37% of revenue (our calculation). The line counts money paid to outside agencies, ad platforms, media and printers. The pay of in-house outreach and marketing staff is not in it.

What do families say about hospice care in the CAHPS Hospice Survey?

In CMS's CAHPS Hospice Survey for deaths from October 2023 to September 2025, 85% of family caregivers surveyed nationally said they would definitely recommend the hospice (CMS) and 4% said they would probably or definitely not (CMS). 83% rated the hospice 9 or 10 on a 0-10 scale (CMS). The survey goes to the family member or friend who cared for a patient who died under hospice care, and CMS adjusts scores for survey mode and case mix.

The weakest national scores are on help with symptoms and timing. 76% of caregivers said the patient always got the help they needed for pain and symptoms (CMS) and 78% said the team always provided timely help (CMS). 82% said the team always communicated well (CMS), 91% that it always treated the patient with respect (CMS) and 91% that it gave the right amount of emotional and spiritual support (CMS).

Florida families score their hospices lower on every measure shown here. 82% of Florida caregivers would definitely recommend the hospice (CMS) and 79% rated it 9 or 10 (CMS). 73% said the patient always got help with pain and symptoms (CMS), 73% that help always came on time (CMS), 78% that the team always communicated well (CMS) and 88% that emotional and spiritual support was right (CMS).

How are hospices rated on CMS's family survey stars, nationally and in Florida?

Only 32.4% of the hospices in CMS's August 2026 CAHPS Hospice file have a family caregiver survey star rating; the rest had too few completed surveys (our calculation). In California the share is 9.1%, where the median hospice has an average daily census of 12 patients (our calculation). In Florida, where hospices are large, 73.8% are rated (our calculation).

Among rated hospices, 60.1% nationally have 4 or 5 stars against 28.9% in Florida (our calculation). 10.7% of rated U.S. hospices have 1 or 2 stars against 35.6% in Florida, and 19.3% have 5 stars against 4.4% in Florida (our calculation). Florida's claims-based scores in the next section run the other way.

Ownership tracks the stars. 73.1% of rated non-profit hospices have 4 or 5 stars, against 52.4% of rated for-profit hospices (our calculation, joining the CAHPS file to Care Compare ownership types).

What does CMS's Hospice Care Index show?

The national average Hospice Care Index score is 8.8 out of 10 in CMS's August 2026 Care Compare data, built from 2023-2024 Medicare claims (CMS). Florida hospices average 9.7 (CMS). 39.1% of U.S. hospices with a score reach the maximum 10, against 81.8% in Florida (our calculation). The index adds one point for each of ten claims indicators on which a hospice does not fall among the worst performers.

Visits near death are one of those indicators. Nationally 89.3% of hospice patients who died had a visit from a registered nurse or medical social worker in their last three days (CMS), against 94.7% in Florida (CMS). A stricter measure counts visits on at least two of the last three days: 48.3% nationally (CMS) and 60.9% in Florida (CMS).

Other indicators point the other way for Florida. Nationally 52.4% of hospice elections had a gap of more than seven days between nursing visits (CMS); in Florida 62.0% did (CMS). Hospices provided 19.9 nurse care minutes per routine home care day nationally (CMS) and 15.3 in Florida (CMS). Nationally 9.6% of skilled nursing minutes fell on weekends (CMS).

How often do patients leave hospice alive, and what does Medicare spend per patient?

Patients can leave hospice alive, for example when their condition stabilises or they choose treatment again. In CMS's August 2026 data, 7.3% of live discharges nationally happened within seven days of the start of care (CMS) and 37.4% after 180 days (CMS). In Florida the shares were 12.6% (CMS) and 30.5% (CMS). 8.5% of live discharges nationally were followed by a hospital stay and a return to hospice within days, which CMS counts as a burdensome transition (CMS).

Medicare's average per-beneficiary hospice spending was $19,227 nationally (CMS) and $15,498 in Florida (CMS), on 2023-2024 claims.

How consistently do hospices complete required care processes?

Nationally, 96.15% of hospice patients received all seven care processes in CMS's composite measure (asking about treatment preferences and beliefs, screening and assessing pain and breathlessness, and a bowel regimen with opioids), for October 2024-September 2025 (CMS). 12.6% of hospices provided only routine home care in 2022-2024, with no inpatient, respite or continuous home care (CMS).

How many hospices does Medicare pay, and how many are for-profit?

6,706 hospices served Medicare patients in 2024, up about 3% from 2023 and 39% since 2019, according to MedPAC, the congressional advisory commission that reviews Medicare payment each March (MedPAC). MedPAC counts a hospice when it submitted at least one paid Medicare claim in the year. For-profit hospices numbered 5,497 in 2024, up from 3,435 in 2019 (MedPAC data book). That is a 60.0% rise in five years (our calculation), and for-profits made up 82.0% of all hospices counted (our calculation). Among hospices with ownership data, MedPAC puts the for-profit share at about 82% and notes that these hospices cared for 60% of Medicare hospice patients, because they tend to be smaller than nonprofits (MedPAC).

Much of the recent growth came from four states: Arizona, California, Nevada and Texas. Since July 2023 CMS has reviewed claims from newly enrolled hospices there before paying them. MedPAC reports that CMS reviewed claims for 668 hospices under this program and revoked the Medicare enrollment of 122 of them as of June 2025 (MedPAC, citing CMS).

How many people use Medicare hospice, and what share of deaths?

About 1.82 million Medicare beneficiaries received hospice care in 2024, MedPAC reports, up from 1.61 million in 2019 (MedPAC data book). That is a 13.0% increase (our calculation). Among Medicare beneficiaries who died in 2024, 52.9% used hospice, a new high (MedPAC data book). In 2010 the share was 43.8% (MedPAC), so it has risen 9.1 percentage points in 14 years (our calculation).

Use still differs by race. In 2024, 55.6% of White Medicare decedents used hospice (MedPAC data book), against 40.9% of Black decedents (MedPAC data book), a gap of 14.7 percentage points (our calculation). MedPAC says the reasons are not fully understood and lists cultural and religious beliefs, care preferences, access to information about hospice and mistrust of the medical system among the factors researchers cite.

Cancer accounts for under a quarter of hospice patients. In 2024, cancer accounted for 23% of Medicare hospice patients, the same share as circulatory conditions other than heart failure, and neurological conditions such as Alzheimer's disease accounted for 22% (MedPAC data book). The count covers every Medicare hospice patient that year, by the primary diagnosis on their last claim.

How much does Medicare spend on hospice?

Medicare paid about $28.3 billion to hospices in 2024, about 10% more than in 2023 (MedPAC data book). Spending was $23.7 billion in 2022 by MedPAC's count, so it rose 19.4% in two years (our calculation). That works out to about $15,549 per hospice user in 2024 (our calculation).

Hospices are paid a daily rate whether or not staff visit that day. MedPAC estimates Medicare's average payment was about $191 per day in 2024 (MedPAC), while hospices' average cost per day across all payers was about $168 (MedPAC). The difference is about $23 a day (our calculation); this is a rough gap, not MedPAC's margin, which uses Medicare-allowable costs and removes cap repayments.

Long stays drive the bill. Medicare spent $17.5 billion in 2024 on patients whose hospice stays exceeded 180 days, longer than the six-month prognosis that eligibility rests on (MedPAC data book). That is 61.8% of all Medicare hospice spending that year (our calculation).

How long do Medicare hospice stays last?

The median Medicare decedent who used hospice was enrolled for 19 days in 2024, up from 18 (MedPAC data book). The average was 99.6 days, up more than 3 days from 2023 (MedPAC data book). The gap between the two shows that most stays are short while a minority are very long. MedPAC counts lifetime days in the hospice benefit for people who died that year.

Ownership matters. Decedents served by for-profit hospices had an average stay of 120 days in 2024 (MedPAC data book), against 71 days at nonprofit hospices (MedPAC data book), 1.7 times as long (our calculation).

How many patients leave hospice alive?

19.1% of Medicare hospice discharges in 2024 were live discharges, up from 18.5% in 2023 and 17.3% in 2022 (MedPAC data book). Some live discharges are expected: patients can change their minds, move, or improve. The patient revoking the benefit accounted for 7.1% of all discharges and the patient no longer being terminally ill for 6.1% (MedPAC data book). MedPAC treats unusually high rates as a possible sign of poor care or of enrolling people who were not eligible. Among hospices with more than 30 discharges, one in ten had live-discharge rates of about 65% or more in 2024 (MedPAC data book).

GAO, the audit agency of Congress, found the same pattern in 2017 data: 472 hospices discharged half or more of their patients alive, 462 of them for-profit (GAO). For-profits were 97.9% of that group (our calculation).

How often do hospice staff visit, and did video visits replace them?

Medicare hospice patients receiving routine home care got on average 3.9 in-person visits a week in 2024: 1.8 from nurses, 1.9 from aides and 0.3 from social workers, each just under an hour (MedPAC data book). The 2019 average was 4.3.

From 2020 until the public health emergency ended on May 11, 2023, hospices could make routine visits by telecommunications technology instead of in person when that was feasible (MedPAC). Hospices did not have to report those telehealth visits, apart from social worker phone calls, so MedPAC says it cannot tell how often video replaced in-person care.

Federal auditors have found gaps in in-person care. GAO found 83 hospices in 2017 whose staff did not visit patients in the last 3 days of life; 80 of them were for-profit (GAO). HHS's Office of Inspector General (OIG) estimated about 99,000 instances in 2016 in which registered nurses did not make the required visit at least once every 14 days to check on the care hospice aides gave (HHS OIG). OIG reached that estimate from a sample of 78 of about 189,000 high-risk visit pairs.

How profitable is Medicare hospice care?

MedPAC estimates the aggregate fee-for-service Medicare margin for hospices at 8.0% in 2023, down from 9.8% in 2022 (MedPAC data book). The margin is Medicare payments minus Medicare-allowable costs, as a share of payments, after cap repayments; it trails other data by a year. The 2020 margin was 14.2%, so it has fallen 6.2 percentage points (our calculation).

For-profit hospices had a 13.7% Medicare margin in 2023 (MedPAC data book). Nonprofit hospices as a group had –1.3%, though freestanding nonprofits had 2.6% (MedPAC data book). Hospices that exceeded the cap had a margin of about 17.8% before returning the excess and –1.4% after (MedPAC data book).

What is the hospice cap, and how many hospices exceed it?

The aggregate cap for fiscal year 2026 is $35,361.44 per Medicare patient (see the rules section below). It applies to each hospice's total payments, not to each patient: a hospice whose payments exceed its number of Medicare patients times the cap must repay the difference. MedPAC estimates 28% of hospices exceeded the cap in 2023, up from 23% in 2022 (MedPAC data book). On average each one exceeded it by about $410,000 (MedPAC data book). Above-cap hospices are concentrated in Arizona, California, Nevada and Texas; outside those four states the share was about 6%.

What has MedPAC recommended on hospice payment?

For fiscal year 2027, MedPAC recommends that Congress eliminate the update to hospice base payment rates, which current law would raise by about 2.3% (MedPAC). The commissioners voted 17-0. MedPAC has made the same recommendation in each March report since 2024. In March 2023 MedPAC instead backed the current-law update together with a wage-adjusted cap cut by 20% (MedPAC, March 2023). MedPAC's recommendations are advice to Congress; they do not change payment unless Congress acts.

Each March report uses data from two years earlier and a margin from three years earlier. The table shows each figure as that edition published it; later editions sometimes revise earlier years.

What have federal auditors found in hospice billing?

HHS OIG reviewed 100 initial hospice certification periods from fiscal year 2021 for new enrollees with no hospital inpatient or emergency room claims in the prior 18 months. Documentation for 45 of the 100 did not meet Medicare hospice requirements (HHS OIG). OIG estimates Medicare could have saved $255.1 million on those enrollees with eligibility reviews (HHS OIG). CMS agreed with the recommendation.

Two Florida audits covered April 2017 to March 2019. OIG estimated that Hospice of Palm Beach County received at least $42.3 million in improper Medicare payments; 40 of 100 sampled claims did not comply, most because the record did not support a terminal prognosis (HHS OIG). That estimate is 28.4% of the $149 million Medicare paid the hospice in the audit period (our calculation). For Vitas Healthcare Corporation of Florida, OIG estimated at least $140 million in improper payments, mostly for continuous home care and inpatient care the records did not support (HHS OIG). That is 66.7% of the $210 million paid for the higher-level-of-care claims OIG audited, not of all VITAS billing (our calculation).

Older OIG work points the same way. Over 80% of hospices surveyed from 2012 through 2016 had at least one deficiency, most often poor care planning, mismanagement of aide services and inadequate patient assessments (HHS OIG). Medicare also paid $6.6 billion from 2010 through 2019 to other providers for services given to people already in hospice, some of which the hospice's daily rate may already have covered (HHS OIG).

How big are the listed hospice companies?

VITAS, the hospice business of Chemed Corporation, is the largest listed hospice operator: it cared for an average daily census of 22,338 hospice patients in 2025, up from 21,171 in 2024, by Chemed's own count in its annual report to the SEC (Chemed 10-K). It admitted 70,817 patients in 2025 (Chemed 10-K) and had net revenue of $1.63 billion ($1,630,101 thousand), up 6.5% on the year (Chemed 10-K). VITAS ran 59 programs under 33 Medicare provider numbers, with 28 inpatient units in 17 states and the District of Columbia (Chemed 10-K).

VITAS's census has grown since before the pandemic. It was 18,846 in 2019 (Chemed 2019 10-K), so the 2025 figure is 18.5% higher (our calculation).

Amedisys's hospice segment had an average daily census of 12,916 in 2024, against 13,091 in 2022, according to its last 10-K before UnitedHealth Group bought it (Amedisys 10-K). It admitted 48,426 hospice patients in 2024, down from 52,656 in 2022 (Amedisys 10-K), and owned and operated 164 Medicare-certified hospice care centers at the end of 2024 (Amedisys 10-K).

Pennant admitted 15,189 hospice patients in 2025, up 24.4% (Pennant 10-K), and its hospice average daily census rose 28.6% to 4,204 (Pennant 10-K). Enhabit's hospice business had an average daily census of 3,985 in 2025 (Enhabit 10-K) from 117 hospice locations in 25 states (Enhabit 10-K), and admitted 12,586 patients, up from 11,713 in 2023 (Enhabit 10-K). Addus, mainly a personal care company, ran 39 hospice locations at the end of 2025, with 13,240 admissions and an average daily census of 3,760 (Addus 10-K).

Together the five reported a combined average daily census of 47,203 hospice patients in their latest annual reports, and VITAS alone held 47.3% of it (our calculation). Amedisys's figure is for 2024, the rest for 2025. BrightSpring, which also runs hospices, does not report a hospice-only census.

How long do patients stay with these hospices?

VITAS's average length of stay was 120.2 days in 2025, up from 103.0 days in 2024, but its median was only 18.0 days (Chemed 10-K). The average was 6.7 times the median: half its patients were discharged within the median stay, while a minority stayed for many months (our calculation). In 2019 the average was 92.6 days and the median 16.0 days (Chemed 2019 10-K).

The other companies report averages only. Enhabit's discharged average length of stay was 104 days in 2025, while its census grew from 3,441 in 2023 (Enhabit 10-K). Amedisys's was 94 days in 2024 (Amedisys 10-K) and Addus's 95.6 days in 2025 (Addus 10-K).

Stays also differ by diagnosis. Patients with a "cerebro" diagnosis, Chemed's label for a group that includes dementia, made up 44.6% of VITAS's average daily census in 2025 (Chemed 10-K). Cancer patients were 26.0% of admissions but only 9.8% of the daily census (Chemed 10-K).

How much of their hospice revenue comes from Medicare?

Medicare paid $1.56 billion ($1,558,832 thousand) of VITAS's $1.66 billion (1,664,203 thousand) in routine home, inpatient and continuous care revenue in 2025 (Chemed 10-K), or 93.7% (our calculation). Medicare paid 98.2% of Enhabit's hospice revenue in 2025 (Enhabit 10-K), 93.1% of Addus's (Addus 10-K) and 87.0% of Pennant's, where Medicaid paid 10.8% (Pennant 10-K). At Amedisys, Medicare paid $783.9 million of $825.8 million in hospice revenue in 2024 (Amedisys 10-K), or 94.9% (our calculation).

Pennant's hospice revenue grew 32.4% in 2025, partly through acquisitions (Pennant 10-K). Enhabit's hospice segment brought in 23.2% of the company's revenue in 2025 (Enhabit 10-K), and Addus's hospice revenue grew 15.1% (Addus 10-K). Amedisys spent $90.90 in cost of service per hospice day in 2024 (Amedisys 10-K), Enhabit $78.2 per patient day in 2025 (Enhabit 10-K), and Addus earned 5.5% more per patient day than a year earlier (Addus 10-K). Each company counts revenue per day in its own way, so the figures are a guide, not a like-for-like comparison.

How much does the Medicare hospice cap cost VITAS?

VITAS recorded $27.2 million in Medicare cap revenue reductions in 2025, for programs it expects to exceed the per-beneficiary cap, against $8.4 million in 2024 (Chemed 10-K). Its Medicare cap liability stood at $30.9 million at the end of 2025, against $13.6 million a year earlier (Chemed 10-K). The cap applies to each Medicare provider number, so a program with many long-stay patients can owe money back even when the company as a whole is well under it.

The phrase "hospice cap" appeared in 115 Form 10-K filings from 2001 to 2025, first in 2002 in a report by Odyssey HealthCare, and in 4 filings in 2025, from Amedisys, Chemed, Enhabit and Pennant, by our count of EDGAR full-text search results (our calculation).

What do the companies report about hospice quality and visits?

Enhabit says registered nurses or medical social workers visited 63.8% of its hospice patients in person on at least two of their final three days of life in 2025, against a national average of 48.3% (Enhabit 10-K). Its hospices averaged 3.9 stars in the November 2025 CAHPS Hospice Survey star ratings, against a national average of 3.6 (Enhabit 10-K). Both are the company's own summaries of CMS data, not CMS figures.

In its 2025 annual report, BrightSpring reports a Hospice Care Index score of 9.4, which it calculated from CMS provider reports (BrightSpring 10-K). It says its hospice patients averaged 16.9 total visits per month, against a national average of 15.6 (BrightSpring 10-K).

The companies also describe the market around them, and their counts differ. Enhabit, citing a November 2025 CMS provider catalog, puts the number of U.S. hospice agencies at about 7,000 (Enhabit 10-K). Pennant says there are over 6,000, with the ten largest operators holding about 20% of the market; it names no source (Pennant 10-K). CMS's own provider files are the better count.

How big are the hospice companies in Florida?

VITAS is headquartered in south Florida, and two of its largest programs are there; Chemed says a substantial percentage of its revenue comes from operations across Florida, but it gives no Florida share (Chemed 10-K). Amedisys had 7 hospice care centers in Florida at the end of 2024 (Amedisys 10-K). Enhabit had 25 home health locations and no hospice locations in the state at the end of 2025 (Enhabit 10-K).

BrightSpring bought Haven Hospice (North Central Florida Hospice, Inc.), a Florida hospice and palliative care provider, on September 1, 2024, for an aggregate $64.8 million ($64,750 thousand) in cash, a seller note and stock (BrightSpring 10-K).

Who owns the listed hospice companies now, and how often does private equity come up?

Two of these companies left the stock market within a year. UnitedHealth Group paid $101 in cash for each Amedisys share when its purchase closed on August 14, 2025 (Amedisys 8-K). Enhabit agreed in February 2026 to be bought by an affiliate of the private equity firm Kinderhook Industries in an all-cash deal valued at about $1.1 billion (Enhabit 10-K), and each share was converted into $13.80 in cash when the deal closed on May 15, 2026 (Enhabit 8-K). Their 10-Ks for 2024 (Amedisys) and 2025 (Enhabit) are the last ones they will file.

Form 10-K filings that contained both "hospice" and "private equity" rose from 0 in 2001 to a peak of 43 in 2022, then fell to 20 in 2025, by our count of EDGAR full-text search results (our calculation). In 2022, 60.6% of the 10-Ks that mentioned hospice also mentioned private equity, against 35.1% in 2025 (our calculation). The two terms need not be linked in a filing: in 2025 only 5 of the 20 came from health services companies, and the rest included drug makers and lenders.

What do hospice company filings say about video and telehealth?

The latest 10-Ks of Chemed, Enhabit, Pennant, Amedisys, BrightSpring and Addus contain the word "video" 0 times, by our count of the six main documents (our calculation). Telehealth appears in 4 of the six, and none describes video visits with hospice patients or families (our calculation). Chemed says VITAS's pandemic-era staff training covered telehealth visits among its safety topics (Chemed 10-K).

The phrase pairing grew fast across all filers during the pandemic. 10-Ks that contained both "hospice" and "telehealth" went from 4 in 2019 to 24 in 2021 and a peak of 26 in 2022, and stood at 16 in 2025 (our calculation).

The filings say little about marketing. Chemed, with VITAS and Roto-Rooter together, spent $83.1 million on advertising in 2025, against $72.2 million in 2023, and does not split it by business (Chemed 10-K); most of its advertising note describes pay-per-click and cost-per-call buying.

How often do annual reports mention hospice?

57 Form 10-K reports filed in 2025 contained the word "hospice", against 30 in 2001 and a peak of 72 in 2010, by our count of EDGAR full-text search results (our calculation). From 2001 to 2025, 1,414 10-K filings by 380 different SEC registrants used it (our calculation). The counts cover any context, and private and nonprofit hospices file no 10-K, so they show how often listed companies write about hospice, not how big hospice care is. The yearly counts, filer names and search links are in our CSV, edgar-hospice-10k-counts.csv.

How has hospice education used video and distance learning?

Since 1994, when Hospice Foundation of America first broadcast its Living with Grief program by satellite to hospice and bereavement professionals (Hospice Foundation of America). HFA, a nonprofit that sells courses and memberships to hospice and grief professionals, calls it one of the first distance learning programs in the U.S. In 2011 it received a Centers for Medicare & Medicaid Services grant to produce the HFA CARES webinar series on hospice and end-of-life care (HFA). In 2017 it coordinated a national rollout of the PBS documentary Being Mortal to more than 1,200 communities that hosted public events on advance care planning (HFA). In 2020 its free online events reached over 9,000 hospice and grief professionals during COVID-19 (HFA).

HFA's own counts give the current scale. Its advance care planning projects have reached more than 1,000 communities (HFA). It says it awarded 21,952 continuing education hours to end-of-life care professionals in the past five years (HFA), about 4,390 a year (our calculation), and that 45,235 people receive its monthly Journeys grief-support newsletter (HFA). These are self-reported program figures, not audited.

How common is telehealth for older adults, and what is known about hospice?

Very common since 2020, but no federal page counts hospice telehealth visits on their own. Medicare fee-for-service telehealth visits rose to nearly 52.7 million in 2020, according to the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE). 92% of beneficiaries who used telehealth that year did so from home (ASPE). ASPE groups hospice with transfers as an originating site and publishes no hospice-only count. Video is less common for older adults: among telehealth users aged 65 and older in 2021, 43.5% of visits used video rather than audio only, ASPE found from the Census Bureau's Household Pulse Survey (ASPE).

62% of U.S. adults aged 50 and older had used some form of telehealth by November 2021, an AP-NORC survey of 1,000 adults 50 and older found (AP-NORC). The other 38% had not (our calculation). Relationships matter to them: 69% said a prior relationship with the provider would be very helpful when using telehealth (AP-NORC). Hospice rules on telehealth for the face-to-face recertification encounter are covered in the rules section of this page.

Can a hospice YouTube channel get YouTube's health source label?

Only by applying through a licensed professional. Since October 27th, 2022, U.S. healthcare professionals have been able to apply for YouTube's health source information panel and health content shelves (YouTube Official Blog). YouTube's eligible professions are licensed doctors, nurses, psychologists, marriage and family therapists and clinical social workers; an organization applies through one of them, who must oversee its content (YouTube). So a hospice's nurse or Licensed Clinical Social Worker could qualify its channel, but its chaplains and aides could not.

YouTube treats accredited hospitals, academic medical institutions, public health departments and government organizations as eligible without an application (YouTube). Hospices are not named on that list. YouTube also says that certain types of "for profit healthcare brands" are not eligible, without saying which (YouTube); most U.S. hospices are for-profit. A channel needs more than 1,500 valid public watch hours in the past 12 months, or 1.5 million valid public Shorts views in 90 days (YouTube). YouTube typically decides on an application in about 1-2 months (YouTube).

What do Google's ad rules mean for hospice ads?

Hospice ads fall in a restricted category. Google Ads lists Health among its sensitive interest categories (Google Ads). Advertisers promoting products and services in those categories cannot use advertiser-curated audiences such as Customer Match lists or lookalike segments; they can use Google's predefined audiences (Google Ads). Google's policy pages do not mention hospice by name. Meta's advertising policy pages block AI crawlers, so they were not reviewed for this page.

Do advance care planning videos change what patients choose?

Yes, in most randomized trials, though the effect on actual care is smaller than the effect on stated choices. In the first trial, run in four Boston primary care clinics from September 2007 to May 2008, 200 adults aged 65 and over heard a description of advanced dementia; 86% of those who also watched a short video chose comfort care as their goal for that future, against 64% of those who only heard the description (BMJ). Six weeks later, 6% of re-interviewed video viewers had changed their minds, against 29% in the verbal-only group (BMJ).

The same research group, led by Angelo Volandes and Areej El-Jawahri, repeated the design with seriously ill patients. In a trial of 150 patients with advanced cancer at four U.S. oncology centers (published 2013), 20% of those who watched a 3-minute CPR video wanted CPR, against 48% after a verbal narrative alone (Journal of Clinical Oncology), and 93% of the video group said they were comfortable watching it (Journal of Clinical Oncology). Among 150 seriously ill hospitalized patients over 60 at two Boston hospitals (March 2011 to June 2013), 64% of video viewers did not want CPR, against 32% with usual care (Journal of General Internal Medicine), and by discharge 57% had a medical order to withhold CPR, against 19% (Journal of General Internal Medicine). In a multisite U.S. trial of 246 patients aged 64 and over with advanced heart failure (published 2016), 51% of those shown a 6-minute video selected comfort care, against 30% given a verbal description (Circulation), and 68% chose to forgo CPR, against 35% (Circulation).

Two meta-analyses pool these trials. A 2015 review of 10 randomised trials with 2,220 patients found low-quality evidence that video decision aids make patients less likely to prefer CPR (pooled risk ratio 0.50) (BMJ Open). A 2022 review of 14 randomized trials found video aids reduced preference for life-prolonging care (risk ratio 0.43), while warning that the studies varied widely (Journal of Hospice & Palliative Nursing). A 2020 systematic review of video education for hospice and palliative care patients and family caregivers found 31 studies published from 1969 to 2019, most of them from the United States (Patient Education and Counseling).

Does a hospice video change whether patients use hospice?

It changed what patients and families knew and how they used hospice, but not what patients said they wanted. In a single-site randomized trial of 150 hospitalized patients with advanced cancer and 44 caregivers in Boston (February 2017 to January 2019), patients who watched a 6-minute hospice video were no more likely to prefer hospice than those given the same words verbally: 86.7% against 82.7%, the trial’s primary outcome (Cancer). Among the patients who died during follow-up, 85.2% of the video group had used hospice, against 63.6% of the verbal group (Cancer), and their median hospice stay was 12 days against 3 days (Cancer). Caregivers who watched the video preferred hospice for their loved one more often, 94.4% against 65.4%, though the caregiver groups were small (18 and 26) (Cancer).

What happened when hospitals and nursing homes rolled the videos out at scale?

Results were mixed: hospital programs raised documentation, while the large nursing home trial changed little because few residents saw the videos. In the EVINCE cluster trial in 64 Boston-area nursing homes (February 2013 to July 2017), a 12-minute advance care planning video for the proxies of 402 residents with advanced dementia did not change do-not-hospitalize directives, which stood at 63% in both arms by 6 months (JAMA Internal Medicine); directives against tube-feeding were more common in video facilities, 70.10% against 61.90% (JAMA Internal Medicine).

The PROVEN pragmatic trial offered five short videos on tablets in 360 nursing homes in 32 states owned by two for-profit chains (February 2016 to May 2019). Champions recorded that only 912 of 4,171 intervention residents with advanced illness, 21.9%, watched one (JAMA Internal Medicine); 11.8% of intervention facilities (14 of 119) showed the videos to nobody (JAMA Internal Medicine). Hospital transfers did not fall, at 3.7 per 1,000 person-days alive against 3.9 in control homes, and hospice enrollment did not differ (JAMA Internal Medicine). A later post hoc look at 2,848 PROVEN decedents found 1.7 percentage points fewer hospital transfers in the last 90 days of life in video homes, a modest difference (Journal of the American Medical Directors Association).

Hospital and clinic trials that paired the videos with trained staff did better. In the VIDEO-PCE stepped-wedge trial of 10,802 patients aged 65 and over on 14 units at two hospitals in New York and Boston (July 2021 to October 2022), palliative care educators used a library of video decision aids in 29 languages (JAMA Network Open). Goals-of-care documentation reached 62.2% during the video phase against 50.1% under usual care (JAMA Network Open), and 76.4% against 62.3% among patients living with dementia (JAMA Network Open). At 29 oncology practices in three U.S. health systems (April 2020 to November 2022), videos plus clinician training raised advance care planning documentation among 13,800 patients aged 65 and over with advanced cancer to 25.3% against 20.8% (JAMA Network Open), but hospice documentation barely moved, 5.4% against 5.3% (JAMA Network Open). The newest trial, VIDEO-KD (453 adults aged 65 and over with advanced kidney disease at 12 U.S. clinics, June 2021 to March 2025), paired a video decision aid with a patient-recorded video declaration; 56.6% had advance care planning documented within 12 months, against 40.0% with usual care (JAMA Internal Medicine).

Does video work for palliative care and hospice visits?

For palliative care visits, the largest trial found video as good as in person for patients, with less caregiver involvement. The REACH PC trial randomized 1,250 patients with advanced lung cancer and 548 caregivers at 22 U.S. cancer centers (June 2018 to May 2023) to early palliative care by video or in person; quality of life at 24 weeks was equivalent (mean score 99.7 against 97.7) (JAMA). Caregivers joined 36.6% of video visits against 49.7% of in-person visits (JAMA).

Hospice trials are smaller. The ACTIVE trial linked 446 family caregivers in three Midwestern hospice programs to hospice care plan meetings by web conference or telephone; it did not change caregivers’ overall view of pain management (American Journal of Hospice & Palliative Medicine). In a 2025 pilot randomized trial of 80 home hospice caregivers in one U.S. hospice organization, caregivers in the I-HoME group completed 83% of scheduled nurse practitioner tele-visits (Journal of the American Geriatrics Society), and 88% said the tele-visits and teaching videos increased their confidence in managing symptoms (Journal of the American Geriatrics Society). In a pilot with 59 family caregivers at three Mid-Atlantic hospices and no control group, 86% were satisfied or very satisfied with NOVELA, a four-chapter telenovela-style video watched in weekly telehealth sessions (American Journal of Hospice & Palliative Medicine).

How many bereaved family caregivers develop prolonged grief?

Roughly one in seven in studies pooled through 2024, with wide variation by measure and time. A 2025 meta-analysis of 49 prospective studies covering 14,274 bereaved informal care partners put the pooled prevalence of prolonged grief disorder at 15% more than 6 months after the death (Journal of the American Medical Directors Association), with depression at 27% and anxiety at 22% (Journal of the American Medical Directors Association). In an Australian cohort of 301 family caregivers of palliative care patients in Melbourne, 5% of the 85 still followed at 37 months met criteria for prolonged grief disorder and 14% had subthreshold symptoms (Palliative & Supportive Care).

Hospice use gave surviving spouses only a modest edge. In a matched U.S. sample of 1,016 decedents with serious illness and their spouses (Health and Retirement Study linked to Medicare, interviews 2002 to 2011), 51.9% of spouses had more depressive symptoms after the death whether or not hospice was used (JAMA Internal Medicine); 28.2% of spouses of hospice users improved against 21.7% of spouses of non-users, a difference that was not statistically significant (JAMA Internal Medicine).

Does hospice cost Medicare less than care without hospice?

For patients with short, cancer-related stays, peer-reviewed studies find lower costs; for long stays in nursing homes, they find higher costs. In matched Medicare fee-for-service patients with poor-prognosis cancer who died in 2011 (18,165 per group), total costs in the last year of life were $62,819 with hospice against $71,517 without (JAMA), a difference of $8,697 (JAMA). For Medicare decedents in 2010, 31 to 90 days of hospice was linked to $900-$5,000 lower spending in the last 6 months of life for most beneficiaries not in nursing homes, except those with Alzheimer’s (Journals of Gerontology Series B). In nursing homes, hospice use among decedents rose to 39.8% in 2009 from 27.6% in 2004 (New England Journal of Medicine), and that growth was associated with a mean net increase of $6,761 in Medicare spending in the last year of life (New England Journal of Medicine). The popular savings figures are traced in the myths section.

Do for-profit and private-equity hospices perform differently?

Yes, on average: family caregivers rate them lower and they discharge more patients alive, though quality varies within every ownership type. In CAHPS Hospice Survey responses from 653,208 family caregivers (April 2017 to March 2019), 31.1% of for-profit hospices scored 3 or more points below the national average for overall care experience (JAMA Internal Medicine), against 12.5% of not-for-profit hospices (JAMA Internal Medicine).

Braun and colleagues estimated in 2023 that 16% of U.S. hospice agencies are owned by private equity firms or publicly traded companies (JAMA Network Open). Agencies bought by private equity in 2014 to 2019 saw a 5.98% relative increase in patients with dementia compared with for-profit hospices that were not acquired (Medicare data 2013 to 2020) (JAMA Network Open). In Medicare claims for 2010 to 2021, registered nurse visit minutes per 30 days fell 5.14 percent after a private equity acquisition (Health Affairs) and social worker minutes fell 12.32 percent (Health Affairs), declines the authors traced to four large acquirers. The evidence base is still thin: a 2026 systematic review found only 6 eligible peer-reviewed studies of private equity in hospice out of 630 screened (American Journal of Hospice & Palliative Medicine).

How often do hospice patients leave hospice alive?

About one in five Medicare hospice discharges was a live discharge in 2010, more often at for-profit hospices. That year, 18.2% of Medicare fee-for-service hospice discharges (182,172 of 1,003,958) were live discharges (Journal of Palliative Medicine); the rate was 22.4% at for-profit hospices against 14.6% at not-for-profit hospices, and ranged by state from 12.8% in Connecticut to 40.5% in Mississippi (Journal of Palliative Medicine). Across 5,405,526 Medicare hospice enrollees aged 65 and over from 2005 to 2011, adjusted live discharge rates were 21.0% at for-profit nonchain and 20.2% at for-profit chain hospices against 14.6% to 15.9% at other types (Journal of the American Geriatrics Society).

Medicare’s 2014 audits of long stays and its 2016 two-tier payment change did not push rates down further. In 2008 to 2019 Medicare hospice claims, live discharge rates had been falling 0.13 percentage points a month before the two policies took effect and then stopped falling (Journal of Pain and Symptom Management). Among 1,436,018 Medicare hospice enrollees aged 65 and over with dementia, disenrollment edged down only to 23.2% in 2019 from 24.0% in 2012, and for-profit hospices stayed higher than nonprofits throughout (Journal of the American Geriatrics Society).

Who qualifies for the Medicare hospice benefit, and how is it elected?

A person qualifies when a hospice physician certifies a life expectancy of 6 months or less if the terminal illness runs its normal course, under 42 CFR 418.22 as it stood on November 4, 2026 (eCFR). The person must also be entitled to Medicare Part A. The patient, or a representative, then signs an election statement with one hospice and gives up Medicare payment for curative treatment of the terminal illness. The hospice must file a Notice of Election with its Medicare contractor within 5 calendar days of the election taking effect. If it files late, Medicare does not pay for the days before filing, and the hospice may not bill the family for them (eCFR).

The paperwork grew in 2026. For elections starting on or after October 1, 2026, every patient must get a written addendum at the time of election. It lists the conditions, items, services and drugs the hospice has decided are unrelated to the terminal illness and will not pay for (eCFR). Before that date the addendum was given only on request. CMS gave its reason in the FY 2027 hospice payment rule. Medicare spending on non-hospice Part A and B care for people already in hospice rose by 160 percent between FY 2020 and FY 2024 (Federal Register).

The same rule gives a sense of scale. CMS estimated 1,873,148 hospice elections a year from FY 2024 claims (Federal Register). About 19 percent of hospice patients die within the first five days of care (Federal Register). For its paperwork estimate, CMS counted 6,732 Medicare-certified hospices (Federal Register). These are burden-estimate inputs, not audited counts; the provider-file and MedPAC sections of this page give their own counts.

Florida's licensing law uses a looser definition. It calls a patient terminally ill with a prognosis of 1 year or less, under section 400.601 of the 2026 Florida Statutes (Florida Statutes). Medicare still pays only with the federal 6-month certification.

How long can someone stay on hospice?

There is no fixed limit. Medicare hospice care runs in benefit periods: two 90-day periods, then an unlimited number of 60-day periods, under 42 CFR 418.21 (eCFR). A physician must recertify the terminal prognosis at the start of each period (eCFR). A patient who improves can be discharged, and a patient who stops hospice can elect it again later for any period still available.

When must a clinician see the patient face to face, and can it be done by video?

From the third benefit period on, a hospice physician or nurse practitioner must meet the patient no more than 30 calendar days before each recertification, under 42 CFR 418.22, a rule in force since 2011 (eCFR). The clinician gathers the clinical findings that support continued eligibility. The certifying physician's narrative must then explain why those findings still point to a life expectancy of 6 months or less.

The visit may be held by two-way, real-time audio and video through December 31, 2027, when it is only for recertification (eCFR). Congress set that date in the Consolidated Appropriations Act, 2026, and CMS wrote it into the regulation in the FY 2027 hospice rule. The allowance has run on short extensions. The FY 2026 rule, published in August 2025, carried an end date of September 30, 2025 (Federal Register).

Since January 31, 2026, the video option is closed in three cases: the patient lives in an area under a hospice enrollment moratorium, the hospice is under enhanced oversight, or the clinician is not enrolled in Medicare (eCFR). From January 1, 2027, hospices must flag every telehealth face-to-face encounter on the claim (eCFR). The FY 2027 rule says this is done with a G-code, so CMS will be able to count these video visits for the first time.

How much does Medicare pay hospices, and what is the hospice cap?

CMS raised hospice payment rates by 2.3 percent for fiscal year 2027 (October 2026 to September 2027): the hospital market basket increase less a productivity cut, in the final rule published August 3, 2026 (Federal Register). CMS estimated the update adds $755 million in payments to hospices in FY 2027 (Federal Register). The year before, the FY 2026 update was 2.6 percent (Federal Register), worth an estimated $750 million (Federal Register).

Most hospice days are paid at the routine home care rate, a flat daily amount adjusted for local wages. For days 1 to 60 of a stay, the national base rate is $236.33 a day in FY 2027, as corrected by CMS on September 30, 2026 (Federal Register), up from $230.83 in FY 2026 (Federal Register). Both rates apply to hospices that report quality data.

The aggregate cap limits what Medicare pays one hospice in a year. It equals a per-beneficiary amount times the hospice's share of Medicare patients. Payments above it are overpayments the hospice must refund. The amount was $6,500 in 1983 (eCFR). It is $36,174.75 for the FY 2027 cap year (Federal Register), up from $35,361.44 in FY 2026 (Federal Register). Through cap years ending before October 1, 2035, the cap rises by the hospice payment update rather than by medical-care inflation (eCFR). The FY 2027 rule moved that date out by two years.

Families pay little. Under Original Medicare there is no deductible. The patient pays a copayment of up to $5 per prescription for pain and symptom drugs (Medicare.gov) and 5% of the Medicare-approved amount for inpatient respite care, per the March 2026 edition of CMS's Medicare Hospice Benefits booklet (Medicare.gov).

What quality data must hospices report, including the CAHPS family survey?

A hospice that does not report its quality data loses 4 percentage points of its annual payment update, a penalty in force since fiscal year 2024 (42 CFR 418.306) (eCFR). In FY 2027 that turns the 2.3 percent increase into a cut. To comply, a hospice must submit at least 90 percent of its required patient assessment records (the HOPE tool, which replaced HIS) on time after each admission and discharge (eCFR).

The Hospice Quality Reporting Program also includes the CAHPS Hospice Survey. It asks the family caregivers of patients who died about their experience of care. Hospices must hire a CMS-approved vendor to run it, and no company that owns, runs or staffs a hospice may act as a vendor. A hospice with fewer than 50 survey-eligible patient deaths in the prior year can be exempt (eCFR). That exemption is common. In CMS's analysis for the Special Focus Program, only 49.3 percent of eligible hospices reported the four CAHPS measures in 2019 to 2021 (Federal Register).

How are hospices inspected, and what is the Special Focus Program?

Every Medicare hospice must have a standard survey by a state agency or an approved accrediting body at least once every 36 months, under 42 CFR 488.1110 (eCFR). Complaints trigger extra surveys.

The Special Focus Program, in force since January 2024, adds closer oversight for the hospices that score worst. CMS ranks hospices with an algorithm built on survey deficiencies, substantiated complaints, a claims-based care index and CAHPS scores. At least once a year it must post the 10 percent of hospices with the worst scores and which of them it picked (eCFR). A hospice in the program is surveyed at least once every 6 months and loses any accreditor's deemed status (eCFR). To leave the program, it needs two surveys within 18 months with no condition-level deficiencies. A hospice that does not manage this is considered for termination from Medicare (eCFR).

Serious findings are concentrated in a small group. When CMS built the program, it found that 88.3 percent of eligible hospices had no quality-of-care condition-level deficiencies over 2019 to 2021 (Federal Register).

What training and supervision do hospice aides need?

A hospice aide needs at least 75 hours of classroom and supervised practical training, under 42 CFR 418.76 (eCFR). At least 16 of those hours must be classroom training completed before the supervised practical training starts (eCFR). An aide may instead pass a competency evaluation or qualify through a state nurse aide or licensure program. Once working, an aide needs at least 12 hours of in-service training each year, and it may happen during patient care (eCFR). An aide who goes 24 consecutive months without paid aide work must retrain (eCFR).

A registered nurse must visit the patient's home at least every 14 days to check the aide's care. The aide does not need to be present (eCFR). A nurse must also watch each aide give care once a year. The home health aide rule allows an occasional check by video. The hospice rule has no such allowance, so these visits stay in person.

What do the rules require for volunteers, bereavement and respite care?

Volunteers must give time equal to at least 5 percent of all paid staff and contract patient care hours, under 42 CFR 418.78 (eCFR). The hospice must document its efforts to recruit and keep volunteers and the money they save it. Florida writes the same 5 percent floor into state law, counting patient care or administrative hours (Florida Statutes). This makes volunteer recruiting a standing compliance task for every hospice.

Bereavement support is required. A hospice must offer services to the family for up to 1 year after the patient's death, led by a professional trained in grief or loss counseling (eCFR). Medicare does not pay for it separately: bereavement counseling is "a required hospice service but it is not reimbursable" (eCFR). Florida sets a floor rather than a ceiling: support for a minimum of 1 year after the death (Florida Statutes).

Respite care gives a family caregiver a break while the patient stays in a hospital, nursing home or hospice facility. Medicare pays for it only occasionally and for no more than five consecutive days at a time (eCFR).

What does Florida require to open and run a hospice?

Florida requires a certificate of need. The state may not license a hospice that has not received a certificate of need (section 400.606, 2026 Florida Statutes) (Florida Statutes). The certificate-of-need law lists the establishment of a hospice or hospice inpatient facility among the projects subject to review (section 408.036) (Florida Statutes). An existing health care provider that starts offering hospice care is making a significant change in service and also needs a certificate (section 408.043) (Florida Statutes).

The need test is numeric. Under Florida Administrative Code rule 59C-1.0355, a service area shows need for a new hospice program only when the projected number of patients who would elect hospice but are not being served reaches 350 or more a year (Fla. Admin. Code). The projection is built from deaths by age and by cancer versus other causes, times statewide hospice election rates, minus current admissions. Even with need shown, the state normally will not approve a new program unless every hospice already serving the area has been licensed and operating for at least 2 years (Fla. Admin. Code). Without numeric need, an applicant must show that a specific terminally ill population or a county is going unserved.

Licensed hospices must keep inpatient days to no more than 20 percent of all hospice days for their patients in any 12-month period (Florida Statutes). The license fee is set by rule, capped at $1,200 per two-year license (Florida Statutes). The state's licensing agency, the Agency for Health Care Administration, publishes its need projections and hospice counts on a website that asks AI crawlers not to visit, so we did not read them.

What do the popular hospice numbers really say?

Hospice websites, trade groups, news features and marketing vendors repeat four numbers more than any others. We traced each one to the study, survey or company that produced it and read what it measured. Pages that repeat a number are linked only as dated evidence of how it spread, never as a source for the number itself.

“88% of dying patients see deceased loved ones”

The 88% comes from one 2014 study of 59 hospice inpatients in one unit near Buffalo, New York, and it counted any dream or vision, not only visions of the dead. Kerr and colleagues at the Center for Hospice & Palliative Care enrolled 66 lucid patients admitted between January 2011 and July 2012 and interviewed them repeatedly until death (Journal of Palliative Medicine); 59 made up the final sample (Journal of Palliative Medicine). The authors’ abstract gives no percentage: Most participants reported at least one dream or vision, and deceased friends and relatives were the most common content, followed by living friends and relatives (Journal of Palliative Medicine). Dreams of the dead were rated more comforting than other kinds and became more common closer to death.

Repeats change what was counted. A 2024 feature reposted by the hospice that ran the study says “88 percent of patients” reported at least one vision, which matches the study’s measure (Hospice & Palliative Care Buffalo). The ASCO Post wrote in November 2024 that 88.1% had a dream or vision “of a deceased relative or friend”, narrowing a figure for any dream into one about the dead (ASCO Post). The same article put the share who found their dreams comforting at 60%, with nearly 19% finding them distressing (ASCO Post). An August 2026 Upworthy article quotes a podcast remark that “88% rated them (the dreams) comforting”, a figure we could not find in any published study (Upworthy). An October 2026 feature says the team recorded about 1,400 patients and families and that over 80% had experiences beyond strange dreams; PubMed lists no paper with that sample (ModernGhana).

Other studies count differently and find lower shares. In a 2013-2015 study of 83 patients receiving hospice care at home in western New York, 55 reported dreams or visions over 842 weekly visits, or 66% (Palliative Medicine Reports). A nationwide 2016 Japanese survey of bereaved families of cancer patients, with 2,221 responses analysed, found family members reported deathbed visions for 21% of patients (Journal of Pain and Symptom Management). In a U.S. survey of 75 hospice nurses, 89% said patients who had deathbed communications died peacefully and calmly, a nurse impression rather than a patient count (American Journal of Hospice and Palliative Medicine). The feature reposted by Hospice Buffalo sums up studies in Japan, India, Sweden and Australia as finding 20 to 80 percent, mostly from caregivers’ reports (Hospice & Palliative Care Buffalo). An international survey of 247 clinicians, published in 2026, found they meet these experiences often but lack protocols and training (Journal of Palliative Medicine).

Use instead: “In a 2014 study of 59 hospice inpatients in New York, most reported at least one end-of-life dream or vision, most often of deceased loved ones; a later home hospice study found 66%.” Name the setting and the measure, and avoid “of a deceased relative” or “88% found them comforting”.

“Hospice saves Medicare $2,309 per patient” or “$3.5 billion a year”

Both numbers are real but narrow: $2,309 is a 2007 estimate from deaths in 1993-2003, and $3.5 billion is a one-year 2019 estimate commissioned by the hospice trade associations. Taylor and colleagues at Duke compared 1,819 Medicare hospice decedents with 3,638 matched controls from the National Long Term Care Survey (Social Science & Medicine) and found hospice cut Medicare spending in the last year of life by an average of $2,309 per hospice user (Social Science & Medicine). Duke’s November 2007 release headlined it as $2,309 per person “compared to normal care” (Duke Today). An NHPCO fact sheet hosted on kff.org in 2014 was still repeating $2,309 per hospice patient (NHPCO). The study’s own caveat travels less: one 2011 hospice blog notes that savings for cancer patients held only up to 233 days of care, and up to 154 days for other patients, beyond which hospice cost Medicare more (Hospice Care Research blog).

Kelley and colleagues (Health Affairs, 2013), using Health and Retirement Study data for 2002-08 linked to Medicare claims, found $2,561 in savings per patient enrolled 53-105 days before death against a matched control (Health Affairs), and larger savings for the shorter, more common stays, up to $6,430 for 15-30 days (Health Affairs). The 53-105 day group was 88 hospice patients matched to 1,404 non-hospice decedents (Health Affairs).

The 2023 report by NORC at the University of Chicago, commissioned by NHPCO and NAHC (since 2025 the National Alliance for Care at Home), studied the 2.3 million Medicare beneficiaries who died in 2019 using 2016-2019 claims and enrollment data (NORC). It found last-year-of-life spending was 3.1 percent lower for hospice users than for propensity-weighted non-users (National Alliance for Care at Home) and translated that into $3.5 billion less Medicare spending in 2019 (National Alliance for Care at Home). The dollar figure is extrapolated: NORC applied the percentage to an assumed spend of around $112 billion for hospice-user decedents (NORC). Hospice News headlined it as “upwards of $3.5B annually”, though the report estimates one year (Hospice News).

MedPAC, the congressional advisory commission on Medicare, reads the evidence differently. Its 2015 contractor report concluded that hospice does not appear to produce lower aggregate Medicare spending and that very long stays are a net cost to the program (MedPAC). It found that studies comparing only the enrollment period, the design behind the Taylor and Kelley figures, showed very large savings (e.g., 24 percent) that may be an artifact of the method (MedPAC). NORC reported the opposite for long stays, 11 percent lower spending for decedents with six months or more of hospice (National Alliance for Care at Home). MedPAC staff slides in November 2023 describe the NORC study as sponsored by industry groups and finding 3% savings in the last year of life (MedPAC).

Use instead: “An industry-commissioned NORC study estimated hospice users’ last-year Medicare costs were 3.1 percent lower in 2019; MedPAC’s reviewers found no aggregate savings and a net cost for very long stays.” Give the year and who paid for the study.

“80% of Americans want to die at home, but only 20% do”

Both halves are out of date: in KFF’s 2016 survey, 71% of U.S. adults preferred to die at home, and by 2018 about 31% of U.S. deaths happened at home. The 80/20 pairing traces to Stanford School of Medicine’s palliative care training page “Where Do Americans Die?”, which said “studies have shown” approximately 80% of Americans would prefer to die at home and cited no study (Stanford, archived 2015). The same page said 60% die in acute care hospitals, 20% in nursing homes and only 20% at home, with no year (Stanford, archived 2015). The Internet Archive’s first capture of the page is from September 2015; it was taken down in September 2022. Repeats now date it: a college textbook on LibreTexts cites “the Stanford Medical School (2019)” for the 80% (LibreTexts). Hospice News credited the 80% to the CDC in 2019, which publishes where people die, not where they want to (Hospice News).

The measured preference is lower. KFF and The Economist surveyed 1,006 U.S. adults by telephone from March 30 to May 29, 2016 (KFF). 71 percent said that, given the choice, they would prefer to die at home (KFF), and 41 percent thought they were most likely to die there (KFF).

The measured outcome is higher than 20%. CDC’s National Center for Health Statistics counted the share of all U.S. deaths at the decedent’s home rising from 22.7% in 2000 to 31.4% in 2018, as hospital deaths fell from 48.0% to 35.1% (NCHS, archived). Its earlier edition found deaths in hospice and all other places rose from 3.5% in 2000 to 12.0% in 2014 (NCHS, archived). Cross and Warraich’s December 2019 letter in the New England Journal of Medicine found home deaths from natural causes passed hospital deaths: AP reported home deaths rising from 24% to 31% between 2003 and 2017 (WHYY/AP), and Hospice News put the 2017 count at 788,757 home deaths (Hospice News). Public radio gave the 2017 home share as 30.7 percent (KWBU). The same authors found hospice facility deaths rose from 0.2% of natural deaths in 2003 to 8.3% in 2017 (Journal of Pain and Symptom Management).

Use instead: “In a 2016 KFF survey, 71 percent of U.S. adults said they would prefer to die at home; CDC data show 31.4% of deaths occurred at home in 2018.”

“Video on a landing page lifts conversions by 80%”

The 80% is a best case from one video vendor, EyeView, in 2009-2010, about financial and tutoring websites, not healthcare. EyeView’s blog first reported that eToro visitors who watched its video were 20% more likely to download the product (December 2008) (EyeView, archived). In February 2009 it said UMOO viewers were 80% more likely to become depositing users, comparing viewers with non-viewers for one client (EyeView, archived), and in November 2009 it quoted a TutorVista manager on a first test that lifted conversion by over 80 percent (EyeView, archived). Its 2010 white paper said only that “in some cases” the boost was over 80% (EyeView white paper, archived), and the one test it described, the eToro split test, was now almost 32 percent (EyeView white paper, archived).

The scope fell away in repeats. By August 2010 Unbounce, a landing-page software seller, wrote that video on landing pages can increase conversion by 80% (Unbounce, archived), and WordStream, a pay-per-click software seller, repeated 80% in March 2016, crediting “EyeWideDigital” (WordStream). Healthcare video sellers carried it on: Nucleus Medical Media listed 80% in 2018, credited to Eyeview Digital (Nucleus Medical Media), a 2026 health and wellness roundup says healthcare landing-page videos lift conversions by up to 80%, crediting a statistics aggregator (Webtonic), and a video production company selling to nursing care facilities lists “up to 80% higher landing page conversions” with no source (Beverly Boy Productions). No hospice or healthcare test behind the figure was found.

The larger later evidence points the other way. Unbounce’s own 2021 analysis of about 35,000 customer landing pages in each of three periods (Unbounce) concluded that video appears to have a minimal or negative impact on landing-page performance regardless of the conversion goal (Unbounce). Use instead: do not cite a conversion lift for hospice video; say Unbounce’s 2021 study of 35,000 pages found video had a minimal or negative effect, and judge a hospice’s video by its own enquiries and family feedback.

Every popular claim our research pages trace, 789 in all, is on one page: popular video statistics, fact-checked.

How we built this page

We started from the questions people search for about hospice video statistics and looked for the organization that actually produced each answer. Every figure on this page sits in an evidence ledger with its source, the exact table or paragraph it came from, the measurement period, the population measured, and the date we checked it. This edition holds 674 figures from 62 publishers.

On November 6, 2026, each sourced figure on this page was re-fetched with the fetch cache cleared and matched against the recorded wording: CMS Care Compare hospice and CAHPS Hospice files (through Internet Archive Save Page Now copies, because the provider-data API refuses browser requests), the Provider of Services, hospice enrollment and ownership, and post-acute care and hospice files on data.cms.gov, and CMS’s Special Focus Program pages; NCHS hospice counts on data.cdc.gov; MedPAC’s March 2023 to 2026 hospice chapters and July 2026 data book; HHS OIG report pages and GAO-20-10; BLS occupation wage and staffing estimates (through the BLS data API), the Quarterly Census of Employment and Wages, Employment Projections and injury pages (through Internet Archive copies, because bls.gov refuses automated requests); Census County Business Patterns, Nonemployer Statistics, the 2022 Economic Census and the Annual Integrated Economic Survey (through the Census data API); federal rules on eCFR and the Federal Register, the Medicare hospice booklet, and Florida statutes and rules on Online Sunshine and flrules.org; Chemed, Enhabit, Pennant, Amedisys, BrightSpring and Addus filings and EDGAR full-text search; The Conversation Project, AARP and the National Alliance for Caregiving, the National Alliance for Care at Home, the Hospice Foundation of America, YouTube, Google, ASPE, AP-NORC, Pew and KFF pages; peer-reviewed studies (PubMed abstracts, re-read through NCBI’s E-utilities because the abstract pages answer scripts with a bot check); and the pages behind each popular claim. Our hospice counts come from CMS’s own files and our YouTube figures from the YouTube Data API. We left out Florida AHCA’s pages and Congress.gov, Meta’s ad policy pages, the New England Journal of Medicine, STAT and HuffPost (robots rules that bar AI agents), WellSky (robots rules), NHPCO’s own site (it refuses automated requests) and the members-only Facts and Figures report.

We only cite the producer: government agencies, regulators, company filings and official posts, and the survey owner's own report. We do not cite statistics roundups, Statista-style aggregators, or salary sites without a public method. We did not bypass paywalls or sign-up forms; where a full report was gated, we used only the figures its publisher states publicly.

Figures marked "our calculation" are arithmetic on the cited numbers, and anyone can reproduce them:

This edition contains no Mark Studios customer data.

Limitations

• Hospice counts differ by source. CMS’s Provider of Services file lists 6,327 active certified hospices, Care Compare lists 6,669, MedPAC counted 6,706 serving Medicare in 2024 and NCHS 5,800 in 2022. Each counts a different thing (active certifications, listed providers, hospices with claims, agencies surveyed), so we print them side by side rather than pick one.
• Industry and worker data are shared context. Most freestanding hospices sit in NAICS 621610 with home health agencies, and BLS has no hospice occupation. Wage and job figures cover the whole home health care industry; only the Economic Census hospice product line isolates hospice revenue.
• Star ratings cover a minority of hospices. Only hospices with enough completed family surveys get a CAHPS star rating, so the U.S. and Florida star shares describe rated hospices, not all of them.
• Our YouTube read follows YouTube’s ranking. The 440 videos are what YouTube’s search returned for ‘hospice’, ‘hospice nurse’ and ‘end of life’ (the top 200 results of each, sorted by views, with no country filter) on November 6, 2026. It is not a census of hospice video, view counts are lifetime snapshots, and we sorted 198 channels by hand from their public text.
• Trial results come from specific settings. Most video decision-aid trials were run in a few U.S. hospitals, clinics or nursing homes, and their effects on documented preferences do not show what happens to every patient or family.
• Association figures are the industry’s own. The National Alliance for Care at Home represents hospices, and its full Facts and Figures report is members-only; we cite only its public release.

How to cite this page

For a single figure, cite the original publisher named next to it, and link here if the verification trail is useful to your readers. Each figure has its own anchor, so you can link straight to it, for example https://www.markstudios.com/research/hospice-video-statistics#DRV-217. To cite the page as a whole:

Mark Studios. "Hospice Video Statistics." Last verified Nov 6, 2026. https://www.markstudios.com/research/hospice-video-statistics

@misc{markstudios_hospice_video_statistics_2026,
  author = {{Mark Studios}},
  title = {{Hospice Video Statistics}},
  year = {2026},
  month = nov,
  url = {https://www.markstudios.com/research/hospice-video-statistics},
  note = {Last verified 2026-11-06}
}

Our calculations and the evidence table are free to reuse with attribution and a link to this page. Each underlying figure remains the claim of its original publisher, and some publishers ask for a link when their figures are reused.

Sources

Download the evidence table (CSV)

1. The Conversation Project (Institute for Healthcare Improvement; advocacy initiative), About Us - The Conversation Project (undated). Accessed 2026-11-06.
2. The Conversation Project (Institute for Healthcare Improvement; advocacy initiative), Most Americans 'relieved' to talk about end-of-life care (press release, April 10, 2018) (2018-04-10). Accessed 2026-11-06.
3. The Conversation Project (Institute for Healthcare Improvement; advocacy initiative), New Survey Reveals 'Conversation Disconnect' (press release, September 18, 2013) (2013-09-18). Accessed 2026-11-06.
4. Pew Research Center, Views on End-of-Life Medical Treatments (2013-11-21). Accessed 2026-11-06.
5. AARP and National Alliance for Caregiving, Caregiving in the US 2025 (2025-07-24). Accessed 2026-11-06.
6. AARP and National Alliance for Caregiving, New Report Reveals Crisis Point for America's 63 million Family Caregivers (AARP press release, July 24, 2025) (2025-07-24). Accessed 2026-11-06.
7. National Alliance for Care at Home (trade association; with the Research Institute for Home Care), 2025 Facts and Figures Report Now Available to Alliance Members (press release, 2025 Facts and Figures: Hospice Care in America) (2026-03-03). Accessed 2026-11-06.
8. National Alliance for Care at Home (trade association; with the Research Institute for Home Care), Our History - National Alliance for Care at Home (undated). Accessed 2026-11-06.
9. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
10. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
11. Centers for Medicare & Medicaid Services, Hospice - General Information (Care Compare provider data, dataset yc9t-dgbk), datastore count query (2026-08-19). Accessed 2026-11-06.
12. Centers for Medicare & Medicaid Services, Hospice Enrollments, 2026-09-29 release (data-api dataset 25704213) (2026-10-01). Accessed 2026-11-06.
13. National Center for Health Statistics (CDC), Biennial Overview of Post-acute and Long-term Care in the United States (NPALS web tables, data.cdc.gov dataset wibz-pb5q) (2024). Accessed 2026-11-06.
14. National Center for Health Statistics (CDC), FastStats: Hospice Care (NCHS), Internet Archive capture of 2026-09-30 (2026-02-06). Accessed 2026-11-06.
15. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
16. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
17. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
18. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
19. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
20. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
21. Centers for Medicare & Medicaid Services, Hospice - General Information (Care Compare provider data, dataset yc9t-dgbk), datastore count query (2026-08-19). Accessed 2026-11-06.
22. National Center for Health Statistics (CDC), Biennial Overview of Post-acute and Long-term Care in the United States (NPALS web tables, data.cdc.gov dataset wibz-pb5q) (2024). Accessed 2026-11-06.
23. Centers for Medicare & Medicaid Services, Medicare Post-Acute Care Utilization - Hospice by Geography and Provider, 2024 (data-api dataset 4e73f1b5) (2026-07). Accessed 2026-11-06.
24. Centers for Medicare & Medicaid Services, Medicare Post-Acute Care Utilization - Hospice by Geography and Provider, 2024 (data-api dataset 4e73f1b5) (2026-07). Accessed 2026-11-06.
25. Centers for Medicare & Medicaid Services, Medicare Post-Acute Care Utilization - Hospice by Geography and Provider, 2024 (data-api dataset 4e73f1b5) (2026-07). Accessed 2026-11-06.
26. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
27. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
28. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
29. Centers for Medicare & Medicaid Services, Provider of Services File - Internet Quality Improvement and Evaluation System, Q3 2026 (data-api dataset 086e48c4) (2026-10-16). Accessed 2026-11-06.
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31. Centers for Medicare & Medicaid Services, Hospice Enrollments, 2026-09-29 release (data-api dataset 25704213) (2026-10-01). Accessed 2026-11-06.
32. Centers for Medicare & Medicaid Services, Hospice Enrollments, 2026-09-29 release (data-api dataset 25704213) (2026-10-01). Accessed 2026-11-06.
33. Centers for Medicare & Medicaid Services, Hospice - General Information (Care Compare provider data, dataset yc9t-dgbk), datastore count query (2026-08-19). Accessed 2026-11-06.
34. National Center for Health Statistics (CDC), Biennial Overview of Post-acute and Long-term Care in the United States (NPALS web tables, data.cdc.gov dataset wibz-pb5q) (2024). Accessed 2026-11-06.
35. National Center for Health Statistics (CDC), Biennial Overview of Post-acute and Long-term Care in the United States (NPALS web tables, data.cdc.gov dataset wibz-pb5q) (2024). Accessed 2026-11-06.
36. Centers for Medicare & Medicaid Services, Hospice Special Focus Program (CMS page, Internet Archive capture of 2025-01-03) (2024-12-20). Accessed 2026-11-06.
37. Centers for Medicare & Medicaid Services, Hospice Special Focus Program (CMS page) (2025-02-14). Accessed 2026-11-06.
38. Centers for Medicare & Medicaid Services, Medicare Post-Acute Care Utilization - Hospice by Geography and Provider, 2024 (data-api dataset 4e73f1b5) (2026-07). Accessed 2026-11-06.
39. National Center for Health Statistics (CDC), Biennial Overview of Post-acute and Long-term Care in the United States (NPALS web tables, data.cdc.gov dataset wibz-pb5q) (2024). Accessed 2026-11-06.
40. National Center for Health Statistics (CDC), Biennial Overview of Post-acute and Long-term Care in the United States (NPALS web tables, data.cdc.gov dataset wibz-pb5q) (2024). Accessed 2026-11-06.
41. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
42. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
43. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
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47. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
48. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
49. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
50. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
51. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
52. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
53. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
54. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
55. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
56. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
57. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
58. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
59. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
60. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
61. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
62. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
63. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
64. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
65. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
66. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
67. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
68. U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 estimates (2026-05-15). Accessed 2026-11-06.
69. U.S. Bureau of Labor Statistics, Home Health and Personal Care Aides : Occupational Outlook Handbook (not stated on page (2025-35 projections edition)). Accessed 2026-11-06.
70. U.S. Bureau of Labor Statistics, Registered Nurses : Occupational Outlook Handbook (not stated on page (2025-35 projections edition)). Accessed 2026-11-06.
71. U.S. Bureau of Labor Statistics, Social Workers : Occupational Outlook Handbook (not stated on page (2025-35 projections edition)). Accessed 2026-11-06.
72. U.S. Bureau of Labor Statistics, Table 2.11 Employment and output by industry, 2025 and projected 2035 (not stated on page (2025-35 projections edition)). Accessed 2026-11-06.
73. U.S. Bureau of Labor Statistics, TABLE 1. Incidence rates of nonfatal occupational injuries and illnesses by industry and case types, 2024 (not stated in capture (2024 data)). Accessed 2026-11-06.
74. U.S. Census Bureau, 2022 Economic Census: Products and Services by Product across Industries (Census Data API, ecnnapcsprd) (not stated in API response). Accessed 2026-11-06.
75. U.S. Census Bureau, 2022 Economic Census: Products and Services by Industry (Census Data API, ecnnapcsind) (not stated in API response). Accessed 2026-11-06.
76. U.S. Census Bureau, 2022 Economic Census: Selected Statistics by Industry (Census Data API) (not stated in API response). Accessed 2026-11-06.
77. U.S. Bureau of Labor Statistics, QCEW Open Data: 2025 annual averages, industry 6216 (CSV) (not stated in CSV (2025 annual file)). Accessed 2026-11-06.
78. U.S. Bureau of Labor Statistics, QCEW Open Data: 2019 annual averages, industry 6216 (CSV) (not stated in CSV (2019 annual file)). Accessed 2026-11-06.
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81. U.S. Census Bureau, Nonemployer Statistics: 2023 (Census Data API) (not stated in API response). Accessed 2026-11-06.
82. U.S. Census Bureau, County Business Patterns: 2023 (Census Data API) (2025-06-26). Accessed 2026-11-06.
83. U.S. Census Bureau, 2022 Economic Census: Health Care and Social Assistance: Sales, Value of Shipments, or Revenue by Type of Payer (Census Data API) (not stated in API response). Accessed 2026-11-06.
84. U.S. Census Bureau, Annual Integrated Economic Survey: Selected Sectors: Detailed Operating Expenses: 2024 (Census Data API) (2026-09-03). Accessed 2026-11-06.
85. U.S. Census Bureau, Annual Integrated Economic Survey: All Sectors: Summary Statistics for Employer Firms: 2024 (Census Data API) (2026-09-03). Accessed 2026-11-06.
86. Centers for Medicare & Medicaid Services, Hospice care - National CAHPS Hospice Survey Data (dataset 7cv8-v37d, August 2026 refresh) (2026-08-07). Accessed 2026-11-06.
87. Centers for Medicare & Medicaid Services, Hospice care - State CAHPS Hospice Survey Data (dataset a55e-5b88), state FL (2026-08-07). Accessed 2026-11-06.
88. Centers for Medicare & Medicaid Services, Hospice - National Data (Care Compare provider data, dataset 3xeb-u9wp, August 2026 refresh) (2026-08-07). Accessed 2026-11-06.
89. Centers for Medicare & Medicaid Services, Hospice - State Data (Care Compare provider data, dataset eda0-92f0), state FL (2026-08-07). Accessed 2026-11-06.
90. Medicare Payment Advisory Commission (MedPAC, a congressional advisory commission), A Data Book: Health care spending and the Medicare program, July 2026, Section 11: Other services (hospice charts 11-7 to 11-18) (2026-07). Accessed 2026-11-06.
91. Medicare Payment Advisory Commission (MedPAC, a congressional advisory commission), Report to the Congress: Medicare Payment Policy, March 2026, Chapter 10: Hospice services (2026-03). Accessed 2026-11-06.
92. U.S. Government Accountability Office (GAO), Medicare Hospice Care: Opportunities Exist to Strengthen CMS Oversight of Hospice Providers (GAO-20-10) (2019-10-18). Accessed 2026-11-06.
93. U.S. Department of Health and Human Services, Office of Inspector General (HHS OIG), Registered Nurses Did Not Always Visit Medicare Beneficiaries' Homes At Least Once Every 14 Days To Assess The Quality of Care and Services Provided by Hospice Aides (A-09-18-03022) (2019-11-18). Accessed 2026-11-06.
94. Medicare Payment Advisory Commission (MedPAC, a congressional advisory commission), Report to the Congress: Medicare Payment Policy, March 2023, Chapter 10: Hospice services (2023-03). Accessed 2026-11-06.
95. Medicare Payment Advisory Commission (MedPAC, a congressional advisory commission), Report to the Congress: Medicare Payment Policy, March 2024, Chapter 9: Hospice services (2024-03). Accessed 2026-11-06.
96. Medicare Payment Advisory Commission (MedPAC, a congressional advisory commission), Report to the Congress: Medicare Payment Policy, March 2025, Chapter 9: Hospice services (2025-03). Accessed 2026-11-06.
97. U.S. Department of Health and Human Services, Office of Inspector General (HHS OIG), Medicare Could Have Saved $255.1 Million Related to Hospice Services for Certain New Hospice Enrollees (A-06-22-09003) (2026-06-18). Accessed 2026-11-06.
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101. U.S. Department of Health and Human Services, Office of Inspector General (HHS OIG), Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for Increased Oversight (A-09-20-03015) (2022-02-14). Accessed 2026-11-06.
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114. The Associated Press-NORC Center for Public Affairs Research, Telehealth and Equity (The Long-Term Care Poll, December 2021) (2021-12-15). Accessed 2026-11-06.
115. YouTube Official Blog, New ways for licensed healthcare professionals to reach people on YouTube (2022-10-27). Accessed 2026-11-06.
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118. BMJ (Volandes et al.), Video decision support tool for advance care planning in dementia: randomised controlled trial (2009-05-28). Accessed 2026-11-06.
119. Journal of Clinical Oncology (Volandes et al.), Randomized controlled trial of a video decision support tool for cardiopulmonary resuscitation decision making in advanced cancer (2013-01-20). Accessed 2026-11-06.
120. Journal of General Internal Medicine (El-Jawahri et al.), A Randomized Controlled Trial of a CPR and Intubation Video Decision Support Tool for Hospitalized Patients (2015-08-01). Accessed 2026-11-06.
121. Circulation (El-Jawahri et al.), Randomized, Controlled Trial of an Advance Care Planning Video Decision Support Tool for Patients With Advanced Heart Failure (2016-07-05). Accessed 2026-11-06.
122. BMJ Open (Jain et al.), Video decision aids to assist with advance care planning: a systematic review and meta-analysis (2015-06-24). Accessed 2026-11-06.
123. Journal of Hospice & Palliative Nursing (Shu et al.), The Effectiveness of Video Decision Aid on Advance Care Planning With Adult Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials (2022-11-08). Accessed 2026-11-06.
124. Patient Education and Counseling (Cruz-Oliver et al.), The evidence supporting educational videos for patients and caregivers receiving hospice and palliative care: A systematic review (2020-03-19). Accessed 2026-11-06.
125. Cancer (El-Jawahri et al.), Randomized trial of a hospice video educational tool for patients with advanced cancer and their caregivers (2020-08-01). Accessed 2026-11-06.
126. JAMA Internal Medicine (Mitchell et al.), An Advance Care Planning Video Decision Support Tool for Nursing Home Residents With Advanced Dementia: A Cluster Randomized Clinical Trial (2018-07-01). Accessed 2026-11-06.
127. JAMA Internal Medicine (Mitchell et al.), Advance Care Planning Video Intervention Among Long-Stay Nursing Home Residents: A Pragmatic Cluster Randomized Clinical Trial (2020-08-01). Accessed 2026-11-06.
128. Journal of the American Medical Directors Association (Moyo et al.), Effect of a Video-Assisted Advance Care Planning Intervention on End-of-Life Health Care Transitions Among Long-Stay Nursing Home Residents (2021-10-08). Accessed 2026-11-06.
129. JAMA Network Open (Volandes et al.), Video Intervention and Goals-of-Care Documentation in Hospitalized Older Adults: The VIDEO-PCE Randomized Clinical Trial (2023-09-05). Accessed 2026-11-06.
130. JAMA Network Open (Volandes et al.), An Intervention to Increase Advance Care Planning Among Older Adults With Advanced Cancer: A Randomized Clinical Trial (2025-05-01). Accessed 2026-11-06.
131. JAMA Internal Medicine (Volandes et al.), Video Decision Support and Advance Care Planning in Older Adults With Advanced Kidney Disease: The VIDEO-KD Randomized Clinical Trial (2026-10-22). Accessed 2026-11-06.
132. JAMA (Greer et al.), Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer: A Multisite Randomized Clinical Trial (2024-09-11). Accessed 2026-11-06.
133. American Journal of Hospice & Palliative Medicine (Parker Oliver et al.), Hospice Family Caregiver Involvement in Care Plan Meetings: A Mixed-Methods Randomized Controlled Trial (2016-07-27). Accessed 2026-11-06.
134. Journal of the American Geriatrics Society (Phongtankuel et al.), A Hospice Intervention for Caregivers: Improving Home Hospice Management of End-Of-Life Symptoms (I-HoME) Pilot Study (2025-09-24). Accessed 2026-11-06.
135. American Journal of Hospice & Palliative Medicine (Cruz-Oliver et al.), Promising Impact of Telenovela Intervention for Caregivers of Hospice Patients: A Pilot Study (2024-02-06). Accessed 2026-11-06.
136. Journal of the American Medical Directors Association (Malhotra et al.), Psychological Risk Factors Associated With Mental Health Outcomes Among Bereaved Care Partners: A Meta-Regression Analysis of Prospective Studies (2025-10-22). Accessed 2026-11-06.
137. Palliative & Supportive Care (Zordan et al.), Long-term prevalence and predictors of prolonged grief disorder amongst bereaved cancer caregivers: A cohort study (2019-10-01). Accessed 2026-11-06.
138. JAMA Internal Medicine (Ornstein et al.), Association Between Hospice Use and Depressive Symptoms in Surviving Spouses (2015-07-01). Accessed 2026-11-06.
139. JAMA (Obermeyer et al.), Association between the Medicare hospice benefit and health care utilization and costs for patients with poor-prognosis cancer (2014-11-12). Accessed 2026-11-06.
140. Journals of Gerontology Series B (Zuckerman et al.), Hospice Use, Hospitalization, and Medicare Spending at the End of Life (2015-12-11). Accessed 2026-11-06.
141. New England Journal of Medicine (Gozalo et al.), Changes in Medicare costs with the growth of hospice care in nursing homes (2015-05-07). Accessed 2026-11-06.
142. JAMA Internal Medicine (Anhang Price et al.), Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences (2023-04-01). Accessed 2026-11-06.
143. JAMA Network Open (Braun et al.), Changes in Diagnoses and Site of Care for Patients Receiving Hospice Care From Agencies Acquired by Private Equity Firms and Publicly Traded Companies (2023-09-05). Accessed 2026-11-06.
144. Health Affairs (Wen et al.), Hospice Acquisitions By Certain Firms And Corporations Were Associated With Reductions In Care Intensity, 2010-21 (2026-08-01). Accessed 2026-11-06.
145. American Journal of Hospice & Palliative Medicine (Quigley et al.), Private Equity Ownership in Hospice Care: A Systematic Review (2012-2026) (2026-07-28). Accessed 2026-11-06.
146. Journal of Palliative Medicine (Teno et al.), A national study of live discharges from hospice (2014-08-07). Accessed 2026-11-06.
147. Journal of the American Geriatrics Society (Stevenson et al.), Effect of Ownership on Hospice Service Use: 2005-2011 (2016-04-30). Accessed 2026-11-06.
148. Journal of Pain and Symptom Management (Gianattasio et al.), Medicare Hospice Policy Changes and Beneficiaries' Rate of Live Discharge and Length-of-Stay (2022-12-13). Accessed 2026-11-06.
149. Journal of the American Geriatrics Society (Hunt et al.), National Trends in Types of Hospice Disenrollment Among Older Adults With Dementia, 2012-2019 (2026-09-15). Accessed 2026-11-06.
150. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.22 Certification of terminal illness (2026-11-04). Accessed 2026-11-06.
151. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.24 Election of hospice care (2026-11-04). Accessed 2026-11-06.
152. Centers for Medicare & Medicaid Services (final rule, Federal Register), Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements (final rule, 91 FR 49118) (2026-08-03). Accessed 2026-11-06.
153. Florida Legislature (Florida Statutes, Online Sunshine), Florida Statutes 400.601 Definitions (chapter 400, part IV, Hospices) (2026). Accessed 2026-11-06.
154. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.21 Duration of hospice care coverage—Election periods (2026-11-04). Accessed 2026-11-06.
155. Centers for Medicare & Medicaid Services (final rule, Federal Register), Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements (final rule, 90 FR 37404) (2025-08-05). Accessed 2026-11-06.
156. Centers for Medicare & Medicaid Services (correction notice, Federal Register), Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction (91 FR 61791) (2026-09-30). Accessed 2026-11-06.
157. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.309 Hospice aggregate cap (2026-11-04). Accessed 2026-11-06.
158. Centers for Medicare & Medicaid Services (Medicare.gov), Medicare Hospice Benefits (CMS Product No. 02154, March 2026) (2026-03). Accessed 2026-11-06.
159. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.306 Annual update of the payment rates and adjustment for area wage differences (2026-11-04). Accessed 2026-11-06.
160. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.312 Data submission requirements under the hospice quality reporting program (2026-11-04). Accessed 2026-11-06.
161. Centers for Medicare & Medicaid Services (final rule, Federal Register), Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; ... Hospice Informal Dispute Resolution and Special Focus Program Requirements (final rule, 88 FR 77676) (2023-11-13). Accessed 2026-11-06.
162. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 488.1110 Hospice program: surveys and hotline (2026-11-04). Accessed 2026-11-06.
163. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 488.1135 Hospice Special Focus Program (SFP) (2026-11-04). Accessed 2026-11-06.
164. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.76 Condition of participation: Hospice aide and homemaker services (2026-11-04). Accessed 2026-11-06.
165. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.78 Conditions of participation—Volunteers (2026-11-04). Accessed 2026-11-06.
166. Florida Legislature (Florida Statutes, Online Sunshine), Florida Statutes 400.6105 Staffing and personnel (2026). Accessed 2026-11-06.
167. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.64 Condition of participation: Core services (2026-11-04). Accessed 2026-11-06.
168. Centers for Medicare & Medicaid Services (regulation text, eCFR), 42 CFR 418.204 Special coverage requirements (2026-11-04). Accessed 2026-11-06.
169. Florida Legislature (Florida Statutes, Online Sunshine), Florida Statutes 400.609 Hospice services (2026). Accessed 2026-11-06.
170. Florida Legislature (Florida Statutes, Online Sunshine), Florida Statutes 400.606 License; application; renewal; conditional license or permit; certificate of need (2026). Accessed 2026-11-06.
171. Florida Legislature (Florida Statutes, Online Sunshine), Florida Statutes 408.036 Projects subject to review; exemptions (2026). Accessed 2026-11-06.
172. Florida Legislature (Florida Statutes, Online Sunshine), Florida Statutes 408.043 Special provisions (2026). Accessed 2026-11-06.
173. Florida Agency for Health Care Administration (Florida Administrative Code, flrules.org), Florida Administrative Code Rule 59C-1.0355 Hospice Programs (2015-09-10). Accessed 2026-11-06.
174. Florida Legislature (Florida Statutes, Online Sunshine), Florida Statutes 400.605 Administration; forms; fees; rules; inspections; fines (2026). Accessed 2026-11-06.
175. Journal of Palliative Medicine (Kerr et al.), End-of-life dreams and visions: a longitudinal study of hospice patients' experiences (2014-01-11). Accessed 2026-11-06.
176. Hospice & Palliative Care Buffalo (repost of a feature by Phoebe Zerwick), What Deathbed Visions Teach Us About Living (2024-03-12). Accessed 2026-11-06.
177. The ASCO Post (interview with Christopher W. Kerr), How End-of-Life Dreams and Visions Are Bringing Comfort to Dying Patients (2024-11-10). Accessed 2026-11-06.
178. Upworthy, Hospice doctor reveals the loved ones who will visit and those who won't in your final dreams (2026-08-01). Accessed 2026-11-06.
179. ModernGhana (feature article), The Dying Are Not Afraid The Way We Are: What 1,500 Deathbeds Taught One Doctor (2026-10-25). Accessed 2026-11-06.
180. Palliative Medicine Reports (Depner et al.), Expanding the Understanding of Content of End-of-Life Dreams and Visions: A Consensual Qualitative Research Analysis (2020). Accessed 2026-11-06.
181. Journal of Pain and Symptom Management (Morita et al.), Nationwide Japanese Survey About Deathbed Visions: "My Deceased Mother Took Me to Heaven" (2016-11). Accessed 2026-11-06.
182. American Journal of Hospice and Palliative Medicine (Lawrence & Repede), The incidence of deathbed communications and their impact on the dying process (2012-12). Accessed 2026-11-06.
183. Journal of Palliative Medicine (Hamza Habib et al.), Understanding Clinicians' Perspectives on End-of-Life Dreams and Visions: An International Survey (2026-06-24). Accessed 2026-11-06.
184. Social Science & Medicine (Taylor et al.), What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program? (2007-06-27). Accessed 2026-11-06.
185. Duke Today (Duke University), Hospice Use Saves Money for Medicare, Duke Study Finds (2007-11-07). Accessed 2026-11-06.
186. National Hospice and Palliative Care Organization (trade association; document hosted by KFF), The Medicare Hospice Benefit (2014-07). Accessed 2026-11-06.
187. Hospice Care Research (blog), Hospice Care Saves Money for Medicare (2011-04-21). Accessed 2026-11-06.
188. Health Affairs (Kelley et al.), Hospice enrollment saves money for Medicare and improves care quality across a number of different lengths-of-stay (2013-03). Accessed 2026-11-06.
189. NORC at the University of Chicago (for NHPCO and NAHC), Value of Hospice in Medicare (NORC at the University of Chicago, March 2023) (2023-03-22). Accessed 2026-11-06.
190. National Alliance for Care at Home (trade association; NHPCO and NAHC merged in 2025), reporting NORC at the University of Chicago, New Research Shows the Value of Hospice in Medicare, and for Patients and Families (2023-03-22). Accessed 2026-11-06.
191. Hospice News (trade press), Hospice Saves Medicare Upwards of $3.5B Annually, with Longer Stays Especially Valuable (2023-03-22). Accessed 2026-11-06.
192. Medicare Payment Advisory Commission (MedPAC, a congressional advisory commission), MedPAC contractor report: Hospice does not lead to lower Medicare spending (2015-07-10). Accessed 2026-11-06.
193. Medicare Payment Advisory Commission (MedPAC, a congressional advisory commission), Assessing payment adequacy and updating payments: Hospice services (MedPAC public meeting slides, November 2023) (2023-11). Accessed 2026-11-06.
194. Stanford School of Medicine (Palliative Care education site), Where Do Americans Die? (2015). Accessed 2026-11-06.
195. LibreTexts (open textbook, Lally and Valentine-French), 10.3: Where Do People Die? (2024-04-15). Accessed 2026-11-06.
196. Hospice News (trade press), More Deaths Now Occur in Homes Than Hospitals, Nursing Facilities (2019-12-12). Accessed 2026-11-06.
197. KFF (Kaiser Family Foundation), survey owner, with The Economist, Views and Experiences with End-of-Life Medical Care in Japan, Italy, the United States, and Brazil: A Cross-Country Survey (2017-11). Accessed 2026-11-06.
198. KFF (Kaiser Family Foundation), survey owner, with The Economist, Views and Experiences with End-of-Life Medical Care in the U.S. (Findings) (2017-04-27). Accessed 2026-11-06.
199. CDC National Center for Health Statistics (MMWR QuickStats), QuickStats: Percentage of Deaths, by Place of Death - National Vital Statistics System, United States, 2000-2018 (2020-05-15). Accessed 2026-11-06.
200. CDC National Center for Health Statistics (MMWR QuickStats), QuickStats: Percentage Distribution of Deaths, by Place of Death - United States, 2000-2014 (2016-04-08). Accessed 2026-11-06.
201. WHYY (Associated Press story), More Americans are dying at home rather than in hospitals (2019-12). Accessed 2026-11-06.
202. KWBU (public radio), Business of Health Care: Dying at Home (2020-04-03). Accessed 2026-11-06.
203. Journal of Pain and Symptom Management (Cross et al.), National Trends in Hospice Facility Deaths in the United States, 2003-2017 (2020-08-26). Accessed 2026-11-06.
204. EyeView Digital (video production and testing vendor; sold the videos it tested), EyeView - The new "Conversion" game (2008-12-04). Accessed 2026-11-06.
205. EyeView Digital (video production and testing vendor; sold the videos it tested), UMOO - a prime beef example of EyeView's success (2009-02-10). Accessed 2026-11-06.
206. EyeView Digital (video production and testing vendor; sold the videos it tested), Another video conversion success story (2009-11-10). Accessed 2026-11-06.
207. EyeView Digital (video production and testing vendor; sold the videos it tested), Making Video Accountable (EyeView white paper) (2010). Accessed 2026-11-06.
208. Unbounce (landing-page software seller), The benefits of using video on landing pages (2010-08). Accessed 2026-11-06.
209. WordStream (PPC advertising software seller), 6 Ways to Use Video to Increase Conversion Rates (2016-03-30). Accessed 2026-11-06.
210. Nucleus Medical Media (healthcare video producer; sells the videos it describes), Current Trends: Healthcare Video Usage on the Web (2018-03-13). Accessed 2026-11-06.
211. Webtonic (web and marketing agency; sells video and websites), 42+ Statistics Shaping Video Marketing in the Health & Wellness Industry (2026) (2026). Accessed 2026-11-06.
212. Beverly Boy Productions (video production company; sells into the market), Video Production for Nursing Care Facilities - Marketing and Training (undated). Accessed 2026-11-06.
213. Unbounce (landing-page software seller; analysis of its own customers' pages), Video on landing pages means more conversions, right? Wrong. Here's why (2021-08-26). Accessed 2026-11-06.

Update policy and change log

We re-verify every figure quarterly and when a major source publishes a new edition. The next scheduled review is February 2027. Corrections go to contact@markstudios.com.

• Nov 6, 2026: First published with 674 figures from 62 publishers, each checked against its original source.
• Nov 7, 2026: Dated BrightSpring's Hospice Care Index score and visit count to its 2025 annual report.