Heaven help the dying in the greedy hands of private equity hospice

As everyone dies eventually, private equity has detected profits in providing hospice care.

Hospice Is a Profitable Business, but Nonprofits Mostly Do a Better Job

Nearly three-quarters of hospice organizations are now for-profit. Complaints of fraud and profiteering are growing.
By Paula Span, The New York Times, June 10, 2023

Researchers have for years reported that there are, indeed, substantial differences overall between for-profit and nonprofit hospices; a new study based on family caregivers’ experiences provides additional evidence.

Medicare began covering hospice care four decades ago, when most hospices were nonprofit community organizations relying heavily on volunteers. It has since become a growth industry dominated by for-profit businesses…

Roughly half of Americans who die each year now turn to hospice. The number of Medicare beneficiaries enrolling in hospice rose to 1.7 million in 2020…

The most recent report from MedPAC, the independent agency advising Congress on Medicare spending, found that in 2020, for-profits received 20.5 percent more from Medicare than they spent providing services. The margin for nonprofits, whose daily per-patient expenditures are higher, averaged 5.8 percent… [end quote]

OK, now my blood is boiling. I hate private equity with a passion for the way they destroy companies by loading them with debt and sucking them dry. But it’s purely evil to wring profits out of dying people by cutting staff and by discharging them before they die when they are so ill and may have nobody to take care of them.

The Medicare.gov website notes not only which hospices are nonprofit but also other quality measures. (The National Hospice Locator also provides such information, and the CaringInfo site from the National Hospice and Palliative Care Organization offers general guidance.)

If you or someone you love is ill and expected to need hospice, investigate in advance. Don’t leave it to the last minute.



Hospice is supposed to be until the patient dies. Are the for-profits looking at the “life of the patient’s wallet” and when it dies, they (and their wallets) are then discharged–to make room for “alive-but-not-yet-dead” patients AND their wallets"?

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I don’t understand under what conditions hospice patients are discharged before death.

They’re discharged if it’s necessary to maintain steadily increasing excessive Executive Compensation. I suspect it’s like Medicare Advantage. The hospice gets a lump sum to work a patient. And if they can devise a way to provide less care or discharge them early, the savings goes right to the Executive’s bottom line.

And the best part – dead men tell no tales. What’s the dead guy who was defrauded out of his hospice care going to do? Sue them?



Whoever ended up taking care of the discharged hospice patient(s) could sue–and win. Although the companies would pay to settle out of court…

The most common reason for discharge is improvement in the patient. It is not that uncommon. If conditions improve then hospice could end without the death of the patient. My father is a hospice nurse and he has had quite a few discharged for no longer being terminal. A quick search suggests 10 to 15% leave hospice due to improvement.

Note, Jimmy Carter has been in hospice now for about 3 months. Max hospice is six months without an extension. It would not surprise me if he left hospice if his conditions improved if not for him stopping ongoing medical treatment