Hospice
The Maryland Health Care Commission (MHCC) regulates hospice services in Maryland to support quality care, demonstrated need, and appropriate distribution of services across the state. This page provides an overview of how hospice services are regulated, along with access to facility data, reports, and information on Certificate of Need and related regulatory processes.
About Hospice Agencies in Maryland
A Hospice Agency is a licensed health care provider that delivers palliative and end-of-life care to patients with terminal illnesses, focusing on comfort, pain management, and quality of life rather than curative treatment. Hospice services are typically provided in a patient’s home, but may also be delivered in hospice facilities, hospitals, assisted living facilities or nursing homes. Hospice services can include medical equipment, nursing, social work, spiritual care, bereavement, and volunteer services for both patients and their families.
The Maryland Health Care Commission (MHCC) regulates hospice services through the Certificate of Need (CON) program. MHCC reviews and approves the establishment of new hospice agencies and the expansion of hospice services into new jurisdictions to ensure consistency with State Health Plan standards, demonstrated need, and appropriate distribution of services. MHCC may also review certain changes in services or service areas to determine whether CON approval is required.
A CON is not required for an agency to open, close or change the number of beds in a hospice house or in a general inpatient unit.
Quick Facts: Hospice Agencies
Hospice Agencies provide palliative and end-of-life care, typically in a patient's home but also in hospice facilities, hospitals, assisted living, or nursing homes.
Establishing a new agency or expanding into a new jurisdiction
- Requires Certificate of Need (CON) review
Opening, closing, or changing beds in a hospice house or general inpatient unit
- CON review not required
Change of ownership / acquisition
- Notice of Acquisition required; CON review not typically required
Facility Data and Reports
Quality & Performance
Access information on the quality and performance of hospice facilities in Maryland.
Facility Data
Request public use files containing inventory and utilization information on hospice facilities in Maryland.
Reports
Browse staff reports and recommendations on hospice services in Maryland, prepared by the Commission in accordance with the State Health Plan.
Regulatory Process
The CON process begins with the submission of a Letter of Intent (LOI), followed by a pre-application conference with MHCC staff. The applicant then files a formal CON application, which is reviewed by MHCC for completeness. Once deemed complete, the application enters a formal review period that includes opportunities for public comment and, if applicable, comparative review with competing applications. The CON review schedules are posted on the MHCC website at mhcc.maryland.gov.
MHCC staff evaluate the application in accordance with the State Health Plan and applicable review criteria, including project need, cost-effectiveness, impact on existing providers, financial feasibility and health equity. A staff report and recommendation are prepared and presented to the Commission. The Commission then issues a final decision to approve, approve with conditions, or deny the application.
Following approval, the applicant must meet applicable conditions and will be required to obtain first use approval from MHCC prior to initiating services.
The Commission administers an annual survey application, conducted by the Health Facility Planning division around the third quarter of every year.
Acquisitions or changes of ownership involving a hospice agency do not typically require a Certificate of Need (CON); however, the Maryland Health Care Commission (MHCC) must be notified of the transaction. The applicant is required to submit a Notice of Acquisition, including details of the proposed ownership structure, pre- and post-transaction organizational charts, and a description of the transaction.
MHCC reviews the submission to ensure that no additional services or expansion into new jurisdictions is proposed that would otherwise require CON approval.