​We believe you deserve to know exactly what you're looking at — so here's the honest breakdown of what's paid, what's earned, and what can't be bought.

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The short version

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Hospice providers can pay for an enhanced listing on Hospice Guidebook. That subscription affects how a provider's listing looks and where it can rank when you haven't chosen a specific sort order. It does not affect the quality data itself — CMS scores, star ratings, and our "Provider Excellence" recognition are pulled from federal data and can't be purchased, adjusted, or influenced by any subscription.

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What a paid subscription affects

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• Visual presentation — a subscribing provider can add a photos, short and long descriptions, a website link, and additional coverage areas beyond their primary address.

• Default browsing order — when you first arrive and haven't chosen a specific sort option, listings are ordered by distance first, with subscriber tier used only to break ties between providers at the same distance

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What a paid subscription does NOT affect

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• CMS quality scores — HCI scores and CAHPS caregiver ratings come directly from federal Medicare data and are identical regardless of subscription status.

• The "Provider Excellence" recognition — this only appears when a provider's actual CMS data meets a fixed quality threshold and cannot be purchased. This is presented only when a provider's HCI score is at least 9.0/10 AND its CAHPS score is at least 4 stars out of 5. 

• Explicit search results — the moment you actively choose to sort by Quality, Urgent Response, or Inpatient Care, we check the real answer to that question first, for every provider, before subscription tier is used for anything. A non-subscribing provider that genuinely offers inpatient care will always outrank a subscribing provider that doesn't, when you've asked to sort by that.

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Why we built it this way

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Subscriptions are how we fund the expenses that let this directory exist — collecting and maintaining accurate, current CMS data for thousands of hospice providers nationwide isn't free. But we don't think a family looking for the right hospice for someone they love should ever have to wonder whether the "best" result is actually the best, or just the one who paid the most. So we drew a hard line: money can buy visibility and presentation. It cannot buy quality data, and it cannot override what you explicitly asked to see.

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Questions or concerns

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If anything about how a listing appears seems off, or you'd like more detail on how we handle a specific case, contact us at info@hospiceguidebook.com.