On June 4, 2026, the California Department of Public Health (CDPH) issued a 5-day Notice of Proposed Emergency Regulatory Action pursuant to Government Code section 11346.1, subdivision (a)(2) regulating hospice agencies operating in California pursuant to Health & Safety Code sections 1751.70 (moratorium on new licenses) and 1753.1 (authorizing emergency regulations). CDPH also issued an All Facilities Letter, AFL 26-18, to all of California’s hospice agencies informing them of its intent to submit the proposed emergency regulations to the Office of Administrative Law (OAL) on June 11, 2026.
CDPH proposes regulating hospice agency patient care and business practice standards, much like it regulates skilled nursing facilities. CDPH states these emergency regulations will improve patient care and safety, establish standards of care, create consistency, and enhance CDPH’s surveying process. Specifically, CDPH noted six areas raised by a recent California State Auditor report that the rules address:
(1) Some hospice agencies employ management personnel responsible for more hospices than they can realistically oversee. One administrator managed 27 agencies. Others used names and personal information of individuals who were not actually employed.
(2) Multiple hospice agencies shared the same business address or operated in adjacent buildings without signage or capacity for operations.
(3) Agencies moved or sold their businesses without notifying the Department. Some obtained licensure and then immediately advertised their agencies for sale as “brand new, never billed” hospice solely for profit.
(4) Agencies seemingly hired management personnel with no experience or training in hospice care.
(5) Geographic service areas were often too large to reasonably provide timely and high-quality care.
(6) Lack of patient care standards to encourage accountability and to ensure sufficient nursing staff.
5-Day Notice of Proposed Emergency Regulatory Action, June 1, 2026, at p. 4 (numbers added).
CDPH claims the proposals will clarify licensing standards, adopt comprehensive application requirements to systemize screening, prevent identify theft, avoid oversaturation of geographic regions, require qualified personnel, protect hospice patients, combat fraud, and align requirements with federal rules and industry standards. Comments on the proposal must be submitted by June 10, 2026, by mail: 300 Capitol Mall, Suite 1250, Sacramento, California 95814; fax: (916) 323-6826; or email: staff@OAL.ca.gov.
