California implemented emergency state-level requirements for hospices last month, reminding stakeholders across the country that CMS isn’t the only government body looking to put an end to fraud in the post-acute space.  
 
The California Department of Public Health's Emergency Regulations for Hospice Agencies went into effect on June 22, 2026. Key changes include stricter guidelines around licensing and changes in ownership; 24/7 nursing coverage requirements; a two-hour response time expectation; and a caseload limit of 12 patients per licensed nurse. 
 
The state regulations also introduced intensified documentation and medical record requirements, geographical requirements to limit oversaturation of providers in certain areas and increased training and clinical care standards.