LAS VEGAS (KTNV) — You only get one chance to say goodbye.
Families trust hospice to deliver dignity, comfort and compassion in life's final chapter. However, state officials warn some operators are exploiting a system designed to care for the dying.
For years, respected Las Vegas hospice providers have warned that some operators may be putting profits ahead of patients. Lawmakers added safeguards in the 2025 legislative session, but advocates say critical gaps remain and vulnerable families are making end-of-life-decisions in a system they often don't understand.
We investigated what families face when searching for hospice care.
WATCH | Part 1 of 13 Investigates investigation into Las Vegas hospices:
Caring for the dying has become big business in Clark County. But sometimes, the care isn't there.
A report submitted to state leaders and lawmakers shows hospice generates some of healthcare's biggest profits for the least effort.
Medicare pays providers a fixed daily rate per patient and requires certain services, but payments flow regardless of care delivered. Most hospice care happens at home where oversight is minimal. That, combined with weak licensing, has created opportunities for massive Medicare and Medicaid fraud.
In late May, the feds launched a nationwide crackdown on hospice and home health companies.
WATCH | Nationwide moratorium announced for new Medicare enrollments by providers of hospice and home care:
Nevada followed two weeks later after being flagged for high fraud risk, something Karen Rubel, CEO of non-profit Nathan Adelson Hospice, has warned about for years. We first discussed her concerns in April.
"When we first met, you were frustrated," I said. "Why?"
"Well, I was frustrated because we weren't seeing any kind of definable action," she replied.
Rubel applauds Nevada's six-month freeze on new licenses and Medicaid enrollments for hospice and home health providers. The Nevada Health Authority said the moratorium will help them validate current providers' legitimacy.
Gov. Joe Lombardo said the pause will help NHA "identify fraudulent providers, strengthen accountability, and work alongside law enforcement to pursue criminal prosecutions wherever wrongdoing is found."
"I don't know if there's enough people or time to investigate all of it," Rubel said.
So, 13 Investigates took a closer look.
A grouping of 13 different hospice and home health companies brought us to a building on West Lake Mead Boulevard near Rampart Boulevard.
"I'm looking for the hospice companies that are in here," I told the receptionist when we walked in.
"Is there like a specific one?" the receptionist asked.
"365 Hospice, Accucare Hospice, Americana Hospice, Carefree Hospice, Desert Rose Home Care, Empathy Hospice. I could go on," I said. "There are about 13 of them all registered in here."
"Do you need to speak with someone from the companies?" the receptionist asked.
When I said yes, the receptionist said she didn't believe anyone was in the office at the moment.
"There's a whole bunch of suite numbers," I said. "Are you saying you don't think there's anybody in any of those suites?"
"I believe in two of them, I have people right now," the receptionist said.
The practice is known as clustering — a term used by regulatory auditors to describe an unusually dense concentration of hospice or home health licenses at a single address, strip mall or office space.
"That is a red flag because why would 12 hospices that weren't connected to anything or anyone of the same owner be registered at the same address?" Rubel said.
California banned hospice clustering after an audit found co-locating was a red flag for fraud, especially without corresponding patient population growth.
You can read those documents below:
"Because what is going on there?" Rubel questioned. "If you go there, you know, someone should be there answering the door, answering the phone, be available, or there should be a contact number."
Back at the Lake Mead building...
"What they said is basically, the owners are not allowing you guys to go back to the office," the receptionist told us.
"Why not?" I asked. "Why don't the owners want to talk to us about their businesses if their businesses are legitimate?"
"I don't know," the receptionist said. "They just said that they don't allow the access to our businesses."
"How about they come out here," I asked.
"They just didn't want to talk to anyone," the receptionist told me.
I called all their publicly listed numbers. Many were disconnected or out of service. Some led to generic voicemails with no business name. My messages and emails went unanswered. Those I reached claimed to be out of business, being sold or awaiting Medicare enrollment.
Only one, Las Vegas Home Health, claimed to be operational and gave us a glimpse into a smaller agency's journey. Vilik Harutyunyan, who's listed in federal Medicare records as the CEO, told me on the phone that he's a registered nurse.
Our background check and his LinkedIn page show he's affiliated with multiple medical businesses in the Los Angeles area, including a hospice, immunity center and more.
He explained that Las Vegas Home Health is only seeing a few patients because they're still seeking a provider number, so they can't bill Medicare or Nevada Medicaid yet. There's nothing improper about any of that. We later learned he is working to sell the business.
State records show Las Vegas Home Health hasn't had a smooth road. It had its initial licensure survey in late 2024. The state reviewed files for four employees hired two years prior, finding a problem — none contained required felony conviction affidavits. Those documents confirm whether employees are convicted felons.
The state gave Las Vegas Home Health two weeks for documentation, but the agency "failed to provide" it. They also failed to prove employees were competent caregivers with proper credentials. Records show three of the four employees "were replaced with new staff members" who submitted all the required documentation.
You can read that document below:
We visited another hospice cluster and got conflicting answers about who's operating, who's serving patients and who's even open. Our investigation led us to a building on Paseo Del Prado near Sahara Avenue and Rancho Drive. Medicare enrollment and state licensing records show 10 hospice and home health companies at this address.
"Prime Care, Pura Care, TrueServe, Uniteam, not seeing any of them," I remarked while looking at the building's business directory.
WATCH | Part 2 of 13 Investigates investigation into Las Vegas hospices:
We started at Jireh Healthcare Services.
"Well, it says their office hours are 9 to 5, Monday to Friday," I said. "We are right in the middle of that."
I knocked on the door to see if anyone would answer.
"Hello. It's Darcy Spears from Channel 13. Is anyone in there?"
Seeing no one, I looked in the mail flap.
"Oh. It's dark. Definitely nobody in there."
My voicemail for their director went unanswered. Upstairs, Healthplus Hospice had a sign directing us to another suite.
"It's like a wild goose chase."
So did a sign for Crosslink Hospice, which said they had moved to a different suite. At a fourth suite...
"There are three different hospice or health services listed here."
The office was empty, so I called the number on the sign and reached a woman who identified herself as Ashley Flores. Public records list her as a manager for several current and past businesses at this address. She called herself a consultant.
Flores wouldn't go on camera but agreed to answer questions, including about Mojave Hospice — one of the businesses on the sign. She told me they're newly licensed and they have no patients.
We found people working in an office upstairs.
"Are you Mojave or are you Crosslink?" I asked.
"Yeah," the front desk receptionist told me, wearing medical gloves. "We're just a new company."
"Mojave is new, I know, and still doesn't have any patients yet, according to the woman I just spoke to," I said.
"No," he replied.
"You do have patients?" I questioned.
"Yeah," he said. "We do, currently, right now."
"You do?" I asked.
"Yeah," he said. "We're both a home health and hospice."
He brought us to his manager.
"There's two hospice company names on the door and I'm trying to find someone from one of them," I said.
"Let me check with," she said as she walked out of the office. She returned, telling me Mojave Hospice isn't open yet.
"OK," I said. "Well, he just told me it is."
"Well, we're not operating yet so it's just home health," the manager said.
"What about Crosslink?" I asked. "That's a hospice company who has a name on the door. So who's that?"
"Well, that was us but we closed," the receptionist told us.
"You closed Crosslink?" I questioned.
"Yeah," he said.
"So there's a sign on the door for a business that does not exist," I said.
"Well, it's still existing. It's just that we don't have any patients at the moment," he said. "We're just in transition."
I sought clarification from Flores.
"With you helping Mojave to set up as a new company, why do you think there's so many?" I asked. "Is there that big a need?"
She said the need is not there and she said businesses she's worked with open and close frequently because it's hard to get patients.
"Why do you think there's so much fraud, waste and abuse in the industry?" I asked Flores.
Because it's easy, she said, citing weak oversight and regulation.
We shared our findings at both cluster addresses with the NHA. In an email, an agency spokesperson said "to ensure a fair process..." it "cannot confirm or deny if there is currently an ongoing investigation into these providers," adding NHA is "always appreciative of these matters being brought to our attention, and we encourage anyone in the community who may suspect an instance of fraud to report it to the Medicaid Inspector General."
So with all the uncertainty, documented fraud, and ongoing investigations into alleged waste and abuse, how do you choose a reputable hospice when you need one?
We found it can be difficult for families to meaningfully research providers. Medicare's hospice compare website helps, but smaller hospices have no reporting requirements, making it difficult to assess the quality of care.
I tested that by checking Nevada's Health Care Quality and Compliance website. Under the "For Consumers" tab, I clicked on "Hospice Comparison." That took me to Medicare.gov. I typed in the 89128 ZIP code, where the Lake Mead address is, and up popped 74 hospice agencies serving just that area. For most, no rating was available because "the number of cases is too small to report..."
Nevada law requires every hospice to be nationally accredited, have a licensed physician as medical director and provide medical, nursing, psychological and pastoral care, plus social services matching the patient's condition. Hospices must also provide supportive services for the patient's family.
Rubel told me Nathan Adelson Hospice had 155 transfers in 2024 alone from families fleeing other hospices due to subpar care.
"They were saying, well, we had never seen a nurse. We couldn't get our medication," Rubel said. "When we called after hours for crisis management, we were told to go to the emergency room."
She also helped a family who was turned away when trying to get a pacemaker fixed at a local hospital.
"The hospital came back and said, well, you're technically enrolled in hospice and so we cannot do the procedure," Rubel told me. "They were surprised that they were enrolled in hospice."
In June, the FBI pushed out an alert about fraudulent Medicare billing for hospice patients, including those enrolled in hospice without their knowledge.
Christopher Delzotto heads the FBI's Las Vegas office. He said tackling this persistent problem requires a whole-of-government approach.
"It's the dollars and cents but it's also the patient harm to me. That's the priority," he told me. "From our perspective, we need tips, complaints, and referrals, and people to bring that information to us so we can investigate it properly. It's also an education for everyone that pays into healthcare. Perhaps there's some legislative controls that can be implemented."
The legislature passed AB161 in the last session. It took effect on July 1. It targets "license flipping" to evade regulatory scrutiny, imposes strict operational and staffing evaluations during a hospice's first two years, and establishes a hospice patient bill of rights.
Rubel said it's a good start.
"But we didn't really feel it had enough teeth," she told me.
Nevada's Hospice Coalition told us at a recent meeting that they plan to push for tighter regulations in the 2027 session. Rubel said the moratorium will help, but it didn't come soon enough.
"There are over 300 hospices just in Clark County," Rubel said. "That's not the state of Nevada. That's just in our county, and that is too many."
So what can families do while the state works to separate legitimate providers from questionable ones? Families can check out ChoosingHospice.org, where you'll find help to ask the right questions when researching and choosing a hospice, guidance on what to look for in a good hospice and what red flags to watch for.
You can also report potential fraud to the inspector general's office.