More than one in three patients are leaving hospices in America alive, according to new research.
The findings raise questions about the hospice sector, which is supposed to focus on providing care to terminally ill patients.
But the growing number of people leaving hospices alive could show that the sector is riddled with inadequate care and poor amenities, or that some are enrolling patients who are not really dying in order to increase their profits, the Washington Post suggests.
The number of "hospice survivors" is particularly high in the neighbouring south-eastern states of Mississippi and Alabama where 41% and 35% of hospice patients were discharged alive respectively.
It is normal for hospices to release a small portion of patients before they die - around 15% has been typical in the past - often because a patient's health unexpectedly improves. But researchers have found that the rate of those leaving hospice care alive is often double that or more.
The research has been lead by Dr Joan Teno at Brown University hospice and will be published in the Journal of Palliative Medicine.
Dr Teno said: "One part of the reason is some of the new hospice providers may not have the same values - they may be more concerned with profit margins than compassionate care.
"When you have a discharge rate that is as high as 30%, you have to wonder whether a hospice programme is living up to the vision and morality of the founders of the hospice."
A patient must have a life expectancy of six months or less to enrol in federal-funded hospice care in the US, according to Medicare rules.
Researchers on the report suggest that some of the hospices involved appear to be abandoning patients when their care becomes too expensive. To support this they discovered that one in four patients who leave a hospice alive are hospitalised within 30 days.
It may also be the case that hospices are enrolling patients who are not dying or are many years from death in order to claim money from the federal Medicare fund, which guarantees access to health insurance for retired people over 65. The federal government has in recent years sought to recover more than $1 billion (£593m) from hospices that were found to have illegally billed Medicare for patients who were not near death.