← Hospice Quality Reporting Program (HQRP)

CAHPS Hospice Survey

Hospice Quality Reporting Program (HQRP)

Hospice Item Set (HIS) Claims-Based Quality Measures CAHPS Hospice Survey Public Reporting (Care Compare)

CAHPS® Hospice Survey… The CAHPS Hospice Survey assesses the experiences of patients who died while receiving hospice care and their primary informal caregivers. The survey treats the patient and caregiver as a single unit of care. Its purpose is to:

      • Provide a source of information on patient/caregiver experiences that can be publicly reported to beneficiaries and their family members to help them select a hospice program,
      • Support hospices with their internal quality improvement efforts and external benchmarking with other facilities, and
      • Provide the Centers for Medicare & Medicaid Services (CMS) with information for monitoring the care provided by hospices. The survey contains 47 questions and is administered to eligible decedents/caregivers from all payer sources.

CAHPS Star Ratings

      • CMS will display overall Hospice CAHPS Star ratings on public reporting no sooner than August 2022 and will be updated every other quarter.
      • CMS will provide preview reports to providers in February and May 2022 as a dry run.

Fast Facts about Star ratings:

      • Calculation and display: The calculation and display of the CAHPS Hospice Survey Star Ratings be like that of other CAHPS Star Ratings programs such as Hospital CAHPS and Home Health CAHPS.
      • Star Ratings range: The stars would range from one star (worst) to five stars (best) like other post-acute provider types.
      • Reportability: Hospices must have a minimum of 75 completed surveys over the given eight-quarter period in order to receive a CAHPS Hospice Star Rating.
      • A hospice with fewer than 75 respondents will not receive a Star Rating; however, their measure scores may be used to determine Star Ratings cut points and may be publicly reported on Care Compare.

Calculation of Star ratings

      • Top box score: Ratings will be calculated based on “top-box” scores for each of the eight CAHPS Hospice Survey measures.
      • Hospice level score: A hospice-level score for a given survey item would then be calculated as the average of the individual-level responses, with adjustment for differences in case mix and mode of survey administration.
      • Calculation of the overall CAHPS Hospice Survey Star Rating:
          • The calculation will average the Star Ratings across the 8 measures
          • Scoring weights will be rounded to a whole number
Measure name
Scoring weight
Communication with family
1
Getting timely help
1
Treating patient with respect
1
Emotional and spiritual support
1
Help for pain and symptoms
1
Training family to care for patient
1
Rating of this hospice
1/2
Willing to recommend this hospice
1/2

CMS Star Ratings resources are located on the CMS CAHPS Star Ratings webpage

CAHPS® Measures

Measure name
Questions from the survey
Communication
with family
Family caregivers reported how often the hospice team:
  • Kept them informed about when they would arrive to care for their
    family member
  • Explained things in a way that was easy to understand
  • Listened carefully to them when they talked about problems with
    their family member’s hospice care
  • Kept them informed about the family member’s condition
  • Listened carefully to them
  • Gave them confusing or contradictory information about their
    family member’s condition or care
Getting timely help
Family caregivers reported how often:
  • They got help as soon as they needed it, when they asked the
    hospice team for help
  • They got the help they needed from the hospice team during
    evenings, weekends, or holidays
Treating patient
with respect
Family caregivers reported how often:
  • The hospice team treated their family member with dignity and
    respect
  • They felt the hospice team really cared about their family member
Emotional and spiritual support
Family caregivers reported about how much:
  • Emotional support they got from the hospice team while their family member was in hospice care
  • Emotional support they got from the hospice team in the weeks
    after their family member died
  • Support they got for their religious or spiritual beliefs
Help for pain and symptoms
Family caregivers reported whether their family member got as much
help with pain as needed, and how often their family member got
needed help for:
  • Pain
  • Trouble breathing
  • Trouble with constipation
  • Feelings of anxiety or sadness
Training family
to care for patient
Family caregivers reported whether the hospice team gave them
the training they needed about:
  • Side effects to watch for from pain medicine
  • If and when to give more pain medicine
  • How to help if their family member had trouble breathing
  • How to help of their family member became restless or agitated
Rating of this hospice
Family caregivers rated this agency on a scale of 0 (worst possible)
to 10 (best possible)
Willing to recommend this hospice
Family caregivers reported how likely they would be to recommend
this agency to other friends or family

CAHPS Survey Instruments

The CAHPS Hospice Survey Instruments posted below have been approved by OMB (mail and telephone).

Access CAHPS survey instruments HERE. 

Participation Exemption for Size Process

      • The Participation Exemption for Size process has been created to provide hospices that have fewer than 50 survey-eligible decedents/caregivers in the “reference period” (see table below) with a means to request an exemption from participation in the CAHPS Hospice Survey.

NHPCO Resource

CMS CAHPS Survey Resources: