CAHPS Hospice Survey: 2025 update FAQs
Coming in 2025, updates to the CAHPS Hospice Survey are extensive. Agencies that will achieve success under these changes are preparing now to educate their staff and gain a deeper understanding of what’s to come.
This blog is the second in a two-part series explaining these hospice updates where we answer your most pressing questions.
Communicating about the survey
Q: Can hospices include a note about the CAHPS survey in their patient/family handbook?
A: Hospices can let all caregivers know that they may receive a survey, but there are restrictions and guidelines that must be followed to prevent bias in survey results:
- If informing caregivers, must notify all (all or none)
- Cannot ask or share any CAHPS Hospice Survey (or similarly worded) questions
- Cannot attempt to influence, encourage answers or offer incentives
- Cannot imply you’ll be rewarded for specific responses
- Cannot ask if they want to participate or to opt out
- Cannot show any survey materials, including the envelope it comes in
For more information about communicating about the survey, see page 12 of QAG v11.0.
Q: When can we start to use the informational flyer?
A: Hospices can begin to use the new informational flyer now by including it within bereavement packets provided to caregivers after the patient’s death.
Q: Can we make changes to the informational flyer?
A: Hospices may not change the wording or layout of the informational flyer except to include your hospice logo and the survey vendor’s name and logo.
Q: Where can I find the informational flyer?
A: If you are a MatrixCare CAHPS Survey customer, you can download the MatrixCare version of the informational flyer, with our vendor name and logo already added, along with instructions for adding your logo from our Hospice CAHPS portal. For all others, the CMS-published template is available from the Forms section of the CAHPS Hospice Survey website.
Q: Are the prenotification letter and informational flyer the same thing?
A: Although both the prenotification letter and the informational flyer are used to notify caregivers about the survey, there are several key differences:
Selecting a primary caregiver
Q: Who should be selected as the primary caregiver?
A: The CAHPS Hospice Survey is designed to be administered to the person who is most knowledgeable about the hospice care received by the decedent. The hospice is responsible for identifying one primary caregiver who is eligible to receive the survey.
For more details about selecting a primary caregiver, see page 29 of QAG v11.0.
Q: Who is eligible to receive the CAHPS Hospice Survey?
A: Survey vendors identify if decedent/caregivers are eligible to receive the CAHPS Hospice Survey based on meeting the following criteria:
- Decedent age 18 or over at time of death
- Decedent with death at least 48 hours (admission date + 2 days)
- Decedent has a caregiver of record
- Caregiver is a familial legal guardian (not a paid or non-familial legal guardian)
- Caregiver has a US or US Territory home address
Monthly data files
Q: Should we remove live discharges before sending to our vendors?
A: Yes. The monthly decedent/caregiver list should include a record for all patients who died, excluding any “no publicity” records. Hospices must report the total number of patients discharged alive during the month in your CCN-specific monthly counts, but no individual records should be provided.
Survey materials
Q: Are hospices allowed to make any changes to the cover letter?
A: CMS has simplified the wording for both the initial and follow-up cover letters and strongly recommends hospices use the wording provided. Additional options for cover letters are outlined on page 42 of QAG v11.0, however, any modifications to the standard templates will need to be reviewed and approved by MatrixCare if you are a customer, or by your current survey vendor. Additional fees may apply.
Q: Does my survey vendor or the hospice send the prenotification letter?
A: Your survey vendor must send the prenotification letter, as it is required as part of the survey administration process and can only be mailed by them.
Survey administration
Q: How do I select which survey administration mode we would like to use?
A: For all MatrixCare customers, we will be reaching out to our hospice customers to discuss mode selection as well as new survey materials (prenotification letter, cover letters, supplemental questions) that will be used starting with April 2025 deaths.
Q: Can we use a combination of mail-only and web mail mode, depending on the caregiver’s preference?
A: No. Your hospice must select one mode of survey administration.
Web mail mode
Q: If I am using web mail mode, will each survey recipient receive both a web survey and a mailed survey?
A: Caregivers designated to receive the survey may receive up to two email invitations followed by up to two mailed surveys, if a response is not received. A paper survey will not be mailed if a web survey has already been completed.
Q: Will the link to the web survey expire?
A: Yes. Access to the web survey will be turned off once a survey with survey responses has been submitted via web or returned through the mail, or at the end of the 49-day fielding period.
Q: If multiple surveys (web and/or mail) are returned, which one is used?
A: Survey protocols require vendors to use the first survey returned with responses as the “official” survey. Responses from this survey are submitted to CMS and are used in reporting/measure calculations.
Q: If a caregiver enters responses into the web survey, but doesn’t click “Submit,” will the responses be provided to CMS?
A: Responses entered into the web survey, but not officially submitted, are reported to CMS if a paper survey was not returned. Responses provided on the paper survey would be used in place of a partially completed web survey.
Reporting
Q: How will publicly reported measures and Star ratings be affected by the transition to the new survey?
A: Measures will be publicly reported on Hospice Compare quality and used to calculate Star ratings when eight quarters of data are available. The table below identifies when the measures will be publicly reported — dates are based on Hospice Compare Refresh timing:
Q: How will MatrixCare report results during the transition period/when data are available from surveys administered before and after implementation of the new survey?
A: MatrixCare’s Hospice CAHPS reports will include data from both the current and new survey questions, displaying scores for measures and questions based on the report date range selected and whether the measure was significantly impacted by changes in the survey question set:
- Measures and questions with no or minor changes will not change; data from the old and new survey will be aggregated into the measure calculations
- Questions that were removed and are no longer included in the new survey will be reported if the end date of the report date range is March 2025 or before
- Newly added questions and measures will be reported as responses from the new survey are received
Additional resources
Webinar: Your guide to understanding the FY25 Hospice CAHPS Survey updates
Watch this webinar to:
- Gain key insights into how hospice care will be assessed and reported.
- Explore the latest changes to survey measures and public reporting.
- Learn updated requirements, key deadlines, and consequences of non-compliance.
- Discover actionable steps to effectively prepare for the upcoming survey changes.
Website: CAHPS Hospice Survey
- QAG v11.0 & Updated handout from annual training
- Appendix M: Examples of supplemental questions
- Appendix N: Informational flyer
- Appendix O: Prenotification letter
- Appendix P: Mail materials
- Appendix Q: Telephone script
- Appendix R: Web survey materials
Website: Hospice Compare
Connect with us today to learn how we can help you prepare for CAHPS Hospice Survey success.
Liz Silva
With over a decade of valuable experience in the healthcare industry, Liz is a seasoned professional who specializes in working closely with home health and hospice organizations. Her expertise lies in determining strategic needs and seamlessly integrating and utilizing data for informed decision-making. Liz’s proficiency in product management enables her to design user-friendly and quality-driven solutions that empower clients to analyze and comprehend results effortlessly.
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