CAHPS Hospice Measures, Explained for Operators
The CAHPS Hospice Survey asks the family caregiver of a patient who died in your care how that care went. Since April 2025 it has 38 questions and nine measures. Submitting it protects your full Medicare payment update, and the scores feed your Care Compare star rating and the Special Focus Program algorithm.
What the survey is, and who answers it
The survey goes to the primary informal caregiver, usually a family member or friend, of a patient who died while receiving hospice care (AHRQ). You do not run it yourself. An approved survey vendor fields it on your behalf and submits the data to CMS.
Four modes are allowed: mail only, telephone only, mail with telephone follow-up, and, since April 2025, web-mail, which starts with an email invitation and follows up by mail. Web-mail is optional, and not every vendor offers it. If you want it, ask your vendor before the quarter you plan to switch.
The survey's administration rules limit what you can say to families about it. Follow your vendor's guidance on that, and spend your effort on the care the survey asks about instead.
The nine measures
Since April 2025 the survey produces six composite measures and three single-item measures (AHRQ). Each one turns on a moment your staff own.
| Measure | Type | The moment it turns on |
|---|---|---|
| Communication With Family | Composite | The update after the IDG meeting, and whether anyone called the daughter who lives two states away |
| Getting Timely Help | Composite | The call at 9:00 p.m. when the breathing changed |
| Treating Patient With Respect | Composite | How the aide spoke to him on the days he could not answer |
| Emotional and Spiritual Support | Composite | Whether the chaplain and social worker reached the family, not only the patient |
| Help for Pain and Symptoms | Composite | The first night after a medication change |
| Care Preferences | Composite, new in April 2025 | Whether you asked what mattered to him, and whether the plan of care showed you heard |
| Training Family to Care for Patient | Single item, revised in April 2025 | The kitchen-table lesson on the medication box and the positioning wedge |
| Rating of Hospice | Single item | All of the above |
| Willing to Recommend This Hospice | Single item | All of the above, said to a neighbor |
The family answers after the death. They are scoring the weeks before it.
What is riding on it
Three things, and they work differently.
Your payment update depends on reporting, not on scores. The Hospice Quality Reporting Program is pay-for-reporting: CMS checks that your CAHPS data, your HOPE data and your claims data were submitted completely and on time, not how well you scored (CMS). Since FY 2024, a hospice that misses the requirements loses 4 percentage points from its annual payment update. A vendor contract that lapses for one quarter is a payment problem, whatever your scores were.
Your scores are public. CMS reports CAHPS Hospice results on Care Compare, updated quarterly, and they drive the CAHPS star rating families see when they compare hospices. The new Care Preferences measure and the revised training measure join public reporting only after eight quarters of data under the new survey, so the old and new versions will sit side by side for a while.
Four measures feed the Special Focus Program. The program's algorithm uses Help for Pain and Symptoms, Getting Timely Help, Willing to Recommend and Rating of Hospice to help identify poor-performing hospices (CMS FY 2025 final rule fact sheet). CMS paused the program in February 2025 so it could further evaluate it. Check the CMS Special Focus Program page for its current status before you plan around it.
What changed in April 2025
The FY 2025 hospice final rule revised the survey for patients who died from April 2025 onward (AHRQ):
- Shorter. The questionnaire went from 47 questions to 38, with simpler wording.
- One new measure, one rebuilt. Care Preferences was added. The multi-item training measure became a single item.
- A new mode and a new letter. Web-mail joined the other three modes, and a pre-notification letter now goes out before the survey.
- A longer window. The field period was extended from 42 to 49 days.
If you plan to use web-mail, the practical change starts at admission: you need the primary caregiver's email address, collected and confirmed while the patient is on service.
Where scores are made
The survey arrives after the death. The work that moves it happens in four places while the patient is alive.
The night call. Getting Timely Help and Help for Pain and Symptoms are decided when a family calls after hours and either reaches a clinician who can see the chart, or reaches a message. Hospice already has to provide nursing and physician services around the clock under 42 CFR 418.100(c)(2). The survey asks the family whether it felt that way.
The family update. Communication With Family is built in the hours after each IDG meeting. If the plan changed and nobody told the family, the measure has already moved.
The kitchen table. Training Family is one question now, but the moment behind it has not changed: a caregiver who was shown once, in a hurry, will say so.
The first conversation. Care Preferences asks whether the team learned what mattered to the patient. That is an intake question and a plan-of-care question before it is a survey question.
Where QliqSOFT fits
QliqSOFT works on those four moments. Quincy reaches family caregivers by plain text on the phone they already have, with real-time translation, and scored check-ins that cross a threshold escalate to your team in QliqCHAT. The IDG Channel keeps the team on one thread, so the decision from the meeting is in front of whoever calls the family next. And AI Voice Agents answer the night call in your hospice's name and route it to your own on-call clinician.
None of it touches the survey itself, and none of it should. It changes what the family remembers.
A useful exercise this quarter: pull the last ten families who called after hours, and ask how many reached a clinician on the first try. That number is an early read on Getting Timely Help, months before CMS reports it.
Frequently asked questions
What is the CAHPS Hospice Survey?
The CAHPS Hospice Survey is a CMS survey sent to the primary family caregiver of a patient who died while receiving hospice care. It asks about the care the patient and family received. An approved vendor administers it, and the results are publicly reported on Care Compare. Since April 2025 it has 38 questions.
What are the CAHPS Hospice measures?
Since April 2025 the survey produces nine measures. Six are composites: Communication With Family, Getting Timely Help, Treating Patient With Respect, Emotional and Spiritual Support, Help for Pain and Symptoms, and Care Preferences, which is new. Three are single items: Training Family to Care for Patient, Rating of Hospice, and Willing to Recommend This Hospice.
How does CAHPS Hospice affect hospice payment?
Payment depends on participation, not scores. The Hospice Quality Reporting Program is pay-for-reporting, and since FY 2024 a hospice that fails to meet its reporting requirements, including CAHPS, loses 4 percentage points from its annual payment update. Scores affect the public star rating, and four measures feed the Special Focus Program algorithm.