CAHPS Hospice Survey Methodology

The CAHPS Hospice Survey is the CMS-required, vendor-administered survey of the primary informal caregivers of deceased hospice patients, used to measure family-reported experience of care for the Hospice Quality Reporting Program (CMS CAHPS Hospice Survey page)^[1]. Hospices with 50 or more survey-eligible cases in a reference year must participate to receive their full Annual Payment Update (CAHPS Hospice Survey fact sheet, January 2026, https://www.hospicecahpssurvey.org/globalassets/hospice-cahps4/home-page/cahps_hospice_survey_fact_sheet_january-2026.pdf).

Hospices must contract with a CMS-approved third-party survey vendor and provide decedent and caregiver data to that vendor monthly (CAHPS Hospice Survey fact sheet, January 2026, https://www.hospicecahpssurvey.org/globalassets/hospice-cahps4/home-page/cahps_hospice_survey_fact_sheet_january-2026.pdf). Survey administration begins two months after the month of the patient's death, and the fielding period runs up to 49 calendar days from initial contact. The survey is administered in one of four approved modes: Mail Only, Phone Only, Mail with phone follow-up, and Web with mail follow-up. On sampling, hospices with 50 to 699 survey-eligible decedent/caregiver pairs in the prior calendar year must survey all eligible cases, while hospices with 700 or more must survey a minimum sample of 700 and may elect a census. Hospices with fewer than 50 survey-eligible pairs in the reference year may file for a size exemption, and hospices that received their CCN after January 1 of the data collection year are exempt for that year only. CMS introduced a revised 38-question instrument beginning with Q2 2025 decedents, adding a Care Preferences measure and updating question wording (CAHPS Hospice Survey scoring guidance)^[2]. Results are publicly reported on Care Compare using a rolling eight quarters of data, with refreshes in February, May, August, and November (CMS CAHPS Hospice Survey page)^[1].

The CAHPS track is the compliance obligation most susceptible to being missed, because it runs on a monthly vendor handoff rather than on anything the clinical staff touches directly. A single month of missed data files to the vendor can jeopardize the full APU, making vendor oversight a parallel compliance requirement alongside iQIES timeliness monitoring. The 50-case threshold is a meaningful operational line: crossing it triggers mandatory full monthly participation, and hospices operating near it face a status change if case volume rises. Because scores are built on a rolling eight quarters, a weak stretch of caregiver experience lingers in public results for two years, which means CAHPS performance reflects actual care and bereavement follow-up sustained over time, not end-of-period effort.