Your Guide to the 2025 Hospice CAHPS Survey Changes

For hospice organizations, an important part of delivering compassionate, high-quality care is staying current with regulatory changes. One key update to understand is the 2025 revision of the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) survey. These changes, which went into effect in April of 2025, impact everything from survey structure to data submission protocols.

In this article, we’ll take a look at what’s changed in the new version of the survey, the impact on public reporting, and how your organization can stay compliant and succeed with this transition. 

Understanding Hospice CAHPS

The CAHPS Hospice Survey is a standardized, national survey of family members or close friends of patients who passed away while receiving hospice services. Administered after the patient’s death, the survey captures the caregiver’s perspective on the quality of care provided, from communication and symptom management to emotional and spiritual support.

Hospice CAHPS serves three important purposes:

• Public reporting: Information is publicly posted to help families select a hospice provider.

• Quality improvement: Internal benchmarking helps organizations identify areas for growth.

• CMS compliance: Participation is required to avoid a 4 percent annual payment update (APU) reduction.

Given the sensitive nature of this survey, it’s essential to prepare nursing staff to understand and implement the latest version of the survey with care and confidence.

What’s Changing in 2025?

CMS finalized key changes in the FY 2025 Hospice Payment Rule, including a new survey version, expanded response options, and revised measures. Here’s what to expect:

New Survey Version 

Starting with Q2 2025 decedents, the new version of the survey (QAG 11.0) will replace all prior versions. Surveys for these decedents will begin on July 1, 2025, and data must be submitted by November 12, 2025. 

Action item: Be sure to collaborate with your CAHPS vendor to preview and validate data before submission to CMS.

New Survey Modes: Introducing Web-Mail

CMS is introducing a web-mail mode: an email invitation followed by a mailed survey if there’s no initial response. This adds to the existing mail-only, phone-only, and mixed modes. Other changes to survey modes include: 

• A pre-notification letter sent 1 week before the survey.

• Extended response window: 49 days (up from 42).
  

Action item: Check with your CAHPS vendor to confirm if they support the new web-mail mode and consider collecting caregiver email addresses during or shortly after admission.

Survey Structure and Question Changes

CMS is shortening and refining the survey by: 

• Reducing the number of questions from 47 to 39.

• Simplifying the language to make the survey more accessible to grieving caregivers.

• Removing three outdated items, including one confusing question on contradictory communication. 

• Creating a brand new measure, Care Preferences, that includes these two questions:

  • “Did the hospice team provide care that respected your family member’s wishes?”

  • “Did the hospice team make an effort to listen to the things that mattered most to you or your family member?”

• Streamlining the language of the Hospice Team Communication measure. 

• Making minor updates to the Getting Hospice Care Training measure for clarity. 

Impact on Public Reporting and Star Ratings

While survey changes take effect in 2025, public reporting will be delayed for the new measures until eight quarters of data have been collected. This ensures accuracy and fairness in star ratings.

Until then, star ratings will be based on a temporary set of seven measures versus the usual eight. Full integration of new measures into public reporting is anticipated by February 2028.

Avoiding Compliance Risks

Hospice providers must submit both Hospice Item Set (HIS) and CAHPS data on time and accurately through a CMS-approved vendor, with noncompliance resulting in a four percent reduction to your APU reimbursement.

Exemptions include: 

• Size exemption: Fewer than 50 eligible decedents are included in the reference period.

• New provider exemption: CMS provides a one-time exception for newly certified hospice organizations. 

A quick note on HIS: It’s worth mentioning that HIS will be replaced by the Hospice Outcomes and Patient Evaluation (HOPE) assessment tool on October 1, 2025. HOPE will require more frequent and detailed patient assessments, along with more narrow submission timelines. If your team is beginning to plan for HIS, don’t miss our on-demand webinar, overview article, and three-part course series to help you succeed with the transition. 

Preparing Your Organization for CAHPS

Adapting to the 2025 Hospice CAHPS survey changes requires both awareness and action. Whether your organization is already preparing or just starting to get up to speed, these steps can help ensure a smooth transition and ongoing success with the new survey. 

Collaborate with Your CAHPS Vendor

Don’t assume your vendor is automatically implementing the updated survey or the optional web-mail mode. Proactively confirm:

• They are prepared to administer the QAG 11.0 version starting with Q2 2025 decedents.

• They support the web-mail mode if your organization chooses to use it.

• You will preview submitted data together to ensure accuracy before it’s uploaded to CMS.
  

Maintaining close communication with your vendor reduces the risk of late or incorrect submissions that could trigger the four percent APU penalty. 

Understand and Train on the Updated Survey

Organization and team leaders should ensure that they: 

• Understand what’s changed, including shortened length, revised language, and new measures like Care Preferences.

• Train clinical and administrative staff on what’s being measured and how survey content has shifted.

• Equip teams with clear guidelines on what they can and cannot say to patients and families about the survey.
  

Review Compliant Communication Practices

Staff may inform families that they will receive a Medicare survey and which vendor will be contacting them, but they may not:

• Preview the survey with families.

• Offer incentives or try to influence responses.

• Ask similar questions outside the official survey.
  

Action item: Include survey information in your admission materials, then follow up later in the hospice stay with a reminder delivered to caregivers. 

Implement Internal Quality Checks

Treat this transition as the launch of a new clinical and compliance process that includes: 

• Routine quality checks to verify data integrity before submission.

• Ensuring accurate caregiver identification, as the survey must go to the correct designated caregiver for each decedent.

• Regular data audits to avoid CMS compliance flags.
  

Prepare to Collect Email Addresses

If you plan to use the web-mail mode, begin building systems now to collect email addresses for the primary caregiver. Consider gathering this information either at admission or soon after, depending on the expected length of stay. Ensure staff are trained to collect this data respectfully and securely. By establishing these workflows early, you’ll avoid scrambling later and improve your survey response rates.

How Medbridge Can Help 

Navigating regulatory changes like CAHPS 2025 is easier with the right partner. The Medbridge Hospice Ecosystem offers a comprehensive digital solution tailored to hospice care that integrates easily with existing processes and delivers high-quality training in an accessible format. By preparing nurses to confidently take on the challenges of hospice, our solution improves staff confidence, quality of care, and regulatory compliance. It includes: 

• Role-specific onboarding and education for nurses, aides, social workers, chaplains, volunteers, and more.

• Interactive compliance courses aligned with CHAP and ACHC standards.

• Clinical Procedure Manual: Trustworthy, expert-reviewed procedure guidance at the point of care, with hospice-specific skills. 

• Hospice Outcomes and Patient Evaluation (HOPE) assessment training: An in-depth series to help organizations prepare for the launch of HOPE in October 2025. 

• Live and on-demand webinars focused on key industry topics, including our recent “Hospice CAHPS Survey Updates: Preparing For 2025 Changes” with expert Jennifer Kennedy, Vice President of Quality, Standards, and Compliance at Community Health Accreditation Partner (CHAP). 

Want to learn more about Medbridge for hospice? Schedule a demo today.