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The CAHPS Hospice Survey response rate for the upcoming public reporting period, first quarter of 2017 through the fourth quarter of 2018 (1/1/2017 through 12/31/2018) is 32%. The response rate for the current public reporting period, fourth quarter of 2016 through the third quarter of 2018 (10/01/2016 through 09/30/2018) is 32%.

How does your agency’s response rates compare?

Tips to Increase Your Hospice CAHPS Survey Response Rates

1. Branding

Building a strong brand is key to the health of your agency. Most CAHPS survey vendors will include your hospice agency’s logo on the survey cover letter. Leverage your brand so that when the caregiver receives the Hospice CAHPS survey it will increase the chance they will respond.

A few examples of how to promote your brand:

  • Throughout the hospice experience make sure all staff wears branded uniforms/name-tags.
  • Direct caregivers to your agency website/social media page as a resource.
  • Make sure all literature left with caregivers is branded properly.
  • Provide branded products such as brochures, pens, magnets and other leave behinds.
  • Make sure email signatures are properly formatted with your agency logo.
  • Especially if you’ve rebranded at some point, make sure your CAHPS survey vendor has your updated logo.

Wherever you have the opportunity to cement the brand of your agency with the caregiver, the greater likelihood they will keep your agency at the top of their mind and treat the CAHPS survey as an important and official event and not merely another company’s customer satisfaction survey

2. Choose Who Gets the CAHPS Hospice Survey

Selects the right caregiver to receive the survey. Don’t simply default to the spouse or P.O.A.

Here is a section from  the CMS  Quality Assurance Guidelines v6.0, Sept. 2019: One caregiver category does not automatically have preference over another. Hospices should not prioritize a primary informal caregiver that is a family member over a friend, as a friend may have more knowledge regarding the decedent’s hospice care than a family member.

Often we find that hospice agencies simply select the spouse or P.O.A. but that may not be the person actually most involved or knowledgeable about the hospice care that was provided. The most involved caregiver will provide the best quality feedback and most complete responses.

  1. Select the person most knowledgeable about the care the patient received.
  2. Because you may select someone other than the spouse or P.O.A, make sure you capture and send all of the necessary contact information so that the survey is received by the caregiver without delay.
  3. Identify the best language for the caregiver and identify the languages your survey vendor provides.
3. Education

Make sure caregivers are aware that they may receive a survey. Raising awareness should start from the first meeting with the patient & caregiver and continue through bereavement.

However, be aware of the CMS regulations regarding communicating with caregivers about the Hospice CAHPS survey, especially as it regards the language you use to communicate and how that may insert bias into the responses.

Check out the CMS  Quality Assurance Guidelines v6.0, Sept. 2019

Here are some of the key highlights from CMS regarding use of language to discuss the CAHPS survey with caregivers:

Certain types of communications are not permitted because they may introduce bias in the survey results. For instance, hospices/survey vendors are not allowed to:

  • Ask any CAHPS Hospice Survey or CAHPS Hospice Survey-like questions of caregivers prior to administration of the survey
  • Attempt to influence or encourage caregivers to answer CAHPS Hospice Survey questions in a particular way
  • Imply that the hospice, its personnel or agents will be rewarded or gain benefits for positive feedback from caregivers by asking caregivers to choose certain responses, or indicate that the hospice is hoping for a given response, such as a “10,” “Definitely yes” or an “Always”
  • Indicate that the hospice’s goal is for all caregivers to rate them as a “10,” “Definitely yes” or an “Always”
  • Offer incentives of any kind for participation in the survey
  • Invite or ask the caregiver if they want to participate in a survey or suggest they can “opt out” of the survey
  • Show or provide the CAHPS Hospice Survey or cover letters to caregivers while they are in the hospice or at any time prior to the administration of the survey
  • Mail or distribute any pre-notification letters or postcards after patient death to inform caregivers about the CAHPS Hospice Survey

Examples of statements that comply with CAHPS Hospice Survey protocols include

  • “We are looking for ways to improve your family member’s stay. Please share your comments with us.”
  • “What can we do to improve your family member’s care?”
  •  “We want to hear from you, please share your experience with us.”
  • “Please let us know if you have any questions about your family member’s treatment plan.”
  • “Let us know if your family member’s room is not comfortable.”
4. Additional Surveys & Supplemental Questions

We strongly recommend that you don’t go down this road.  1st, there is a great risk in trying to thread the needle between gaining valuable insight and not crossing CMS regulations regarding language that may present bias in respondents to the CAHPS survey. More importantly though,  people generally don’t like surveys:

1. Survey respondents by and large feel surveys are a waste of their time and don’t believe their responses will have any impact: “They (the survey sender)won’t even read it”

2. Privacy fears: where will all this  information go?

3. WIIFM  “What’s In It For Me?” The truth is, surveys are for your benefit, not the respondents.

Additional surveys or supplemental questions will most likely lower your CAHPS hospice survey response rate.

Rather than asking more questions of a primary caregiver who recently lost someone, make sure your agency is:

  1. Selecting the right caregiver to receive the survey
  2. Educating the caregiver to be aware that they will receive the survey
  3. Providing correct & complete information so the survey reaches the right person in the right time
  4. Leveraging your brand so the caregiver recognizes the survey


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