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The CAHPS Hospice Survey is a national survey of family members or friends who cared for a patient who died while under hospice care.

The Hospice survey includes measurements such as:

  • Communication with family
  • Getting timely help
  • Treating patient with respect
  • Emotional and spiritual support
  • Help for pain and symptoms
  • Training family to care for patient
  • Rating of this hospice
  • Willing to recommend this hospice

Survey results are open to the public and published as part of Care Compare on the website (CAHPS® Hospice Survey | CMS, 2020).

CAHPS Obstacle: Perception

The CAHPS measurements are questions of perception.

The survey does not go to the person who received your agency’s care, the survey goes to the primary caregiver. The questions are asking for their perception of how their loved one was treated and how their loved one felt during the worst moment of that person’s life and through the trauma the family experienced.

You can do everything right, better than right, and it may not matter. The person responding to the survey is operating under a different set of expectations and a wildly different perspective.

On top of that, there is a massive knowledge imbalance. Your agency is full of hospice professionals. You’ve most likely dealt with the issues this patient and family is suffering through many times before. You know the regs. You know what to expect. You know hospice, the survey respondent doesn’t. Studies show that when people feel a knowledge imbalance, it negatively impacts their feelings of loyalty and trust (Sullivan et al, 2020), their perception of your agency.

To get survey respondents to respond to the survey with the perception and understanding that your agency delivered exceptional care to their loved one, you need to overcome these challenges and build the positive feelings of trust and loyalty, just like in any relationship.

Your CAHPS Secret Weapon: Empathy

Empathy is the key to building the perception of trust and loyalty. Across every industry, product, and service, loyalty is the strongest determinant of behavior (Hoffmann, 2013). Developing loyalty requires empathy and consistency to reach customers on an emotional plane and create and maintain psychological impact.

Empathy is often confused with sympathy. When people hear the word empathy they imagine a soft-spoken hand-holding teary-eyed scenario; that’s sympathy or pity, which is nice, but it’s not empathy. Empathy means understanding the other person’s perspective, understanding what is important to that survey respondent. Empathy is how you recognize their expectations and gauge if your agency has made them feel as if they’ve been met.

How do you use empathy to form and build a strong positive emotional relationship?

The answer is so super-simple and extremely practical that it is almost shocking: Responsiveness.

The CMO Council has found that fast response time is the single most important factor in how customer’s feel about you.

From the perspective of the patient, family, and caregivers, your customers, they expect a response in 15 minutes with anything over an hour considered a failure. It doesn’t matter if you think that’s unreasonable. What matters is their expectations and their perspective, that’s empathy. Your customer, your survey respondents, need to have seen and heard that throughout their loved one’s stay on care, your agency was consistently responsive.

Think about it like this: if you called your bank or credit card company to question a charge, how long would you wait to speak to someone before getting frustrated? Is a question a patient or family member has about hospice less important than an unrecognized Amazon charge on your statement?

Responsiveness doesn’t mean solving the problem in 15 minutes. It means someone has made contact and then regularly follows up. And 15 minutes is generous. That’s enough time to meet expectations so they don’t have a negative impression of your agency, to at least stay neutral. A response in 5 minutes or less will create positive impact and if done consistently, will improve their perception which has direct correlation on response rates.

Tips to Improve

  • Have an easy central number that immediately gets routed to a live person.
  • Link your mobile devices through a central digital phone system so if patients or loved ones call clinicians directly, they can leave a message or be connected to someone else live in real-time.
  • If patients or loved one’s text clinicians directly, make sure auto reply is always set when the clinician is unavailable.
  • Don’t just rely on the telephone. Provide an email address for patients and families to reach out to and set autoresponders and track follow up times.
  • Leverage your website and social media as communication tools where messages get routed from any online medium to a central hub for immediate response.
  • Most importantly, create a culture of responsiveness. Mandate, educate, and reward staff for speed of communication.

Not every agency has the resources to implement technological solutions to help with speedy responses. Every agency has the ability to make responsiveness a core value.

To quote Maya Angelou, “People will forget what you said. People will forget what you did. But people will never forget how you made them feel.”

How Hospice Tools Helps

The Hospice Tools CAHPS Dashboard flows from your caregiver contact list when a patient status changes from admitted to expired. The caregiver contact list allows you to define which caregivers are primary. Many systems can over-automate you into a problem by automatically sending the data.

However, often, who you list as primary when a patient comes on care changes over time, or the caregiver demographic data changed or is incomplete. The Hospice Tools CAHPS dashboard allows you to download the report before sending to your CAHPS survey provider to ensure the information is accurate and to fix errors before sending to your survey provider.

References, (2020),,family%20caregivers%20and%20hospice%20patients. (2017),

Hoffmann, N. (2013). Loyalty. In loyalty schemes in retailing: A comparison of stand-alone and multi-partner programs. (NED-New edition, pp. 21–52). Peter Lang AG.

Sullivan, M. W., Jones, M. T., Reynolds, C. L. (2020, July) The Auto Buyer Study: Lessons from in-depth consumer interviews and related research. Joint Staff Report of the Bureau of Economics and Bureau of Consumer Protection Federal Trade Commission.

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