The Home Health industry is preparing for a significant HHCAHPS survey update that will take effect on April 1. The HHCAHPS survey has not been updated since its original implementation, and the changes taking effect April 1 represent a significant overhaul.
As part of this update, four of the six current medication-related questions will be completely removed. In addition, three questions asking patients whether they received nursing services, therapy services, and similar care will be eliminated. Another question will also be removed, one that did not perform well, that asked whether staff discussed the services patients would receive at the start of home health care.
With the removal of these items, several new questions will be added. In total, three new questions will be introduced. One of these specifically asks whether the patient felt the agency cared about them as a person. This question has the potential to be a real game changer and will appear as question number 11 on the survey. The concern is that when patients reach this question, it may shape how they think about the rest of the survey. If they feel they were not truly seen, heard, or treated as a person, or that care felt task-focused rather than centered on their overall well-being, it could influence their responses to every question that follows.
Other new questions follow a similar theme. The second added question, which will be question number 12, asks whether family members were given enough information to care for the patient in your absence, to the extent the patient desired. This question requires careful attention, especially when there is an additional person in the home who may not have been involved previously. It is important to identify who that person is, whether they are typically involved in the patient’s routine care, and to obtain the patient’s permission, assuming the patient is cognitively able, before sharing health information. This question ultimately focuses on whether family and friends received sufficient information about the patient’s care, as much as the patient wanted, and that second part of the question should not be overlooked.
As the updated survey is rolled out, questions are likely to arise. A crosswalk to reflect how these changes affect the outcome measures will be calculated as a results of these changes moving forward. For example, under the Value-Based Purchasing Model, there were five HHCAHPS-related measures in 2025. With the revised survey, that number will be reduced to two, since many of the questions previously used in the Value-Based Purchasing Model are being removed from the survey.
Along those same lines, the outcome measures and HHCAHPS Star Ratings will also need to be updated to align with the new survey, reflecting both the removal of certain questions and the addition of new ones.
Please be sure to meet with your HHCAHPS vendor before April 1 to confirm they are fully prepared to administer the updated CAHPS survey and are ready to support your organization throughout 2026.
One of the major questions during the Proposed and Final Rule process for home health HHCAHPS was whether an email version of the survey would be allowed, similar to what was approved for hospice. The answer is no.
In the Final Rule, the email version of the survey was specifically addressed and noted as having been tested with poor results. As a result, the HHCAHPS survey will not be distributed by email at this time. If you feel strongly about this decision, as I do, and believe an email option would be beneficial, it is important to share your concerns with CMS. The HHCAHPS website includes an email address for submitting questions or feedback related to the survey, and I encourage you to provide comments there if you believe an email version would be helpful.
If you need assistance with interpreting your HHCAHPS data or with ongoing staff education related to the survey content so your team is fully prepared to perform effectively and support positive patient responses, please reach out to us.
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