You’ve probably felt the pressure:
- Surveyors want proof that your agency listens to patients
- QAPI requires you to use feedback for improvement
- CMS mandates participation in standardized surveys
Meanwhile, you’re balancing staff shortages, billing headaches, and endless documentation demands. Patient satisfaction surveys can feel like “one more thing” on the compliance checklist.
But, patient satisfaction surveys are also a valuable tool your agency can use to learn and improve processes. Done right, patient satisfaction surveys protect you from deficiencies and help you deliver better care.
*This article was written in consultation with Mariam Treystman.
At The Home Health Consultant, we’ve walked hundreds of agencies through the process of setting up and using patient satisfaction surveys. We know the nuances of CMS requirements and accreditor expectations.
In this article we’ll break down what’s required for patient satisfaction surveys, and what’s smart practice, for your agency.
What Are Patient Satisfaction Surveys and Why Are They Required?
Patient satisfaction surveys capture the experiences of patients and caregivers. They measure things like, but not limited to:
- Timeliness of care
- Communication
- Whether patients felt involved in their care plan
CMS requires agencies to collect and use this feedback as part of their Quality Assurance and Performance Improvement (QAPI) program.
Surveyors expect to see both the surveys and evidence that you’re using the results to improve care. In other words, it’s not enough to just collect the data, you also need to act on it.
What Is the Role of CAHPS in Patient Satisfaction Surveys?
CMS runs an official patient satisfaction survey: CAHPS. There are different branches of CAHPS for home health and hospice:
These are standardized, third-party surveys that agencies above a certain patient census must participate in.
If your agency is enrolled in HHCAHPS or Hospice CAHPS, you’ve met CMS’s requirement and you don’t need to run additional surveys. That said, many agencies choose to add their own supplemental surveys to gather agency-specific feedback.
Smaller agencies often fall below the CAHPS threshold, but that doesn’t mean you don’t have to conduct patient satisfaction surveys. To learn how to file for a CAHPS exemption waiver and see if you qualify, check out the article below.
Why Should Agencies Collect Their Own Surveys?
If you don’t meet the CAHPS patient threshold, you must run your own surveys. Even if you do meet the CAHPS threshold, you may still want to:
- Add agency-specific questions (e.g., timeliness of a particular service).
- Collect more frequent feedback to identify problems earlier.
- Supplement the standardized CAHPS data with insights more relevant to your daily operations.
Pro Tip: A simple but effective patient survey question is, “Were you involved in the creation of your care plan?” This not only provides useful feedback but also gives you documentation that directly ties back to CMS’s patient rights requirements.
What Methods Work Best for Collecting Patient Satisfaction Surveys in Home Health & Hospice?
Agencies have flexibility in how they collect satisfaction data. A few of the most common methods include:
- Phone surveys: Randomly calling patients with standardized questions.
- Paper surveys: Handed out or mailed, often at discharge or alongside the Notice of Medicare Non-Coverage, with stamped return envelopes.
- Clinician-led surveys: Performed during supervisory visits or competency checks.
- Caregiver/family interviews: Especially important in hospice, where caregivers often provide the most accurate perspective.
An easy way to work surveys into your agency’s processes is to print the survey, and place it in patient home folders, with a self-addressed pre-stamped envelope. This keeps them visible and makes it easy for patients or families to fill them out at their convenience.
Should Home Health & Hospice Patient Satisfaction Surveys Be Anonymous?
This is a balancing act. There are pros and cons to each option.
- Anonymous surveys encourage honesty but limit your ability to follow up on individual complaints.
- Identified surveys let you respond directly but may discourage some patients from being truthful.
Whatever you decide, never present a survey as anonymous if it’s not. That’s misleading, and if patients complain about it later, it can reflect poorly on your agency’s reputation to surveyors, referrers and other patients.
How Should Home Health & Hospice Agencies Use Patient Survey Data Once It’s Collected?
Collecting data is step one, actually using it is step two. Surveyors want to see that you integrate results into your QAPI program and performance improvement plans.
Here are a few examples of how to use the data:
- Flagging discrepancies between documentation and patient reports (e.g., patients saying “the nurse didn’t visit as often as expected” when documentation says otherwise).
- Confirming compliance with requirements, such as patient involvement in their plan of care.
- Tracking patterns that suggest training gaps or process breakdowns.
What Policies Should Agencies Have Around Patient Satisfaction Surveys?
Your policy should explain how and when you conduct surveys. But don’t overpromise. Policies should meet CMS’s minimums, but you don’t need to go beyond unless you have the resources to keep it up.
If your policy says you’ll survey every patient every month, but you only manage to do it quarterly, surveyors can cite you twice: once for not completing the task and once for not following your own policy.
Instead, set a realistic frequency (e.g., at discharge or quarterly samples) and follow it consistently.
How to Maintain Compliant Patient Satisfaction Surveys for Home Health & Hospice Agencies?
Patient satisfaction surveys are required by CMS and must feed into your QAPI program. CAHPS meets the requirement for larger agencies, but smaller agencies still need to collect their own.
Patient surveys don’t have to be complex. A combination of paper, phone, and caregiver surveys can give you the compliance proof you need.
Focus on making surveys consistent, honest, and integrated into QAPI. Don’t just collect the data, use it to identify and fix problems.
Patient satisfaction surveys are just one piece of the compliance puzzle. To see what other logs your agency should be keeping, check out our article: Compliance Logs Every Medicare-Certified Agency Should Keep.
*Disclaimer: The content provided in this article is not intended to be, nor should it be construed as, legal, financial, or professional advice. No consultant-client relationship is established by engaging with this content. You should seek the advice of a qualified attorney, financial advisor, or other professional regarding any legal or business matters. The consultant assumes no liability for any actions taken based on the information provided.
