CAHPS Hospice Survey Results

Case-Mix Adjustments for Q2 2017 – Q1
2019 Publicly Reported CAHPS Hospice
Survey Results
Overview

Prior to public reporting, hospices’ CAHPS Hospice Survey results are adjusted for
the effects of both mode of survey administration and case mix. Steps for calculating
top-, middle-, and bottom-box scores for public reporting, including adjustment for
mode of survey administration, are available at
http://www.hospicecahpssurvey.org/en/scoring-and-analysis/.

Data from a mode experiment, as well as CAHPS Hospice Survey national
implementation data, were used to develop and validate the variables to be included
in the CAHPS Hospice case-mix model. In order to estimate the exact case-mix
coefficients as accurately as possible, we employ the large sample size of each
quarterly national publicly reported data set. This approach allows us to detect
changes in the association of case-mix adjustors and CAHPS Hospice Survey
measures over time and then adjust accordingly. This approach is consistent with
recommended CAHPS practice for case-mix adjustment
http://www.ahrq.gov/cahps/.

As described on http://www.hospicecahpssurvey.org/en/scoring-and-analysis/,
case-mix adjustment is performed within each quarter of data after data cleaning
and after mode adjustment. Coefficients obtained in linear regression models
estimate the tendency of caregivers to respond more positively or negatively. The
adjustments needed to counter that tendency are obtained by multiplying the casemix coefficients by (-1.0). Tables 1 through 11 below report case-mix adjustments
for each question composing a publicly reported CAHPS Hospice Survey measure
top- or bottom-box score for the most recent 8-quarter rolling reporting period: Q2
2017 – Q1 2019. 1 As an example, caregivers aged 18-44 were 3.36% less likely to
provide the most positive response (“Definitely yes,” the top-box response) for the
Willing to Recommend this Hospice item (“Would you recommend this hospice to
your friends and family?”) when compared to the reference group of caregivers aged
55-64. Thus, the corresponding adjustment for caregivers aged 18-44 relative to
caregivers aged 55-64 for the top-box score of that measure is an addition of 3.36%,
reflected in the “3.36%” entry in Table 6.
Note that bottom-box adjustments for items in the Emotional and Spiritual Support
composite are not needed, as this measure has no middle-box score.
1

http://www.hospicecahpssurvey.org

1

Publicly reported CAHPS Hospice Survey measure scores are adjusted to the overall
national mean of case-mix variables across all reporting hospices (as reported in
Table 12). Thus, whether the scores of a given hospice are adjusted upward or
downward for a given measure depends not only on these case-mix adjustments,
but also on the case mix of that hospice relative to the national average of these
case-mix characteristics. Specifically, the total case mix-adjustment for a given
hospice is the sum of a series of products, where each product multiplies the
adjustments in Tables 1-11 by the difference between the hospice’s mean on the
corresponding case-mix variable and the national mean on that case-mix variable
(from Table 12).

Four sets of numbers are needed to calculate final case-mix adjusted top- or bottombox scores for a given hospice for a given quarter: (1) Mean top- or bottom-box
scores of the items that compose each CAHPS Hospice Survey measure for the
hospice in question that have been adjusted for survey mode; (2) item-level casemix adjustments from Tables 1-11 of this document; (3) that hospice’s means on
case-mix variables; and (4) national means on case-mix variables from Table 12 of
this document.

Variable Definitions

In this section, we provide additional detail regarding the calculation of the
response percentile variable and the definition of the primary diagnosis categories.
A hospice’s case-mix adjustment variable response percentile is calculated as
follows: for a given hospice and a given quarter, all completed surveys are ranked
based on their respective “lag times.” Lag time is the number of days between a
decedent’s death and the return of the mail survey, or the final disposition of the
telephone survey. Ranks are averaged in the case of ties. Response percentile is
calculated by dividing lag time rank by quarterly sample size. 2

ICD-9 (prior to October 2016) and ICD-10 codes are used to categorize primary
diagnosis. The 20 most common terminal diagnoses categories among hospice
patients in 2004-2009 3 were used to define diagnosis categories with an ‘Other’
category including all other diagnoses. Two of the 20 categories, ‘Debility NOS’ and
‘Failure to Thrive’ were rare in these data, and thus were collapsed into the ‘Other’
category. Further collapsing was attempted but analyses examining the predictive
ability of these diagnosis categories to predict measure scores indicated that the
only appropriate collapsing was of “Alzheimer’s Disease” and “non-Alzheimer’s
Dementias” into a single category; no other categories were combined.
Prior to Q3 2017, response percentile was calculated within month.
https://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/Hospice/Medicare_Hospice_Data.html
2
3

http://www.hospicecahpssurvey.org

2

NOTE: Beginning in Q2 2017, CMS updated the CAHPS Hospice Survey case-mix
adjustment model, simplifying categories and improving the precision of
coefficients. The updates are as follows:
• Payer for Hospice Care: categories ‘Uninsured or no payer’ and ‘Other’ were
combined
• Primary Diagnosis:
o Category ‘Other’ was split into ‘Other, Cancer’ and ‘Other, Non-cancer’
o Categories ‘Ovarian cancer’ and ‘Stomach cancer’ were combined with
‘Other, Cancer’
• Caregiver Age: Three youngest age groups (18-24, 25-34, 35-44) were
combined
• Caregiver Relationship: Category ‘Grandparent’ was combined with ‘Other’
• Survey Language/Respondent’s home language:
o Chinese language (home and survey) was removed
o Categories Spanish at home and Spanish survey language were
combined
CMS’ analyses show that once the streamlined adjustments are implemented,
hospices with a high proportion of caregivers who respond to the survey in Spanish
may experience decreases in their Emotional and Spiritual Support and Getting
Timely Help scores; changes to other measure scores will be smaller. However, by
employing the updated adjustments, scores will be more accurate than before.

Score Calculation

The formula for applying case-mix adjustment is as follows:
• Let y be the mode-adjusted hospice mean of an item that composes a CAHPS
Hospice Survey measure
• Let a1-a54 be the corresponding individual-level adjustments from Tables 111 for all rows other than reference categories
• Let m1-m54 be the national means for the CMA variables in the same rows in
Table 12
• Let h1-h54 be the CMA means for the hospice in question in the same form as
in Table 12
• Then y’=y+a1(h1-m1)+a2(h2-m2)+...+a54(h54-m54) is the case-mix and
mode-adjusted hospice score for that item

CAHPS Hospice Survey publicly reported multi-quarter hospice averages are
weighted proportionately to the number of respondent decedents/caregivers in the
hospice for a given measure in each of the quarters. Specifically, each quarter’s score
has a weight equal to the quarter’s number of decedent/caregiver respondents.
Weights are applied after case-mix adjustment and survey mode adjustment.
Adjusted scores within each quarter that are below 0 are truncated at 0; adjusted
scores within each quarter that are above 100 are truncated at 100. Rounding
occurs after case-mix and mode adjustments have been applied and after data have

http://www.hospicecahpssurvey.org

3

been combined across quarters. For public reporting purposes, CAHPS Hospice
Survey measure scores are rounded to integer percentages.

Please note: The information presented here will permit a hospice to closely
approximate the effect of case-mix adjustment on its CAHPS Hospice Survey results.
However, exact replication of published CAHPS Hospice Survey results may not be
possible because of (1) the effects of data cleaning, and (2) small differences
between the effects of quarterly case-mix adjustments and the most-recent-quarter
averages presented here. For each future quarter, Tables 1 through 12 will be
updated and will be posted on http://www.hospicecahpssurvey.org/en/scoringand-analysis/.

http://www.hospicecahpssurvey.org

4

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance
Medicare and Medicaid

http://www.hospicecahpssurvey.org

Hospice team gave you
confusing or contradictory
information about your
family member's condition
or care

Hospice team listened
carefully to you

Hospice team explained
things in a way that was
easy to understand

Hospice team kept you
informed about when they
would arrive to care for
your family member

Hospice team listened
carefully to you when you
talked with them about
problems with your family
member's hospice care

Hospice team kept you
informed about your
family member's condition

Table 1. CAHPS Hospice Survey Top-Box Case-Mix Adjustments for Communication with Family, Q2
2017 – Q1 2019

0.06%

0.08%

0.08%

0.08%

0.08%

0.06%

-7.22%
-6.00%
-5.42%
-4.73%
-4.53%
-3.40%
-1.79%
0.00%

-1.11%
-1.19%
-1.00%
-1.04%
-0.99%
-0.54%
-0.45%
0.00%

-1.66%
-1.06%
-0.40%
-0.27%
-0.74%
-0.22%
-0.26%
0.00%

-4.20%
-3.02%
-2.94%
-2.33%
-2.32%
-1.31%
-0.76%
0.00%

-0.71%
-0.71%
-0.30%
-0.34%
-0.56%
-0.34%
-0.23%
0.00%

2.38%
2.59%
2.33%
1.69%
1.15%
0.69%
0.31%
0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

2.50%
8.42%

0.60%
2.57%

0.72%
2.73%

2.49%
5.06%

1.49%
2.11%

1.32%
0.76%

5

Private insurance only
Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
http://www.hospicecahpssurvey.org

1.42%

0.60%

1.09%

0.50%

0.16%

-0.17%

0.47%
4.59%

0.28%
1.42%

0.49%
1.12%

0.20%
2.68%

0.42%
1.22%

0.27%
0.10%

0.00%
-7.76%
-6.95%
-6.68%
-8.81%
-5.47%
-5.34%
-6.06%
-8.90%
-2.77%
-9.97%

0.00%
-0.14%
0.95%
0.40%
0.11%
0.53%
0.29%
0.10%
0.22%
-0.18%
-0.34%

0.00%
0.35%
1.80%
0.05%
-0.73%
0.33%
0.93%
-0.57%
0.65%
-0.79%
0.03%

0.00%
-0.98%
-0.47%
-2.56%
-2.12%
-0.87%
-0.46%
-1.88%
-1.79%
-1.55%
-2.42%

0.00%
0.55%
1.51%
-0.52%
-0.05%
0.70%
1.01%
0.21%
0.83%
-0.57%
0.04%

0.00%
1.64%
2.06%
0.88%
0.73%
1.40%
1.34%
0.98%
1.78%
0.36%
1.62%

-9.26%
-6.39%
-5.19%
-10.20%

0.01%
0.60%
0.30%
-0.19%

0.03%
0.70%
-0.04%
-0.22%

-2.29%
-0.70%
-1.03%
-2.77%

0.39%
1.18%
0.78%
-0.32%

1.59%
2.12%
1.49%
1.28%

-2.27%

0.11%

0.15%

-0.75%

0.05%

0.59%

-4.88%
-8.59%
-8.40%

0.89%
-0.11%
0.48%

1.10%
-0.39%
0.02%

-0.40%
-1.13%
-2.02%

0.35%
0.35%
0.35%

1.61%
1.91%
1.75%

6

Other, non-cancer
Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
http://www.hospicecahpssurvey.org

-3.87%

0.14%

0.25%

-1.07%

0.23%

1.07%

-8.64%
-7.23%
-4.64%
-3.06%
0.00%

-1.74%
-0.62%
0.54%
0.76%
0.00%

2.06%
2.13%
2.22%
1.56%
0.00%

-3.24%
-1.61%
0.01%
0.39%
0.00%

-1.35%
-0.26%
0.86%
0.97%
0.00%

-4.47%
-2.30%
-0.93%
-0.10%
0.00%

0.98%
-0.86%
0.00%
0.54%
2.62%
3.85%

2.34%
0.48%
0.00%
-0.34%
2.31%
5.70%

4.30%
2.09%
0.00%
-2.48%
-1.63%
-0.14%

0.63%
-0.31%
0.00%
0.19%
4.10%
7.30%

3.31%
0.68%
0.00%
-1.13%
1.48%
4.34%

2.31%
0.82%
0.00%
-2.20%
-2.58%
-1.59%

-2.24%
-4.19%

0.18%
-1.09%

-0.66%
-1.50%

-2.28%
-2.85%

-0.12%
-1.10%

11.67%
5.68%

0.00%
4.34%
10.50%

0.00%
1.64%
3.35%

0.00%
3.13%
5.05%

0.00%
2.94%
6.59%

0.00%
2.30%
3.68%

0.00%
-0.15%
0.46%

13.44%

4.48%

6.90%

8.69%

5.53%

1.85%

-5.16%
0.00%
-1.70%

2.00%
0.00%
-2.45%

0.88%
0.00%
-2.66%

1.63%
0.00%
-2.25%

1.85%
0.00%
-2.39%

-0.29%
0.00%
-2.20%

7

Aunt or uncle
Sister or brother
Child
Friend
Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

3.84%
5.45%
-1.37%
4.52%
-0.44%

-0.72%
2.99%
1.74%
1.58%
-0.71%

-0.53%
2.09%
1.08%
-0.44%
-1.23%

1.55%
4.95%
2.68%
3.95%
-0.02%

-0.90%
2.41%
1.96%
0.79%
-0.48%

-2.43%
-0.89%
0.01%
-1.97%
-1.39%

-6.66%
0.00%

-0.76%
0.00%

-3.96%
0.00%

-3.95%
0.00%

-2.56%
0.00%

-4.31%
0.00%

8

Table 2. CAHPS Hospice Survey Top-Box Case-Mix Adjustments for Getting Timely Help and
Treating Patient with Respect, Q2 2017 – Q1 2019

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)

http://www.hospicecahpssurvey.org

Felt that the hospice team
really cared about your
family member

Hospice team treated your
family member with
dignity and respect

Treating Patient with Respect

Got the help you needed
from the hospice team
during evenings,
weekends, or holidays

Got help as soon as you
needed it when you or
your family member asked
for help from the hospice
team

Getting Timely Help

0.10%

0.09%

0.04%

0.07%

-1.86%
-1.69%
-1.21%
-1.50%
-1.43%
-0.95%
-0.67%
0.00%

-1.76%
-1.53%
-0.97%
-1.73%
-1.14%
-0.93%
-0.42%
0.00%

0.60%
0.26%
0.72%
0.27%
0.11%
0.14%
0.04%
0.00%

-0.22%
0.05%
0.58%
0.05%
-0.23%
-0.11%
-0.27%
0.00%

0.00%

0.00%

0.00%

0.00%

9

Medicaid only or Medicaid and
private insurance
Medicare and Medicaid
Private insurance only
Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases

http://www.hospicecahpssurvey.org

0.64%
2.70%
1.12%

1.22%
3.58%
1.11%

1.29%
1.31%
0.47%

1.44%
2.13%
0.66%

0.75%
1.55%

0.50%
1.04%

0.13%
0.92%

-0.05%
1.51%

0.00%
1.04%
1.87%
1.60%
0.31%
1.32%
1.39%
-0.03%
1.18%
-0.03%
0.03%

0.00%
-1.59%
0.22%
-0.80%
-1.10%
-0.95%
-0.09%
-0.66%
0.24%
-1.39%
-0.16%

0.00%
0.36%
0.57%
-0.30%
-0.18%
0.30%
0.37%
-0.46%
0.29%
-0.29%
0.07%

0.00%
0.09%
1.12%
0.01%
-0.25%
0.30%
0.89%
-0.18%
0.62%
-0.24%
0.15%

0.02%
1.59%
1.42%
0.74%

-0.99%
-0.53%
-0.72%
-1.03%

-0.02%
0.17%
0.30%
0.11%

0.05%
0.78%
0.15%
-0.23%

1.62%

0.04%

0.19%

0.29%

10

Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate

http://www.hospicecahpssurvey.org

1.05%
0.84%
1.13%
0.43%

-0.61%
0.01%
-0.63%
-0.86%

0.20%
0.00%
0.21%
0.22%

0.71%
0.08%
0.41%
0.04%

-6.42%
-3.23%
-0.61%
0.12%
0.00%

-6.77%
-4.65%
-2.14%
-0.62%
0.00%

0.05%
0.36%
0.61%
0.54%
0.00%

-0.16%
1.03%
1.59%
1.26%
0.00%

3.31%
0.45%
0.00%
-1.38%
-0.20%
1.53%

3.48%
0.75%
0.00%
-1.20%
1.11%
3.83%

2.12%
0.67%
0.00%
-0.87%
-0.67%
0.13%

3.61%
1.05%
0.00%
-1.57%
-1.03%
0.72%

0.22%
-2.05%

4.90%
1.24%

0.80%
-0.14%

-0.76%
-1.35%

0.00%
3.24%
6.52%

0.00%
0.66%
2.59%

0.00%
0.82%
1.14%

0.00%
2.39%
4.03%

9.38%

4.38%

2.01%

5.93%

11

Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
Aunt or uncle
Sister or brother
Child
Friend
Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-0.05%
0.00%
-2.67%
-1.71%
2.23%
0.16%
0.32%
-2.03%

0.27%
0.00%
-2.11%
-0.75%
2.80%
0.79%
1.51%
0.14%

0.23%
0.00%
-1.33%
-0.45%
0.99%
0.50%
0.87%
-0.19%

0.68%
0.00%
-2.70%
-0.96%
1.38%
0.47%
0.37%
-1.08%

-2.37%
0.00%

3.61%
0.00%

-1.08%
0.00%

-0.35%
0.00%

12

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance
Medicare and Medicaid

http://www.hospicecahpssurvey.org

Amount of support for
your religious and spiritual
beliefs you got from the
hospice team

Amount of emotional
support you got from the
hospice team while your
family member was in
hospice care

Amount of emotional
support you got from the
hospice team in the weeks
after your family member
died

Table 3. CAHPS Hospice Survey Top-Box Case-Mix Adjustments for Emotional and
Spiritual Support, Q2 2017 – Q1 2019

0.03%

0.02%

0.03%

0.19%
0.67%
0.85%
0.51%
0.32%
0.16%
0.09%
0.00%

2.74%
2.05%
1.95%
1.43%
1.33%
0.90%
0.35%
0.00%

-0.89%
-0.10%
0.10%
0.15%
-0.05%
0.22%
-0.01%
0.00%

0.00%

0.00%

0.00%

2.13%
1.91%

2.10%
1.31%

2.18%
1.48%

13

Private insurance only
Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
http://www.hospicecahpssurvey.org

0.17%

-0.24%

-0.03%

0.10%
0.70%

-0.06%
0.20%

-0.13%
0.45%

0.00%
0.49%
1.18%
-0.51%
-0.32%
0.69%
1.01%
0.13%
0.85%
-0.20%
0.64%

0.00%
1.82%
1.74%
0.68%
-0.61%
1.28%
1.01%
0.37%
1.52%
0.14%
1.12%

0.00%
0.29%
0.58%
-0.39%
-0.43%
0.49%
0.22%
-0.08%
0.19%
-0.32%
0.29%

0.57%
1.01%
0.60%
0.33%

1.35%
1.98%
1.07%
1.49%

0.34%
0.69%
0.16%
0.00%

0.32%

0.77%

0.26%

0.62%
0.66%
0.51%

1.55%
2.35%
1.05%

0.26%
0.76%
0.05%

14

Other, non-cancer
Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
http://www.hospicecahpssurvey.org

0.38%

0.53%

0.07%

0.43%
0.68%
1.12%
0.80%
0.00%

-2.30%
-1.48%
-0.52%
0.04%
0.00%

0.47%
0.57%
1.02%
0.79%
0.00%

2.68%
0.90%
0.00%
-1.19%
-1.44%
-0.77%

5.70%
1.83%
0.00%
-2.06%
-2.25%
-1.43%

1.19%
0.44%
0.00%
-0.54%
-0.33%
0.75%

1.97%
0.49%

3.04%
1.30%

2.34%
1.23%

0.00%
0.85%
0.89%

0.00%
1.12%
0.55%

0.00%
0.11%
-0.23%

1.85%

1.53%

0.20%

1.11%
0.00%
-1.13%

4.38%
0.00%
-1.62%

1.21%
0.00%
-0.77%

15

Aunt or uncle

Sister or brother
Child
Friend
Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-0.85%
0.66%
0.95%
-0.32%
-0.27%

-2.67%
-0.24%
1.87%
-1.91%
-0.20%

-0.12%
1.64%
1.80%
0.41%
0.27%

9.55%
0.00%

9.75%
0.00%

8.76%
0.00%

16

http://www.hospicecahpssurvey.org

Your family member got the
help he or she needed for
trouble with constipation

0.07%

0.07%

0.09%

0.12%

1.08%
0.44%
0.42%
-0.17%
-0.68%
-0.31%
-0.18%
0.00%

-0.40%
-0.80%
-0.65%
-0.81%
-0.98%
-0.29%
0.03%
0.00%

-3.72%
-3.07%
-2.21%
-2.20%
-1.60%
-1.26%
-0.65%
0.00%

-5.45%
-5.17%
-5.13%
-3.74%
-3.54%
-1.97%
-1.22%
0.00%

0.00%

0.00%

0.00%

0.00%

1.64%
3.65%

2.08%
3.47%

3.00%
6.64%

3.69%
5.93%

17

Your family member got the
help he or she needed from
the hospice team for feelings
of anxiety or sadness

Your family member got the
help he or she needed for
trouble breathing

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance
Medicare and Medicaid

Your family member got as
much help with pain as he or
she needed

Table 4. CAHPS Hospice Top-Box Survey Case-Mix Adjustments for Help for Pain and Symptoms,
Q2 2017 – Q1 2019

Private insurance only
Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
http://www.hospicecahpssurvey.org

0.51%

0.79%

2.10%

0.87%

0.46%
1.55%

-0.07%
2.76%

1.25%
2.84%

0.45%
2.97%

0.00%
1.89%
2.01%
-2.34%
-0.66%
1.73%
0.43%
-0.46%
0.84%
-0.05%
-1.81%

0.00%
-1.63%
-1.44%
-1.24%
-3.63%
-2.22%
-1.69%
-0.63%
-0.75%
-1.10%
-2.02%

0.00%
2.28%
0.53%
-0.17%
0.26%
1.05%
1.63%
1.33%
1.76%
0.23%
-0.06%

0.00%
0.42%
0.74%
-0.78%
-2.15%
-0.78%
1.29%
-0.68%
0.24%
-0.85%
-1.03%

0.17%
1.27%
1.40%
0.01%

-3.50%
-3.63%
-1.49%
-1.41%

-0.70%
0.48%
1.47%
1.55%

-2.09%
-2.05%
-0.27%
-1.16%

0.21%

-0.74%

0.42%

-0.50%

0.23%
1.17%
0.15%

-3.96%
-1.11%
-1.71%

0.03%
0.56%
0.63%

-2.39%
0.82%
-1.59%

18

Other, non-cancer
Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
http://www.hospicecahpssurvey.org

0.65%

-1.04%

1.28%

-0.69%

-0.21%
0.71%
1.36%
1.60%
0.00%

1.10%
1.74%
2.01%
1.46%
0.00%

12.86%
9.68%
6.26%
3.28%
0.00%

2.84%
3.48%
3.85%
2.80%
0.00%

2.47%
0.42%
0.00%
-0.89%
0.77%
3.57%

3.90%
0.90%
0.00%
-0.93%
2.02%
5.24%

4.30%
0.54%
0.00%
0.01%
3.48%
7.74%

3.35%
-0.33%
0.00%
0.50%
5.95%
11.20%

0.27%
-1.11%

2.67%
0.50%

2.07%
-0.46%

1.30%
-1.60%

0.00%
1.68%
2.68%

0.00%
1.68%
3.63%

0.00%
1.84%
4.74%

0.00%
3.31%
8.18%

4.47%

5.47%

6.53%

10.73%

0.46%
0.00%
-3.32%

1.05%
0.00%
-2.18%

0.62%
0.00%
-4.27%

2.80%
0.00%
-5.87%

19

Aunt or uncle

Sister or brother
Child
Friend
Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-0.37%
2.36%
0.82%
0.75%
-1.38%

-1.43%
2.75%
1.56%
0.16%
-1.33%

-0.99%
3.46%
3.13%
-0.13%
-2.88%

-2.19%
5.62%
3.55%
1.46%
-2.17%

-7.29%
0.00%

3.02%
0.00%

-1.61%
0.00%

-2.31%
0.00%

20

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance

http://www.hospicecahpssurvey.org

Hospice team gave you the
training you needed about
what to do if your family
member became restless or
agitated

A member of the hospice team
discussed side effects of pain
medicine with you or your
family member

Hospice team gave you the
training you needed about how
to help your family member if
he or she had trouble breathing

Hospice team gave you the
training you needed about if
and when to give more pain
medicine to your family
member

Hospice team gave you the
training you needed about
what side effects to watch for
from pain medicine

Table 5. CAHPS Hospice Survey Top-Box Case-Mix Adjustments for Training Family to Care for Patient,
Q2 2017 – Q1 2019

0.05%

0.06%

0.05%

0.09%

0.06%

-4.90%
-4.12%
-4.20%
-3.75%
-3.78%
-2.77%
-1.91%
0.00%

-1.28%
-1.22%
-1.69%
-1.40%
-1.83%
-1.17%
-1.06%
0.00%

-0.18%
-0.39%
-1.61%
-1.13%
-1.62%
-1.04%
-0.98%
0.00%

-1.52%
-1.99%
-2.33%
-2.46%
-3.12%
-2.21%
-1.66%
0.00%

-4.67%
-4.43%
-4.26%
-3.34%
-3.21%
-2.07%
-1.56%
0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

1.61%

0.10%

0.00%

1.41%

1.38%

21

Medicare and Medicaid
Private insurance only
Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
http://www.hospicecahpssurvey.org

6.07%
0.14%

4.65%
0.02%

4.61%
-0.04%

5.67%
1.36%

4.48%
-0.16%

0.43%
1.58%

0.20%
1.01%

0.17%
0.91%

0.34%
2.95%

0.29%
1.29%

0.00%
-2.22%
-3.05%
-4.84%
-5.98%
-3.43%
-4.33%
-3.24%
-3.97%
-1.82%
-4.14%

0.00%
-2.00%
-0.87%
-3.06%
-3.74%
-1.99%
-1.89%
-2.00%
-2.05%
-0.92%
-2.37%

0.00%
-2.57%
-2.19%
-3.09%
-4.92%
-3.63%
-3.31%
-2.78%
-2.36%
-1.31%
-4.92%

0.00%
-0.78%
-0.28%
-5.30%
-2.89%
-1.70%
-2.44%
-4.20%
-1.03%
-2.38%
-2.38%

0.00%
-2.89%
-1.12%
-2.56%
-4.37%
-1.81%
-2.46%
-0.73%
-2.61%
-0.95%
-2.82%

-4.46%
-3.06%
-2.74%
-4.62%

-2.62%
-1.82%
-1.74%
-2.65%

-4.13%
-3.07%
-2.44%
-2.76%

-1.39%
-1.21%
-1.22%
-2.21%

-3.50%
-2.23%
-1.74%
-3.19%

-2.03%

-1.28%

-1.36%

-0.27%

-0.76%

-3.02%
-3.54%

-1.72%
-2.39%

-3.12%
-2.00%

-1.61%
-0.19%

-1.87%
-2.89%

22

Other, cancer
Other, non-cancer
Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
http://www.hospicecahpssurvey.org

-4.42%
-2.75%

-2.46%
-1.76%

-2.90%
-2.25%

-1.04%
-1.55%

-3.18%
-1.56%

4.09%
2.95%
2.33%
1.08%
0.00%

2.52%
1.88%
1.83%
0.98%
0.00%

6.58%
5.34%
4.22%
2.09%
0.00%

2.54%
1.77%
1.43%
1.37%
0.00%

6.79%
5.03%
3.87%
1.74%
0.00%

0.22%
-1.26%
0.00%
1.37%
5.30%
8.81%

0.91%
-0.36%
0.00%
-0.24%
1.63%
5.53%

2.49%
-0.03%
0.00%
-0.47%
2.03%
5.99%

1.92%
-0.88%
0.00%
1.29%
6.09%
10.49%

0.51%
-0.64%
0.00%
0.90%
5.54%
9.91%

-1.20%
-3.48%

-0.49%
-1.59%

-1.31%
-1.46%

-2.49%
-2.62%

-0.57%
-2.03%

0.00%
1.93%
5.84%

0.00%
1.95%
5.04%

0.00%
1.95%
5.30%

0.00%
2.21%
5.95%

0.00%
1.35%
4.11%

7.15%

6.79%

7.11%

8.89%

5.04%

-0.41%
0.00%

-0.64%
0.00%

0.17%
0.00%

-0.79%
0.00%

2.53%
0.00%

23

Mother-in-law or father-in-law
Aunt or uncle
Sister or brother
Child
Friend
Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-5.86%

-3.96%

-4.56%

-6.93%

-4.30%

3.31%
6.01%
2.01%
3.59%
-1.57%

0.61%
2.43%
0.22%
1.42%
-1.26%

0.43%
4.06%
1.50%
0.74%
-2.04%

2.55%
5.38%
1.79%
2.74%
-1.35%

1.28%
5.32%
3.66%
3.52%
-0.07%

-9.49%
0.00%

-5.53%
0.00%

-8.04%
0.00%

-12.95%
0.00%

-6.37%
0.00%

24

Table 6. CAHPS Hospice Survey Top-Box Case-Mix Adjustments for Rating of this Hospice and Willing to
Recommend this Hospice, Q2 2017 – Q1 2019
Rating of this
Hospice
Response percentile (per 1% of response
percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and private insurance
Medicare and Medicaid
Private insurance only
Medicare and private insurance
Other
Primary Diagnosis
Alzheimer’s and non-Alzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers

http://www.hospicecahpssurvey.org

Willing to
Recommend this
Hospice

0.10%

0.10%

-0.85%
-0.51%
-0.01%
-0.29%
-0.83%
-0.21%
-0.40%
0.00%

-0.88%
-0.61%
-0.38%
-0.55%
-0.79%
-0.53%
-0.54%
0.00%

0.00%
1.86%
3.63%
0.55%
-0.02%
1.67%

0.00%
1.30%
3.04%
0.84%
0.20%
1.47%

0.00%
0.36%
1.44%

0.00%
0.73%
2.10%

25

Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other degenerative diseases
Pneumonias and other infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
http://www.hospicecahpssurvey.org

-0.63%
-0.53%
0.57%
0.83%
-0.75%
0.53%
-0.71%
-0.14%
0.03%
0.65%
0.24%
-0.33%
0.16%
-0.08%
0.21%
0.16%
-0.24%

-0.34%
-0.40%
0.83%
1.32%
-0.08%
1.26%
-0.46%
0.49%
0.30%
0.80%
0.63%
0.40%
0.29%
0.97%
0.83%
0.47%
0.45%

-1.06%
0.36%
1.50%
1.36%
0.00%

-0.03%
0.73%
1.59%
1.34%
0.00%

4.00%
1.35%
0.00%
-1.94%
-0.81%

3.36%
0.90%
0.00%
-1.02%
-0.01%

26

Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED (REFERENCE)
Some college
4-year college graduate
More than 4-year college graduate
Caregiver relationship (Decedent was the
caregiver’s ___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
Aunt or uncle

Sister or brother
Child
Friend
Other
Survey Language/Respondent’s home language
Survey language or home language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

1.35%

1.50%

-0.22%
-1.38%
0.00%
2.26%
3.81%
5.34%

1.48%
-0.14%
0.00%
1.32%
2.20%
3.07%

1.17%
0.00%
-2.54%

1.36%
0.00%
-2.20%

-0.74%
1.73%
0.93%
1.01%
-0.24%

0.13%
2.55%
1.48%
0.67%
0.18%

-3.71%
0.00%

-2.44%
0.00%

27

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance
Medicare and Medicaid
Private insurance only

http://www.hospicecahpssurvey.org

Hospice team gave you
confusing or contradictory
information about your
family member's condition
or care

Hospice team listened
carefully to you

Hospice team explained
things in a way that was
easy to understand

Hospice team kept you
informed about when they
would arrive to care for
your family member

Hospice team listened
carefully to you when you
talked with them about
problems with your family
member's hospice care

Hospice team kept you
informed about your
family member's condition

Table 7. CAHPS Hospice Survey Bottom-Box Case-Mix Adjustments for Communication with Family, Q2
2017 – Q1 2019

-0.03%

-0.02%

-0.02%

-0.03%

-0.02%

-0.02%

3.07%
2.21%
1.77%
1.43%
1.57%
1.35%
0.77%
0.00%

0.11%
-0.09%
0.00%
0.06%
0.16%
0.03%
0.15%
0.00%

-0.30%
-0.60%
-0.65%
-0.53%
-0.24%
-0.26%
-0.17%
0.00%

1.06%
0.43%
0.32%
0.20%
0.37%
0.16%
0.14%
0.00%

-0.29%
-0.65%
-0.43%
-0.42%
-0.12%
-0.09%
0.00%
0.00%

-1.06%
-1.27%
-1.15%
-0.93%
-0.60%
-0.30%
0.02%
0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

-2.03%
-5.57%
-0.70%

-0.55%
-1.44%
-0.18%

-0.57%
-0.66%
-0.16%

-1.11%
-2.94%
-0.19%

-0.72%
-1.12%
-0.03%

-1.56%
-1.24%
0.46%

28

Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
Length of hospice stay
2-5 days
http://www.hospicecahpssurvey.org

-0.45%
-2.54%

-0.06%
-0.72%

-0.25%
-0.39%

-0.03%
-1.31%

0.13%
-0.49%

0.24%
-0.10%

0.00%
4.84%
4.38%
4.80%
5.20%
3.27%
2.97%
3.85%
5.13%
2.04%
5.58%

0.00%
0.18%
-0.29%
0.60%
0.65%
0.01%
0.01%
0.06%
0.19%
0.30%
0.45%

0.00%
0.31%
-0.77%
1.23%
0.56%
-0.10%
-0.70%
0.20%
0.05%
0.53%
-0.02%

0.00%
0.94%
0.12%
1.81%
1.35%
0.34%
-0.11%
0.91%
0.77%
0.68%
1.59%

0.00%
-0.27%
-0.30%
0.82%
0.61%
-0.22%
-0.11%
0.38%
-0.19%
0.38%
0.03%

0.00%
0.10%
-0.10%
0.67%
0.21%
-0.21%
-0.49%
0.09%
-0.32%
-0.13%
-0.05%

5.10%
3.45%
3.34%
5.90%

0.31%
-0.15%
0.09%
0.46%

0.16%
-0.32%
-0.13%
0.47%

0.96%
0.14%
0.61%
1.65%

0.07%
-0.34%
-0.04%
0.48%

-0.39%
-0.40%
-0.22%
0.14%

2.14%

0.09%

0.09%

0.56%

0.23%

0.23%

3.20%
5.19%
5.09%
2.30%

-0.08%
0.40%
0.22%
-0.03%

-0.12%
0.55%
0.24%
0.15%

0.57%
0.64%
0.97%
0.31%

0.18%
0.17%
0.07%
0.06%

-0.01%
-0.22%
-0.03%
-0.22%

1.49%

-0.83%

-2.85%

-1.06%

-0.65%

-0.58%

29

6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
Aunt or uncle
Sister or brother
Child
Friend
http://www.hospicecahpssurvey.org

1.72%
1.22%
0.93%
0.00%

-0.76%
-0.75%
-0.48%
0.00%

-2.12%
-1.84%
-1.05%
0.00%

-0.95%
-1.28%
-0.80%
0.00%

-0.74%
-0.84%
-0.63%
0.00%

-0.49%
-0.37%
-0.27%
0.00%

-0.46%
0.33%
0.00%
0.08%
-0.56%
-1.09%

-0.99%
-0.27%
0.00%
0.31%
-0.12%
-1.03%

-3.08%
-1.18%
0.00%
1.31%
1.66%
1.33%

-0.74%
-0.18%
0.00%
0.46%
-0.50%
-1.88%

-1.38%
-0.46%
0.00%
0.68%
0.45%
-0.36%

-0.78%
-0.36%
0.00%
0.43%
-0.06%
-1.09%

-0.40%
0.88%

-0.83%
-0.14%

-0.58%
0.02%

-0.13%
0.44%

-1.19%
-0.14%

-11.30%
-6.38%

0.00%
-1.31%
-3.46%

0.00%
-0.36%
-0.54%

0.00%
-0.96%
-1.43%

0.00%
-0.98%
-1.83%

0.00%
-0.64%
-0.81%

0.00%
1.69%
2.10%

-4.52%

-0.90%

-2.29%

-2.74%

-1.62%

2.12%

2.46%
0.00%
0.09%
-3.37%
-3.54%
0.05%
-3.89%

-0.27%
0.00%
0.43%
-0.22%
-1.00%
-0.48%
-0.72%

-0.03%
0.00%
0.98%
0.46%
-0.29%
-0.24%
-0.20%

-0.47%
0.00%
0.55%
-1.08%
-2.22%
-1.32%
-2.19%

-0.22%
0.00%
0.61%
0.19%
-0.46%
-0.37%
-0.56%

0.05%
0.00%
0.31%
-0.10%
-0.21%
-0.31%
-0.58%

30

Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-1.00%

-0.06%

0.07%

-0.22%

0.02%

-0.59%

2.81%
0.00%

-0.01%
0.00%

1.71%
0.00%

1.58%
0.00%

0.62%
0.00%

-0.45%
0.00%

31

Table 8. CAHPS Hospice Bottom-Box Survey Case-Mix Adjustments for Getting Timely Help and
Treating Patient with Respect, Q2 2017 – Q1 2019

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance

http://www.hospicecahpssurvey.org

Felt that the hospice team
really cared about your
family member

Hospice team treated your
family member with
dignity and respect

Treating Patient with Respect

Got the help you needed
from the hospice team
during evenings,
weekends, or holidays

Got help as soon as you
needed it when you or
your family member asked
for help from the hospice
team

Getting Timely Help

-0.02%

-0.04%

0.00%

-0.02%

-0.01%
0.07%
-0.17%
-0.09%
0.13%
0.01%
0.11%
0.00%

0.56%
0.81%
0.39%
0.50%
0.55%
0.55%
0.13%
0.00%

-0.62%
-0.31%
-0.36%
-0.20%
-0.12%
-0.09%
-0.09%
0.00%

-0.31%
-0.55%
-0.60%
-0.48%
-0.16%
-0.21%
-0.06%
0.00%

0.00%

0.00%

0.00%

0.00%

-0.33%

-0.56%

-0.65%

-0.83%

32

Medicare and Medicaid
Private insurance only
Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
http://www.hospicecahpssurvey.org

-1.61%
-0.36%

-1.44%
-0.52%

-0.46%
-0.04%

-0.99%
-0.28%

-0.24%
-0.46%

-0.04%
0.07%

0.04%
-0.22%

0.00%
-0.43%

0.00%
0.31%
-0.25%
0.26%
0.36%
-0.01%
-0.36%
0.32%
0.01%
0.59%
0.19%

0.00%
1.00%
-0.29%
0.29%
0.63%
0.38%
-0.49%
0.34%
-0.46%
0.93%
0.01%

0.00%
-0.17%
-0.05%
0.14%
0.03%
-0.13%
-0.11%
0.03%
-0.09%
0.10%
-0.07%

0.00%
-0.13%
-0.22%
0.57%
0.39%
-0.21%
-0.36%
0.14%
-0.12%
0.24%
-0.11%

0.33%
-0.08%
-0.03%
0.35%

0.08%
0.42%
0.53%
0.59%

-0.03%
-0.17%
-0.09%
0.01%

-0.06%
-0.29%
-0.07%
0.21%

0.18%

-0.49%

-0.03%

-0.05%

0.50%
0.04%
0.24%
0.18%

0.35%
-0.39%
0.10%
0.62%

-0.01%
-0.04%
-0.05%
-0.03%

0.02%
0.25%
-0.01%
-0.05%

33

Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
Aunt or uncle
Sister or brother

http://www.hospicecahpssurvey.org

-1.08%
-1.08%
-1.25%
-0.87%
0.00%

3.12%
2.36%
1.23%
0.24%
0.00%

-0.60%
-0.43%
-0.33%
-0.20%
0.00%

-0.99%
-0.97%
-1.04%
-0.70%
0.00%

-1.61%
-0.36%
0.00%
0.77%
0.63%
0.02%

-2.05%
-0.49%
0.00%
1.23%
-0.23%
-2.11%

-0.64%
-0.19%
0.00%
0.22%
0.25%
0.06%

-1.63%
-0.52%
0.00%
0.60%
0.71%
0.28%

-1.66%
-0.18%

-4.36%
-1.89%

-0.55%
-0.16%

-0.44%
-0.06%

0.00%
-0.56%
-1.05%

0.00%
0.40%
-0.16%

0.00%
-0.10%
-0.05%

0.00%
-0.50%
-0.62%

-1.88%

-0.75%

-0.32%

-1.24%

-0.14%
0.00%
0.65%

-0.78%
0.00%
0.28%

0.00%
0.00%
0.19%

-0.05%
0.00%
0.71%

0.31%
-0.87%

0.67%
-0.66%

0.08%
-0.06%

0.25%
-0.22%

34

Child
Friend
Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-0.36%
-0.62%
0.20%

-0.51%
-0.25%
-0.84%

0.24%
-0.15%
-0.01%

-0.14%
0.14%
0.13%

0.14%
0.00%

-4.29%
0.00%

-0.09%
0.00%

0.14%
0.00%

35

http://www.hospicecahpssurvey.org

Your family member got the
help he or she needed for
trouble with constipation

-0.01%

-0.03%

-0.04%

-0.07%

-0.62%
-0.44%
-0.42%
-0.24%
-0.08%
-0.06%
-0.12%
0.00%

-0.57%
-0.30%
-0.16%
-0.04%
0.05%
-0.09%
-0.12%
0.00%

0.26%
0.16%
-0.24%
-0.25%
-0.19%
-0.07%
-0.03%
0.00%

2.38%
1.77%
1.71%
1.34%
1.31%
0.71%
0.45%
0.00%

0.00%

0.00%

0.00%

0.00%

-0.05%
-0.51%
0.14%

-1.12%
-1.01%
-0.06%

-1.49%
-2.57%
-0.81%

-2.61%
-2.80%
-0.25%

36

Your family member got the
help he or she needed from
the hospice team for feelings
of anxiety or sadness

Your family member got the
help he or she needed for
trouble breathing

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance
Medicare and Medicaid
Private insurance only

Your family member got as
much help with pain as he or
she needed

Table 9. CAHPS Hospice Survey Bottom-Box Case-Mix Adjustments for Help for Pain and
Symptoms, Q2 2017 – Q1 2019

Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
Length of hospice stay
2-5 days
http://www.hospicecahpssurvey.org

-0.08%
-0.16%

0.49%
-0.73%

-0.68%
-0.48%

0.08%
-1.11%

0.00%
-0.45%
-0.24%
0.15%
0.10%
-0.15%
-0.24%
0.23%
-0.17%
0.23%
0.03%

0.00%
0.44%
0.94%
-0.11%
2.54%
2.56%
1.08%
-0.24%
0.41%
0.99%
0.45%

0.00%
0.44%
-0.13%
0.10%
1.28%
-0.30%
-0.32%
-1.72%
-0.53%
0.04%
0.71%

0.00%
-0.45%
-0.63%
-0.26%
1.63%
0.30%
-1.19%
-0.15%
-0.79%
0.14%
-0.23%

-0.02%
-0.09%
-0.05%
-0.17%

2.81%
3.79%
1.86%
0.04%

1.20%
0.04%
-0.33%
0.53%

0.80%
0.84%
0.02%
-0.04%

-0.02%

0.81%

0.01%

-0.20%

0.19%
0.03%
0.09%
0.07%

3.68%
0.34%
1.19%
1.17%

0.11%
0.90%
0.56%
-0.33%

1.22%
-0.85%
0.39%
0.39%

-1.11%

-1.22%

-10.70%

-6.52%

37

6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
Aunt or uncle
Sister or brother
Child
Friend

http://www.hospicecahpssurvey.org

-0.93%
-0.67%
-0.43%
0.00%

-1.01%
-0.87%
-0.31%
0.00%

-7.52%
-4.32%
-1.94%
0.00%

-5.20%
-4.17%
-2.55%
0.00%

-0.32%
-0.15%
0.00%
0.35%
0.55%
0.33%

-2.36%
-1.01%
0.00%
0.87%
0.61%
-0.72%

-3.96%
-0.97%
0.00%
0.90%
0.41%
-1.31%

-3.60%
-0.91%
0.00%
1.08%
-0.19%
-3.57%

-0.45%
0.21%

-2.71%
-1.38%

-4.65%
-1.49%

-4.60%
-0.95%

0.00%
-0.37%
-0.65%

0.00%
-0.22%
-0.32%

0.00%
0.12%
-0.58%

0.00%
-1.20%
-2.99%

-1.10%

-0.76%

-1.36%

-4.95%

0.06%
0.00%
0.24%

-0.53%
0.00%
0.47%

-0.35%
0.00%
2.03%

-2.02%
0.00%
3.13%

0.25%
-0.18%
-0.09%
-0.10%

0.73%
-0.59%
-0.37%
-0.09%

1.69%
-1.01%
-1.14%
0.44%

2.70%
-1.81%
-2.26%
0.08%

38

Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

0.40%

0.47%

1.23%

1.53%

1.05%
0.00%

-2.79%
0.00%

-0.22%
0.00%

1.41%
0.00%

39

Response percentile (per 1% of
response percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and
private insurance
Medicare and Medicaid

http://www.hospicecahpssurvey.org

Hospice team gave you the
training you needed about
what to do if your family
member became restless or
agitated

A member of the hospice team
discussed side effects of pain
medicine with you or your
family member

Hospice team gave you the
training you needed about how
to help your family member if
he or she had trouble breathing

Hospice team gave you the
training you needed about if
and when to give more pain
medicine to your family
member

Hospice team gave you the
training you needed about
what side effects to watch for
from pain medicine

Table 10. CAHPS Hospice Survey Bottom-Box Case-Mix Adjustments for Training Family to Care for Patient,
Q2 2017 – Q1 2019

-0.02%

-0.02%

-0.01%

-0.03%

-0.02%

2.12%
1.80%
1.87%
1.59%
1.58%
1.26%
1.16%
0.00%

0.24%
0.13%
0.35%
0.55%
0.71%
0.57%
0.55%
0.00%

0.02%
-0.01%
0.47%
0.64%
0.39%
0.60%
0.63%
0.00%

-0.15%
-0.05%
0.59%
0.82%
1.45%
1.34%
1.03%
0.00%

1.65%
1.43%
1.08%
0.90%
0.87%
0.56%
0.50%
0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

-1.26%
-4.24%

-0.94%
-3.76%

-1.12%
-3.48%

-1.76%
-4.75%

-1.09%
-2.86%

40

Private insurance only
Medicare and private
insurance
Other
Primary Diagnosis
Alzheimer’s and nonAlzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity
cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other
degenerative diseases
Pneumonias and other
infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
Length of hospice stay
http://www.hospicecahpssurvey.org

-0.12%

0.11%

0.25%

-0.03%

-0.26%

-0.26%
-0.91%

-0.10%
-0.59%

0.18%
-0.53%

-0.13%
-1.33%

-0.07%
-0.67%

0.00%
3.58%
3.35%
4.58%
5.58%
3.21%
3.67%
3.22%
3.94%
1.94%
4.68%

0.00%
2.67%
2.16%
2.93%
3.23%
1.96%
2.04%
2.31%
2.44%
1.04%
2.77%

0.00%
2.56%
3.09%
3.35%
4.26%
3.25%
3.26%
2.80%
2.64%
1.95%
3.55%

0.00%
1.75%
1.60%
4.82%
4.01%
1.98%
2.71%
3.62%
2.01%
1.80%
3.20%

0.00%
2.28%
1.24%
1.73%
3.08%
1.47%
1.23%
1.48%
2.24%
0.58%
2.35%

4.63%
3.40%
3.06%
5.17%

2.77%
2.11%
1.96%
2.86%

4.06%
3.03%
2.95%
3.05%

2.74%
2.05%
1.79%
2.93%

2.66%
1.69%
1.37%
2.55%

2.49%

1.81%

2.23%

2.17%

1.01%

3.39%
4.56%
4.69%
2.52%

2.39%
2.58%
2.84%
1.78%

3.40%
2.82%
3.56%
2.12%

2.45%
2.73%
2.67%
1.40%

1.66%
2.45%
2.39%
0.99%

41

2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
(REFERENCE)
Some college
4-year college graduate
More than 4-year college
graduate
Caregiver relationship
(Decedent was the caregiver’s
___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
Aunt or uncle
Sister or brother
Child

http://www.hospicecahpssurvey.org

-4.60%
-2.97%
-1.72%
-0.70%
0.00%

-1.85%
-0.91%
-0.59%
-0.17%
0.00%

-4.27%
-2.70%
-1.84%
-0.55%
0.00%

-4.12%
-2.12%
-1.37%
-0.52%
0.00%

-4.94%
-2.92%
-1.97%
-0.89%
0.00%

-0.59%
0.61%
0.00%
-0.77%
-2.61%
-4.66%

0.20%
0.21%
0.00%
-0.46%
-1.44%
-2.95%

-0.74%
-0.07%
0.00%
-0.27%
-1.36%
-3.09%

-1.05%
0.15%
0.00%
-1.12%
-3.24%
-5.20%

-0.10%
0.21%
0.00%
-0.40%
-1.78%
-4.04%

0.92%
1.25%

0.01%
0.75%

0.50%
0.14%

0.58%
0.62%

-0.79%
0.24%

0.00%
-0.79%
-2.18%

0.00%
-0.37%
-1.21%

0.00%
-0.81%
-1.43%

0.00%
-0.94%
-2.03%

0.00%
-0.39%
-0.95%

-2.57%

-1.58%

-1.90%

-3.06%

-1.40%

0.73%
0.00%
1.98%

0.87%
0.00%
1.23%

0.72%
0.00%
2.11%

1.53%
0.00%
2.57%

-0.76%
0.00%
1.00%

-3.68%
-4.37%
-0.99%

-1.97%
-1.47%
-0.22%

-1.94%
-2.28%
-0.64%

-3.79%
-3.53%
-0.84%

-1.73%
-2.60%
-1.35%

42

Friend
Other
Survey
Language/Respondent’s home
language
Survey language or home
language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-4.53%
-0.74%

-1.93%
-0.34%

-1.84%
0.55%

-2.84%
-0.20%

-2.61%
-0.72%

4.37%
0.00%

2.03%
0.00%

2.73%
0.00%

5.52%
0.00%

2.26%
0.00%

43

Table 11. CAHPS Hospice Survey Bottom-Box Case-Mix Adjustments for Rating of this Hospice and
Willing to Recommend this Hospice, Q2 2017 – Q1 2019
Rating of this
Hospice
Response percentile (per 1% of response
percentile)
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+ (REFERENCE)
Payer for Hospice Care
Medicare only (REFERENCE)
Medicaid only or Medicaid and private insurance
Medicare and Medicaid
Private insurance only
Medicare and private insurance
Other
Primary Diagnosis
Alzheimer’s and non-Alzheimer’s dementias
(REFERENCE)
Bladder cancer
Blood and lymphatic cancers
Brain cancer

http://www.hospicecahpssurvey.org

Willing to
Recommend this
Hospice

-0.03%

-0.02%

0.29%
-0.11%
-0.21%
-0.08%
0.13%
-0.06%
0.10%
0.00%

0.10%
-0.14%
-0.26%
-0.16%
0.07%
-0.05%
0.01%
0.00%

0.00%
-0.45%
-1.51%
-0.38%
-0.12%
-0.55%

0.00%
-0.13%
-0.68%
-0.17%
-0.02%
-0.22%

0.00%
0.00%
-0.97%
0.50%

0.00%
-0.29%
-1.06%
0.12%

44

Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other degenerative diseases
Pneumonias and other infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days (REFERENCE)
Caregiver Age
Age 18-44
Age 45-54
Age 55-64 (REFERENCE)
Age 65-74
Age 75-84
Age 85+
Caregiver Education
http://www.hospicecahpssurvey.org

0.49%
-0.28%
-0.51%
-0.12%
-0.48%
0.43%
-0.24%
-0.33%
-0.49%
-0.17%
0.19%
0.05%
0.18%
0.01%
-0.25%
-0.06%

0.27%
-0.37%
-0.52%
-0.38%
-0.64%
0.21%
-0.60%
-0.47%
-0.47%
-0.29%
-0.25%
0.02%
-0.23%
-0.49%
-0.40%
-0.19%

-1.01%
-1.13%
-1.36%
-0.96%
0.00%

-0.41%
-0.69%
-0.97%
-0.72%
0.00%

-1.62%
-0.52%
0.00%
0.89%
0.93%
0.24%

-1.44%
-0.49%
0.00%
0.84%
1.06%
0.89%

45

8th grade or less
Some high school
High school graduate or GED (REFERENCE)
Some college
4-year college graduate
More than 4-year college graduate
Caregiver relationship (Decedent was the
caregiver’s ___)
Spouse or partner
Parent (REFERENCE)
Mother-in-law or father-in-law
Aunt or uncle

Sister or brother
Child
Friend
Other
Survey Language/Respondent’s home language
Survey language or home language was Spanish
All others (REFERENCE)

http://www.hospicecahpssurvey.org

-0.55%
0.13%
0.00%
-0.73%
-1.11%
-1.86%

-0.58%
0.27%
0.00%
-0.79%
-1.18%
-1.94%

-0.49%
0.00%
0.71%

-0.36%
0.00%
0.55%

0.46%
-0.75%
-0.78%
-0.12%
0.02%

0.37%
-0.37%
-0.49%
0.05%
0.29%

1.66%
0.00%

0.95%
0.00%

46

Table 12. National Means of CAHPS Hospice Survey Case-Mix Adjustment
Variables, Q2 2017 – Q1 2019

Response percentile
Decedent Age
Age 18-54
Age 55-64
Age 65-69
Age 70-74
Age 75-79
Age 80-84
Age 85-89
Age 90+
Payer for Hospice Care
Medicare only
Medicaid only or Medicaid and private insurance
Medicare and Medicaid
Private insurance only
Medicare and private insurance
Other
Primary Diagnosis
Alzheimer’s and non-Alzheimer’s dementias
Bladder cancer
Blood and lymphatic cancers
Brain cancer
Breast cancer
Congestive heart failure
Chronic kidney disease
Chronic liver disease
Colorectal cancer
CVA/Stroke
Liver cancer
Lung & other chest cavity cancer
Non-infectious respiratory
Other heart disease
Pancreatic cancer
Parkinson’s and other degenerative diseases
Pneumonias and other infectious lung diseases
Prostate cancer
Other, cancer
Other, non-cancer
http://www.hospicecahpssurvey.org

National Mean

18.3%
2.5%
7.0%
6.5%
9.4%
12.0%
15.5%
19.0%
28.1%
72.3%
1.6%
5.2%
3.9%
5.5%
11.5%
15.5%
1.2%
3.2%
1.3%
2.3%
8.4%
1.8%
1.6%
3.0%
8.4%
1.8%
7.9%
5.7%
8.6%
3.0%
3.4%
2.9%
2.1%
9.4%
8.9%

47

Length of hospice stay
2-5 days
6-12 days
13-29 days
30-80 days
81+ days
Caregiver Age
Age 18-44
Age 45-54
Age 55-64
Age 65-74
Age 75-84
Age 85+
Caregiver Education
8th grade or less
Some high school
High school graduate or GED
Some college
4-year college graduate
More than 4-year college graduate
Caregiver relationship (Decedent was the caregiver’s
___)
Spouse or partner
Parent
Mother-in-law or father-in-law
Aunt or uncle
Sister or brother
Child
Friend
Other
Survey Language/Respondent’s home language
Survey language or home language was Spanish
All other

http://www.hospicecahpssurvey.org

20.2%
18.7%
18.4%
19.2%
23.5%
3.3%
9.7%
29.2%
32.2%
18.6%
7.0%
1.1%
3.5%
25.9%
32.7%
17.1%
19.8%

39.6%
45.0%
2.2%
2.2%
4.5%
1.7%
1.7%
2.9%
1.4%
98.6%

48