Hospice currently serves approximately 42% of dying patients in the United States. Medicare covers most hospice patients under a benefit created in 1983 to provide palliative care at the end of life. Despite its 30-year history as a Medicare benefit, to date no single survey has been systematically administered by all hospices across the country to assess experiences of hospice care. This submission requests approval for national implementation of the CAHPS® Hospice Survey and as well as approval for a mode experiment to test for mode effects, if any, when the survey is implemented. The CAHPS® Hospice Survey will sample caregivers of patients who died while under hospice care. Survey administration will start between 2 and 3 months after the death of the patient. The sample will be provided by the hospice program. This information will ultimately be used to improve hospice care throughout the country. The mod experiment is intended to determine what mode effects, if any, are found while implementing the survey. Three modes will be tested: mail-only, telephone-only, and mixed-mode (mail with telephone follow up). The mode experiment will occur simultaneously with the first year of National Implementation of the survey, which is also covered as part of this submission.
The latest form for CAHPS Hospice Survey CMS-10537) expires 2023-12-31 and can be found here.
Document Name |
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Form and Instruction |
Supporting Statement B |
Supporting Statement A |
Supplementary Document |
Supplementary Document |
Revision of a currently approved collection | 2024-07-10 | ||
Approved without change |
Extension without change of a currently approved collection | 2023-04-18 | |
Approved without change |
Revision of a currently approved collection | 2020-06-01 | |
Approved without change |
Revision of a currently approved collection | 2017-08-07 | |
Comment filed on proposed rule and continue |
Revision of a currently approved collection | 2017-05-04 | |
Approved with change |
New collection (Request for a new OMB Control Number) | 2014-08-29 |
Federal Enterprise Architecture: Health - Health Care Services
Form CMS-10537 | CAHPS Hospice Survey - Telephone | Printable Only | Form |
Form CMS-10537 | Hospice Experience of Care Survey - Mail | Printable Only | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.