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Understanding Hospice Ratings & Quality Information

Learn how Medicare ratings, family surveys, reviews, and accreditations can help you choose a hospice provider.

Written and reviewed by a board-certified hospice & palliative medicine physician

Last reviewed:

12 min read

When choosing a hospice, families may see star ratings, percentages, reviews, and accreditation logos. These come from different sources and measure different parts of the hospice experience.

Understanding what each one means—and what it does not mean—can help you make a more confident decision.

Key point: Medicare does not publish a single "overall quality score" for hospice care. Each rating reflects a specific perspective and should be considered together.

Medicare Star Rating (Family Experience)

CMS formal name: Family Caregiver Survey Rating (Care Compare)

What we call it on our site: Medicare Star Rating (Family Experience)

What this rating measures

This is the only star rating Medicare publishes for hospices. It reflects how family caregivers rated their experience with a hospice, based on responses to the national CAHPS Hospice Survey.

The rating summarizes family feedback across multiple experience areas, including:

  • Communication with the hospice team
  • Getting timely help
  • Emotional and spiritual support
  • Respect and dignity shown to the patient
  • Help with pain and symptom management

How the star rating is calculated

After hospice care ends, family caregivers may be invited to complete a standardized Medicare survey.

Centers for Medicare & Medicaid Services analyzes survey results and assigns 1 to 5 stars based on how a hospice compares with others nationwide.

A hospice must have at least 75 completed surveys during the reporting period to receive a star rating.

Why some hospices don't have a star rating

A hospice may not display a Medicare Star Rating (Family Experience) if:

  • It has not yet reached the minimum number of completed surveys
  • It is newer or serves a smaller number of patients
  • CMS survey data is still being processed

Important: A missing star rating does not mean poor care. It often means there is not enough survey data yet.

Limitations

This rating reflects family experience, not clinical outcomes. It does not measure staffing levels, visit frequency, or medical results. Ratings are updated periodically and may not reflect very recent changes.

CAHPS Family Survey

CMS formal name: CAHPS Hospice Survey – "Recommend Hospice" Measure

What we call it on our site: CAHPS Family Survey

What this score shows

This score reflects one specific question from the national CAHPS Hospice Survey:

The percentage of family caregivers who gave the most favorable response when asked whether they would recommend this hospice.

CMS reports this as a percentage (0–100%).

Example: "Families who would definitely recommend this hospice: 92%"

This means that 92% of responding family caregivers selected the most positive answer.

How this differs from the star rating

  • It reflects a single survey question, not a summary of all experience measures
  • It provides a clear, direct signal of family recommendation
  • Public reporting requires at least 30 completed surveys

Limitations

The score reflects family perceptions and experiences. Response rates can be limited due to the emotional timing of the survey. Results are reported after care ends, so there is a time delay.

Other Medicare Hospice Quality Information (No Stars)

Medicare reports additional hospice quality information separately on Care Compare.

Hospice Care Index (HCI)

  • Claims-based Medicare measure
  • Scored from 0 to 10
  • Reflects patterns of care between hospice admission and discharge
  • Not converted into stars

Hospice Quality Reporting Program (HQRP)

HQRP is the Medicare program that collects hospice quality data, including:

  • CAHPS survey results
  • Claims-based measures
  • Clinical data submissions

HQRP is not a rating and does not produce a single score.

Google Reviews

What they are

Google Reviews are voluntary, public reviews left by families and others on Google Business profiles.

They may include:

  • Personal stories and experiences
  • Recent feedback
  • Comments about staff, communication, or responsiveness
  • A 1–5 star average

Limitations

Reviews are not standardized or verified. People with very positive or very negative experiences are more likely to leave reviews. Review counts vary widely between hospices.

Tip: Look for consistent themes across reviews rather than focusing on a single comment.

Accreditations and Certifications

Medicare Certified (Required)

All hospices serving Medicare patients must:

  • Meet federal hospice requirements
  • Undergo regular state surveys
  • Comply with patient rights and safety standards

This is the minimum requirement for providing hospice care.

ACHC — Accreditation Commission for Health Care

  • Voluntary accreditation
  • Indicates compliance with additional quality and operational standards
  • Typically renewed every three years

CHAP — Community Health Accreditation Partner

  • Voluntary accreditation
  • Focuses on quality improvement and organizational accountability
  • Typically renewed every three years

We Honor Veterans

National program focused on veteran-centered hospice care. Recognizes hospices through progressive participation levels. Indicates training and programs to support veterans and their families.

Key Takeaways

  • The Medicare Star Rating (Family Experience) summarizes family experience across multiple survey questions
  • The CAHPS Family Survey shows how often families would recommend the hospice
  • Missing ratings don't automatically indicate poor quality
  • Accreditations are voluntary and complementary
  • Speaking directly with a hospice team remains essential

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