Home Health CAHPS Survey Changes
Centers for Medicare & Medicaid Services (CMS) finalized changes to the Home Health CAHPS (HHCAHPS) survey instruments for calendar year (CY) 2026 in the CY 2026 Final Rule published on November 28, 2025. At this time, no action is required by you or your organization. Medallia will implement these changes starting with the April 2026 sample month (files uploaded and surveys administered in May 2026).
Changes to the HHCAHPS Survey
The current HHCAHPS survey has 34 questions. The updated survey will include 25 questions. Specifically, these changes include:
Addition of three new questions:
- In the last 2 months of care, how often did you feel that home health staff from the agency cared about you as a person? (Q11)
- In the last 2 months of care, did home health staff from this agency provide your family or friends with information or instructions about your care as much as you wanted? (Q12)
- In the last 2 months of care, how often have the services you received from this agency helped you take care of your health? (Q13)
Removal of medication-related questions (reduced from six to two):
- When you started getting home health care from this agency, did someone from the agency ask to see all the prescription and over-the-counter medicines you were taking? (Q5)
- In the last 2 months of care, did you take any new prescription medicine or change any of the medicines you were taking? (Q11)
- In the last 2 months of care, did home health providers from this agency talk with you about the purpose for taking your new or changed prescription medicines? (Q12)
- In the last 2 months of care, did home health providers from this agency talk with you about when to take these medicines? (Q13)
Removal of questions not used in public reporting composites:
- In the last 2 months of care, was one of your home health providers from this agency a nurse? (Q6)
- In the last 2 months of care, was one of your home health providers from this agency a physical, occupational, or speech therapist? (Q7)
- In the last 2 months of care, was one of your home health providers from this agency a home health or personal aide? (Q8)
Removal of one question that did not perform well in testing:
- When you first started getting home health care from this agency, did someone from the agency tell you what care and services you would get? (Q2)
Minor text changes to some existing questions to help clarify the question or response options, based on feedback from patients.
Impact to Public Reporting
The HHCAHPS Summary Star Rating is currently based on the Overall Rating of Care and the three composite measures that are equally weighted. With the updated survey, CMS will calculate the Summary Star Rating based on the Overall Rating of Care, the two modified composite measures (Care of Patients and Communications between Providers and Patients), and the three stand-alone measures modified from the current Specific Care Issues composite (Talk about Home Safety, Review Medicines, and Talk About Medicine Side Effects).
CMS does not plan to publicly report these new measures until there are four quarters of data. Based on this and the assumption of an April 2026 launch, CMS anticipates that the first Care Compare refresh in which publicly reported measures scores would be updated to include the new measures would be October 2027, with scores calculated using data from Quarter 2, 2026 through Quarter 1, 2027. In the interim, CMS plans to make the following available:
- Continue to publicly report the Overall Rating (and associated star rating) and Willingness to Recommend the Agency scores. HHCAHPS Survey data are publicly reported with a rolling four quarters of data (i.e., with each quarterly refresh, the oldest quarter’s data rolls off while the newest quarter’s data rolls on). The star rating score for the Overall Rating measure will continue to be calculated using four rolling quarters of data, so (as stated in the calendar year 2026 Final Rule) CMS plans to combine scores from quarters using the current and new survey and continue to create the Overall Rating star rating.
- Measure scores for the new measures will be made available to HHAs confidentially via their HHCAHPS Survey Preview Reports on the HHCAHPS Survey website after two full quarters of revised survey data are submitted.
Changes to Patient-Mix Adjustment
Patient-mix refers to characteristics of the patient that are not under control of the HHA that may affect reports of home health experiences. Patient-mix adjustment is performed within each quarter of data after data cleaning.
Based on testing the updated survey in the recent Mode Experiment, CMS found that while no patient-mix variables need to be added, the diagnosis adjustments were no longer significant. CMS has therefore proposed to drop the adjustment for diagnoses of schizophrenia or dementia with the draft updated survey.
| Current Adjustment Variable | Proposed Change |
|---|---|
| Patient age | No change |
| Patient education | No change |
| Self-reported overall health | No change |
| Self-reported mental health | No change |
| Diagnosis of schizophrenia or dementia | Removed |
| Lives alone | No change |
| Proxy respondent | No change |
| Survey language | No change |
Next Steps
- As indicated in the beginning, at this time, no action is required by you or your organization. Medallia will implement these changes starting with the 2026 April sample month (file uploaded and surveys administered in May 2026).
- Thank you for your continued partnership. As always, we are here to support you through the evolving regulatory landscape. If you have any questions, please feel free to reach out to your PS point of contact
Helpful Links
Table: Comparison of current and proposed HCAHPS survey items and survey measures
| HHCAHPS Survey, original version | Old Survey Measures | HHCAHPS Survey, updated version | Changes to the questions | New Survey Measures |
|---|---|---|---|---|
|
1.
According to our records, you got care from the home health agency, [AGENCY NAME]. Is that right?As you answer the questions in this survey, think only about your experience with this agency.
|
N/A |
1.
According to our records, you got care from the home health agency, [AGENCY NAME]. Is that right?
|
Second paragraph revised and moved prior to Question 2. | N/A |
|
2.
When you first started getting home health care from this agency, did someone from the agency tell you what care and services you would get?
|
Communications between Providers and Patients | N/A | Question was removed from the updated survey. | N/A |
|
3.
When you first started getting home health care from this agency, did someone from the agency talk with you about how to set up your home so you can move around safely?
|
Specific Care Issues |
2.
When you first started getting home health care from this agency, did someone from the agency talk about ways to help make your home safer? For example, they may have suggested adding grab bars in the shower or removing tripping hazards.
|
Question wording revised and examples provided. | Specific Care Issues |
|
4.
When you started getting home health care from this agency, did someone from the agency talk with you about all the prescription and over-the-counter medicines you were taking?
|
Specific Care Issues |
3.
Has someone from the agency ever reviewed the prescribed and over-the-counter medicines you were taking? For example, they might have asked you to show them your medicines and talked with you about how and when to take each one.
|
Several questions about medications were combined into this new question. | Specific Care Issues |
|
5.
When you started getting home health care from this agency, did someone from the agency ask to see all the prescription and over-the-counter medicines you were taking?
|
Specific Care Issues | N/A | Question was removed from the updated survey. | N/A |
|
6.
In the last 2 months of care, was one of your home health providers from this agency a nurse?
|
N/A | N/A | Question was removed from the updated survey. | N/A |
|
7.
In the last 2 months of care, was one of your home health providers from this agency a physical, occupational, or speech therapist?
|
N/A | N/A | Question was removed from the updated survey. | N/A |
|
8.
In the last 2 months of care, was one of your home health providers from this agency a home health or personal aide?
|
N/A | N/A | Question was removed from the updated survey. | N/A |
|
9.
In the last 2 months of care, how often did home health providers from this agency seem informed and up-to-date about all the care or treatment you got at home?
|
Care of Patients |
6.
In the last 2 months of care, how often did home health staff from this agency seem to be aware of all the care or treatment you were getting at home?
|
Question reworded to better capture patients’ understanding of care coordination. | Care of Patients |
|
10.
In the last 2 months of care, did you and a home health provider from this agency talk about pain?
|
Specific Care Issues | N/A | Question was removed from the updated survey. | N/A |
|
11.
In the last 2 months of care, did you take any new prescription medicine or change any of the medicines you were taking?
|
N/A | N/A | Question was removed from the updated survey. | N/A |
|
12.
In the last 2 months of care, did home health providers from this agency talk with you about the purpose for taking your new or changed prescription medicines?
|
Specific Care Issues | N/A | Question was removed from the updated survey. | N/A |
|
13.
In the last 2 months of care, did home health providers from this agency talk with you about when to take these medicines?
|
Specific Care Issues | N/A | Question was removed from the updated survey. | N/A |
|
14.
In the last 2 months of care, did home health providers from this agency talk with you about the side effects of these medicines?
|
Specific Care Issues |
4.
In the last 2 months of care, did home health staff from this agency talk with you about any side effects of your medicines?
|
The word “providers” changed to “staff”. | Specific Care Issues |
|
15.
In the last 2 months of care, how often did home health providers from this agency keep you informed about when they would arrive at your home?
|
Communications between Providers and Patients |
5.
In the last 2 months of care, how often did home health staff from this agency keep you informed about when they would arrive at your home?
|
The word “providers” changed to “staff”. | Communications between Providers and Patients |
|
16.
In the last 2 months of care, how often did home health providers from this agency treat you asgently as possible?
|
Care of Patients |
7.
In the last 2 months of care, how often did home health staff from this agency treat you with care –for example, when moving you around or changing a bandage?
|
The word “providers” changed to “staff” and question slightly reworded to provide examples. | Care of Patients |
|
17.
In the last 2 months of care, how often did home health providers from this agency explain things in a way that was easy to understand?
|
Communications between Providers and Patients |
8.
In the last 2 months of care, how often did home health staff from this agency explain things in a way that was easy to understand?
|
The word “providers” changed to “staff”. | Communications between Providers and Patients |
|
18.
In the last 2 months of care, how often did home health providers from this agency listen carefully to you?
|
Communications between Providers and Patients |
9.
In the last 2 months of care, how often did home health staff from this agency listen carefully to you?
|
The word “providers” changed to “staff”. | Communications between Providers and Patients |
|
19.
In the last 2 months of care, how often did home health providers from this agency treat you with courtesy and respect?
|
Care of Patients |
10.
In the last 2 months of care, how often did home health staff from this agency treat you with courtesy and respect?
|
The word “providers” changed to “staff”. | Care of Patients |
| N/A | N/A |
11.
In the last 2 months of care, how often did you feel that home health staff from the agency cared about you as a person?
|
New question for updated survey. | Care of Patients |
| N/A | N/A |
12.
In the last 2 months of care, did home health staff from this agency provide your family or friends with information or instructions about your care as much as you wanted?
|
New question for updated survey. | Communications between Providers and Patients |
| N/A | N/A |
13.
In the last 2 months of care, how often have the services you received from this agency helped you take care of your health?
|
New question for updated survey. | Care of Patients |
|
20.
We want to know your rating of your care from this agency’s home health providers. Using any number from 0 to 10, where 0 is the worst home health care possible and 10 is the best home health care possible, what number would you use to rate your care from this agency’s home health providers?
|
Overall Rating |
14.
We want to know your rating of your care from this agency’s home health staff. Using any number from 0 to 10, where 0 is the worst home health care possible and 10 is the best home health care possible, what number would you use to rate your care from this agency’s home health staff?
|
The word “providers” changed to “staff”. | Overall Rating |
|
21.
In the last 2 months of care, did you contact this agency’s office to get help or advice?
|
N/A |
15.
Have you contacted this agency’s office for help or advice?
|
Question shortened | N/A |
|
22.
In the last 2 months of care, when you contacted this agency’s office did you get the help or advice you needed?
|
Communications between Providers and Patients |
16.
When you contacted this agency’s office, did you get the help or advice you needed?
|
Question shortened | Communications between Providers and Patients |
|
23.
When you contacted this agency’s office, how long did it take for you to get the help or advice you needed?
|
Communications between Providers and Patients | N/A | Question was removed from the updated survey. | N/A |
|
24.
In the last 2 months of care, did you have any problems with the care you got through this agency?
|
Care of Patients | N/A | Question was removed from the updated survey. | N/A |
|
25.
Would you recommend this agency to your family or friends if they needed home health care?
|
Willingness to Recommend |
17.
Would you recommend this agency to your family or friends if they needed home health care?
|
Question is unchanged. | Willingness to Recommend |
|
26.
In general, how would you rate your overall health?
|
N/A |
18.
In general, how would you rate your overall health?
|
Question is unchanged. | N/A |
|
27.
In general, how would you rate your overall mental or emotional health?
|
N/A |
19.
In general, how would you rate your overall mental or emotional health?
|
Question is unchanged. | N/A |
|
28.
Do you live alone?
|
N/A |
20.
Do you live alone?
|
Question is unchanged. | N/A |
|
29.
What is the highest grade or level of school that you have completed?
|
N/A |
21.
What is the highest grade or level of school that you have completed?
|
Question is unchanged. | N/A |
|
30.
Are you Hispanic or Latino/a?
|
N/A | N/A | Question was merged with Q22 (race question). | N/A |
|
31.
What is your race? Please select one or more.
|
N/A |
22.
What is your race or ethnicity? Please mark one or more.
|
Question modified to reflect the combined race and ethnicity response categories. Additional response categories added. | N/A |
|
32.
What language do you mainly speak at home?
|
N/A |
23.
What language do you mainly speak at home?
|
Question is unchanged. | N/A |
|
33.
Did someone help you complete this survey?
|
N/A |
24.
Did someone help you complete this survey?
|
Question is unchanged. | N/A |
|
34.
How did that person help you?
|
N/A |
25.
How did that person help you?
|
Question is unchanged. | N/A |