How to read CMS hospice ratings and measures
CMS publishes two kinds of numbers for each hospice: what families said in a survey, and measures built from Medicare claims. Here is what they mean and where they fall short.
Checked against Medicare.gov, CMS and the federal rules on October 20, 2026. General information, not medical or legal advice.
The family caregiver survey
The CAHPS Hospice Survey is a national survey of family members or friends who cared for someone who died under hospice care. It is run every month. Medicare publishes these results for each hospice:
- Communication with family
- Getting timely help
- Treating the patient with respect
- Emotional and spiritual support
- Help for pain and symptoms
- Training family to care for the patient
- Rating of this hospice: the share who rated it 9 or 10 out of 10
- Willing to recommend this hospice: the share who would definitely recommend it
Each score is the share of caregivers who gave the best answer. Higher is better.
The star rating
Care Compare shows a family caregiver survey rating from 1 to 5 stars, a summary of the survey scores. Scores are updated every quarter. Star ratings are updated twice a year.
When too few families answered the survey, CMS does not publish a star rating for that hospice. A missing rating is not a low rating: it means there were not enough answers to rate. We show it as Not reported by CMS, never as zero.
The Hospice Care Index
The Hospice Care Index (HCI) looks at care through the whole hospice stay, using Medicare claims. A hospice earns one point for each of 10 indicators where it meets CMS's criterion, so scores range from 0 to 10. The indicators are:
- Continuous home care or general inpatient care provided
- Gaps in skilled nursing visits
- Early live discharges
- Late live discharges
- Live discharge followed by a hospital stay and a return to hospice
- Live discharge followed by a hospital stay where the patient died
- Medicare spending per patient
- Skilled nursing minutes per routine home care day
- Skilled nursing minutes on weekends
- Visits near death
Other measures CMS publishes
Care Compare also shows Hospice Visits in the Last Days of Life: the share of patients who had in-person visits from a registered nurse or medical social worker on at least two of their last three days. And a comprehensive assessment measure: the share of patients for whom the hospice completed all seven care steps at admission, such as pain screening and asking about treatment preferences. We do not show these two yet; see them on Care Compare.
How to use the numbers
- Use them as one input, next to what your doctor, friends and the hospice itself tell you.
- Look at the specific scores that matter to you, such as getting timely help, not only the stars.
- Look at how big a difference is, not only which number is higher.
- The survey covers deaths over a past reporting period, so recent changes at a hospice may not show yet.
- Ask the hospice about any result that worries you. See questions to ask a hospice.
Common questions
Why does a hospice have no star rating?
CMS does not publish a star rating when too few family caregivers answered the survey. A missing rating is not a low rating.
How often does CMS update hospice ratings?
Survey scores are updated every quarter. Star ratings are updated twice a year.
What is a good Hospice Care Index score?
The score runs from 0 to 10, one point for each indicator where the hospice meets CMS's criterion. A higher score means it met more of them.
Sources
- CAHPS Hospice Survey (CMS.gov)
- Hospice Quality Reporting Program: Current Measures (CMS.gov)
- Data Dictionary for Hospice Quality Reporting Program Data on Care Compare (CMS Provider Data Catalog (data.cms.gov))
- Care Compare: find and compare hospices (Medicare.gov)
Find a hospice near you
See Medicare’s family survey results for hospices near a home address.