For case managers, discharge planners and physicians
How to read hospice quality data on Care Compare
Medicare's Care Compare tool lists every active Medicare-certified hospice with its quality data. The data come from three places: Medicare claims (the Hospice Care Index and a visits measure), the hospice's own patient assessments (HOPE since October 1, 2025), and the CAHPS Hospice Survey of family caregivers. A missing CAHPS score usually means the hospice had too few eligible families to survey. The steps and tables below work for any hospice.
Medically reviewed by Oscar Chien, MD, Medical Director, November 9, 2026
On this page (9 sections)
- How to look up a hospice's quality data
- What each hospice measure on Care Compare means
- The ten Hospice Care Index indicators
- Why a hospice can show no CAHPS scores
- The Care Compare icon for hospices that do not report
- What HOPE will add to Care Compare
- What is the hospice SSVI score?
- Common questions about hospice quality data
- Related guides
How to look up a hospice's quality data
- Step 1
Find the hospice on Care Compare
Look the hospice up on Medicare's Care Compare (opens in a new tab). Every currently active Medicare-certified hospice is listed.
- Step 2
Confirm it is licensed and enrolled
Check the state license and the Medicare enrollment in the public records before you rely on any score. See how to verify a hospice.
- Step 3
Read each measure with its source
Use the table below. Claims measures, assessment measures and caregiver survey results each cover a different period and have their own minimum sample sizes.
- Step 4
Check the reporting period
Care Compare refreshes hospice data four times a year, in February, May, August and November. Claims measures use eight quarters of data, and CAHPS scores use eight rolling quarters.
- Step 5
Ask about anything that stands out
If a result concerns you, ask the hospice about it before you decide. Each measure covers one part of care.
What each hospice measure on Care Compare means
Care Compare shows three kinds of hospice measures. CMS also publishes the same data in its Provider Data Catalog.
| Measure | Data source | What it shows | Read it with care |
|---|---|---|---|
| Hospice Care Index (HCI) | Medicare claims | A score from 0 to 10. The hospice earns one point for each of ten indicators where it meets the CMS criterion. | No score is calculated for a hospice with fewer than 20 discharges in the two pooled years. CMS is considering changes to the HCI. |
| Hospice Visits in the Last Days of Life | Medicare claims | 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 of life. | Excludes patients on hospice fewer than three days and patients who had continuous home care, respite or general inpatient care in those last three days. |
| Comprehensive Assessment at Admission | Hospice patient assessments (HIS, then HOPE from October 1, 2025) | The share of patients for whom the hospice completed all seven admission care processes that apply: beliefs and values, treatment preferences, pain screening, pain assessment, dyspnea screening, dyspnea treatment, and a bowel regimen for patients on an opioid. | A process measure. It shows what the hospice asked and did at admission, not how symptoms turned out. |
| CAHPS Hospice Survey measures | Survey of family caregivers after the patient's death | The share of caregivers who gave the most positive answer about communication, timely help, respect, emotional and spiritual support, help for pain and symptoms, training, rating of the hospice and willingness to recommend it. A care preferences measure was added for deaths from April 2025. | Scores are adjusted for survey mode and case mix and are published only for hospices with 30 or more completed surveys over the reporting period. |
| Family Caregiver Survey Rating (stars) | CAHPS Hospice Survey | A summary star rating built from the CAHPS results. | Published only for hospices with 75 or more completed surveys over the reporting period, and updated every other quarter. |
Care Compare does not give hospices an overall star rating. In the FY2027 rule, CMS said an overall rating would need more public feedback and analysis first.
The ten Hospice Care Index indicators
The Hospice Care Index (HCI) combines ten claims-based indicators, each weighted equally. A hospice earns a point on an indicator when its result meets the criterion, and its HCI score is the total, from 0 to 10.
| Indicator | What it measures | Point earned when the hospice's result is |
|---|---|---|
| Continuous home care or general inpatient care provided | The share of the hospice's service days at the continuous home care or general inpatient level | Above 0% |
| Gaps in skilled nursing visits | The share of stays of at least 30 days with at least one gap of more than 7 days between nursing visits | Below the 90th percentile nationally |
| Early live discharges | The share of live discharges within the first 7 days after admission | Below the 90th percentile nationally |
| Late live discharges | The share of live discharges on or after day 180 of the stay | Below the 90th percentile nationally |
| Burdensome transitions, type 1 | Live discharges followed by a hospitalization within 2 days and a hospice readmission within 2 days of the hospital discharge | Below the 90th percentile nationally |
| Burdensome transitions, type 2 | Live discharges followed by a hospitalization within 2 days in which the patient died | Below the 90th percentile nationally |
| Per-beneficiary Medicare spending | Average Medicare hospice payments per patient served | Below the 90th percentile nationally |
| Skilled nursing minutes per routine home care day | Average nurse minutes on routine home care days | Above the 10th percentile nationally |
| Skilled nursing minutes on weekends | The share of nurse visit minutes on routine home care days that fell on a Saturday or Sunday | Above the 10th percentile nationally |
| Visits near death | The share of patients with at least one nurse or social worker visit in their last three days of life | Above the 10th percentile nationally |
In these indicators a live discharge is any claim discharge status other than death or transfer to another hospice, so a revocation by the patient counts. Early and late are measured on the patient's lifetime days in hospice, across all hospices. For how discharge and revocation work, see discharge and revocation.
Why a hospice can show no CAHPS scores
The most common reason is size. A hospice that served fewer than 50 survey-eligible patients and caregivers in the previous calendar year can ask CMS for an exemption from the CAHPS Hospice Survey for the current year (42 CFR 418.312(e)). The exemption lasts one year, and the hospice must request it again each year by December 31.
Even a hospice that takes part needs 30 or more completed surveys over the eight-quarter reporting period before CMS publishes its CAHPS scores, and 75 or more for the star rating. Many deaths are not surveyed at all: for example, a patient who died within 48 hours of admission, had no caregiver of record, or whose family asked not to be contacted. A new hospice may also have no results yet.
So a blank CAHPS result usually means the hospice is small or new, and tells you nothing about how families rated it. In that case, ask the hospice how it gathers family feedback, and read its claims-based measures.
The Care Compare icon for hospices that do not report
The FY2027 hospice final rule adds an icon on Care Compare for hospices that submit no HOPE data, or fewer than the required 90% of HOPE records within 30 days, in a year. It will appear no earlier than FY2028 (October 1, 2027), based on 2026 submissions, on both the search results and the hospice's own page, and is added or removed once a year.
The icon flags missing or late HOPE reports, and CMS says Care Compare will explain it in plain language. It does not count CAHPS, because so many hospices are exempt for size, and it does not mark hospices exempted for extraordinary circumstances. In FY2026, CMS found 20.37% of hospices out of compliance with the quality reporting requirements.
What HOPE will add to Care Compare
Two new measures will come from the HOPE assessment: Timely Follow-up for Pain Impact and Timely Follow-up for Non-Pain Symptom Impact. Each counts how often the hospice made an in-person follow-up visit within 2 calendar days after a moderate or severe symptom was found. CMS expects to report them publicly starting in November 2027, no earlier than FY2028, depending on its review of the 2026 data. See the HOPE assessment and HUV visits.
What is the hospice SSVI score?
The Service and Spending Variation Index (SSVI) is a CMS score built from nine claims-based metrics of hospice use and of Medicare spending outside the hospice benefit. Scores run from 0 to 16, and a higher score signals more potential concern. CMS published hospice-level SSVI scores for FY2024 and FY2025 with the FY2027 final rule, and posts the data on its hospice center web page.
CMS calls the SSVI a descriptive tool. It says a hospice that crosses the threshold on one metric is common and not necessarily a problem, and that it would treat a score of 13 or more, about the 99th percentile, as an outlier. The SSVI is separate from the Hospice Care Index. CMS says it will be one of several sources it uses to focus program integrity work, such as medical review.
Common questions about hospice quality data
What is the CAHPS size exemption for hospices?
A hospice that served fewer than 50 survey-eligible patients and caregivers in the previous calendar year can request an exemption from the CAHPS Hospice Survey for the current year. It must request it again each year (42 CFR 418.312(e)).
Why does a hospice have no CAHPS star rating?
Care Compare shows the star rating only for hospices with 75 or more completed surveys over the reporting period, and the measure scores only for hospices with 30 or more. A small or new hospice, or one exempt for size, may have none.
What is a good Hospice Care Index score?
The scale runs from 0 to 10, and 10 means the hospice met the criterion on all ten indicators. Look at which indicators it missed, not only the total.
How often is hospice data on Care Compare updated?
Four times a year, in February, May, August and November. The CAHPS star rating is updated every other quarter.
When will HOPE results appear on Care Compare?
CMS expects to begin public reporting of the two HOPE-based measures in November 2027, no earlier than FY2028.
Is the SSVI on Care Compare?
CMS publishes SSVI scores with the annual hospice rule and on its hospice center web page. Care Compare's hospice measures are the HCI, the visits measure, the comprehensive assessment measure and the CAHPS results.
Related guides
Hospice rules 2026–2027: what changed for referrers, how to verify a hospice, the family guide on how to choose a hospice, and short definitions in the hospice glossary.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- November 9, 2026
- Next review
- May 9, 2027
How we write and review this site
Sources
- Medicare.gov: Care Compare (opens in a new tab)
- CMS: Hospice Quality Reporting Program, current measures (opens in a new tab)
- CMS: HQRP Quality Measure Specifications User's Manual v1.04 (Hospice Care Index indicators and criteria) (opens in a new tab)
- CMS: Public reporting key dates for providers (Care Compare refresh schedule) (opens in a new tab)
- CAHPS Hospice Survey: Public reporting (30 completed surveys for scores, 75 for the star rating) (opens in a new tab)
- CAHPS Hospice Survey: Star ratings (opens in a new tab)
- CAHPS Hospice Survey: Participation exemption for size (opens in a new tab)
- 42 CFR 418.312: Data submission requirements under the hospice quality reporting program (opens in a new tab)
- Federal Register, FY2027 hospice final rule (CMS-1851-F), August 3, 2026: SSVI and the Care Compare icon (opens in a new tab)
- CMS: Hospice center, Service and Spending Variation Index (SSVI) data (opens in a new tab)
- CMS: HOPE implementation FAQs (public reporting of HOPE measures) (opens in a new tab)
These sources support the general information on this page. For one person’s care and coverage, talk with the hospice team.
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