Change is coming to the Home Health CAHPS survey, and agencies that prepare early will be in the best position to protect experience scores and performance outcomes.
The Centers for Medicare and Medicaid Services has released training materials outlining upcoming HHCAHPS updates, alongside a proposed draft survey that signals meaningful shifts in how patient experience will be measured beginning this spring.
While some details are still pending final approval, the direction is clear: greater emphasis on communication, coordination, and how patients feel cared for as people, not just recipients of clinical tasks.
Below, we break down what is changing, what this means for your agency, and concrete steps you can take now to prepare.
What’s really changing
The proposed updates signal that CMS is moving beyond what clinicians do and toward how care is experienced.
New and emphasized questions ask whether:
- Care helped patients take care of their health
- Family or friends received enough information
- Staff cared about patients “as a person,” not just clinically
In other words, empathy, consistency, and coordination are no longer nice to have. They are measurable.
Why this matters operationally
Several themes stand out in the draft language:
Communication and reliability
Patients are asked how often staff kept them informed about arrival times, explained things clearly, and seemed aware of all care being provided. Gaps in handoffs or last-minute schedule changes will show up directly in responses.
Medication education over time
Even with fewer questions, CMS still separates medication review at admission from side-effect discussions later in care. This reinforces that education must be ongoing, not a one-time task.
Emotional experience
One new question explicitly asks whether patients felt staff cared about them as a person. Tone, presence, and small moments of human connection now matter just as much as technical competence.
Caregiver inclusion
Patients are asked whether family or friends received information as much as they wanted. Agencies will need clearer processes for identifying caregivers and communicating consistently with them.
What Agencies Can Do Now
Even before the final survey is released, agencies can take meaningful steps today.
1. Tighten the First Visit Experience
The first visit sets expectations for the entire episode.
Ask yourself: Do patients clearly understand what happens next, who is coming, and how to reach you?
Action: Follow up after the first visit with a short check-in to confirm understanding, surface questions, and catch issues early rather than months later through a survey.
2. Make Communication Consistent Across the Episode
The proposed survey repeatedly references experiences “in the last two months of care,” signaling that consistency matters more than one-time excellence.
Action: Establish a simple cadence for reinforcing visit timing, medication changes, side effects, and emotional well-being throughout care, not just at admission.
3. Improve How Staff Explain Care
Patients are asked whether explanations were easy to understand, not whether information was technically complete.
Action: Train clinicians to use teach-back techniques and plain language, especially during medication discussions, and reinforce this as a core competency.
4. Operationalize Human Connection
Feeling “cared about as a person” is now explicitly measured.
Action: Encourage staff to spend a brief moment on personal connection, remembering details from prior visits, asking about family or routines, and responding with empathy. Document these moments as part of the care narrative.
5. Proactively Include Family and Caregivers
Caregiver experience is no longer indirect. And, playing phone tag isn't going to cut it. Connecting and communucating is part of the patient’s reported experience.
Action: Ask early who helps at home, how involved they want to be, and how information should be shared. Proactively communicate with caregivers rather than relying on information to pass through the patient alone.
6. Reduce Scheduling Friction
Patients notice missed windows, last-minute changes, and disconnected handoffs.
Action: Use reminders and clear arrival communication, minimize unnecessary schedule changes, and ensure handoffs include both clinical and personal context to maintain continuity.
7. Listen Before CMS Measures
HHCAHPS results arrive too late to fix problems.
Action: Capture lightweight, real-time feedback during care through brief check-ins or texts so teams can address issues while the episode is still active.
The bottom line
The first patients surveyed under the updated HHCAHPS, expected to begin this spring, will shape agency reputation, public reporting, and referral confidence for years.
Agencies that align now won’t just perform better on surveys. They’ll deliver care that feels more predictable, supportive, and human to both patients and families.
That’s the direction CMS is heading. The agencies that move early will be the ones that stand out.
At Betterleave, we support home health agencies as they operationalize these experience shifts, without adding burden to clinical teams by:
- Proactively communicate with patients and caregivers through automated, episode-based outreach
- Capture real-time feedback during care so issues can be addressed while they still matter
- Engage and support family caregivers as part of the care team
- Strengthen reputation by systematically surfacing positive patient and caregiver experiences
If you want to talk through how these changes may impact your agency or how to prepare ahead of April, we’re happy to help.
