Nursing Homes Rank as Worst Setting For End-of-Life Care

Reported care experiences are typically worse in the nursing home setting, according to the latest results of a survey by the Centers for Medicare & Medicaid Services (CMS).

The Hospice Experience of Care Survey measured experiences of patients and their caregivers in three hospice settings: nursing home (including both skilled and regular nursing facilities), home care (including assisted living facilities) and inpatient care (acute care hospitals and freestanding hospice IPUs). 

The survey is meant to act as a pilot to test the future Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey, which will be implemented at eligible hospices nationwide beginning in 2015. 


While average overall rating of hospice care scored 93 out of 100 in the survey, nursing home care received a score of 90.2. 

Using a number of criteria, respondents ranked nursing home care, which for the most part scored lower than other care settings.

The composite, Understanding the Side Effects of Pain Medication, ranked lowest in nursing home setting satisfaction, with a score of 71.1. In comparison, that score for home care was 89.5, for acute care hospitals was 73.7 and for hospice IPUs was 81. 


Other nursing home composite scores ranged from 86.2 for Getting Help for Symptoms and 88.5 for Hospice Team Communication to 95.2 for Providing Support for Religious and Spiritual Beliefs and 95.3 for Treating Your Family with Respect. 

The survey was developed to aid beneficiaries and family members in their decision to select a hospice program, to help hospitals with their internal quality improvement efforts and external benchmarking with other facilities, and to provide CMS with information for monitoring the care provided. 

Eligible hospices will be required to administer the CAHPS survey for a dry run for at least one month in the first quarter of 2015. Beginning in the second quarter of 2015, hospices will be required to participate on a monthly basis in order to receive the full Annual Payment Update.

To view the survey results, click here

Written by Emily Study