CY 2026 HHCAHPS CHANGES

Effective with April 2026 sample month (CMS Final Rule – Table C-20)

1. Global Measures (Largely Unchanged)

Overall Rating of Care

• Status: Retained (non-substantive wording change)
   
• What changed: “Provider” language updated to “staff”
   
• Why it matters: This score reflects the entire patient experience
  
  • Courtesy
     
  • Professionalism
     
  • Punctuality
     
  • How the visit is closed
     
• How to improve:
  
  • Be consistent and predictable
     
  • Explain the plan of care clearly
     
  • Ask if needs were met
     
  • Confirm who is coming next and when
     

Willingness to Recommend the Agency

• Status: Unchanged
   
• Why it matters: Driven by trust and responsiveness—not paperwork
   
• How to improve:
  
  • Respond quickly to symptoms and concerns
     
  • Prevent missed visits
     
  • Address supply issues promptly
     
  • Communicate clearly when problems arise
     

2. Revised Composite Measures

(Treated as “NEW” by CMS due to substantive changes)

Care of Patients (Composite)

• Status: Revised
  
  • +2 questions
     
  • –1 question
     
• Why it matters: Patients judge whether:
  
  • Care helped them
     
  • Goals were clear
     
• How to improve:
  
  • Explain goals of care at SOC and revisit them often
     
  • Address symptoms promptly (pain, wounds, SOB)
     
  • Explain what to do between visits and when to call the agency
     

Communication Between Providers and Patients (Composite)

• Status: Revised
  
  • –2 questions
     
  • +1 question
     
• Why it matters: Communication quality is now tightly measured
  
  • Listening
     
  • Respect
     
  • Clarity
     
• How to improve:
  
  • Slow down and actively listen
     
  • Use plain language (avoid medical jargon)
     
  • Use teach-back
    “Can you tell me how you’ll do this?”
     

3. Elimination of “Specific Care Issues” Composite

➡ Replaced with Stand-Alone Measures

Specific Care Issues (Composite)

• Status: Removed as a composite
   
• Why it matters:
  
  • Agencies can no longer “average out” performance
     
  • Each item now stands alone and counts on its own
     

4. NEW Stand-Alone Measures (Reported Separately)

Talk About Home Safety

• Status: New stand-alone measure
   
• Why it matters: Safety education must be visible and memorable
   
• How to improve:
  
  • Conduct a verbal home safety discussion at SOC
     
  • Address:
    
    • Falls
       
    • Equipment
       
    • Lighting
       
    • Rugs
       
    • Pets
       
  • Explain why changes matter
     

Review Medicines

• Status: New stand-alone measure
   
• Why it matters: Medication review is elevated in importance
   
• How to improve:
  
  • Review all medications, including OTCs
     
  • Explain changes
     
  • Confirm understanding of schedules
     

Talk About Medicine Side Effects

• Status: New stand-alone measure
   
• Why it matters:
  
  • Side-effect education now has its own score
     
  • Cannot be offset by other education
     
• How to improve:
  
  • Name common side effects
     
  • Explain what to do if they occur
     
  • Clarify when to call the agency vs. 911
     

5. Survey Items Removed (Why the Survey Is Shorter)

Staff-Type Questions (RN, PT/OT, Aide)

• Why removed: Patients struggled to distinguish roles
   
• Clinical takeaway:
  
  • Patients judge the experience, not the discipline
     
  • Team consistency matters
     

SOC “Information About Services” Question

• Why removed: Overlap and reliability concerns
   
• Clinical takeaway:
  
  • Don’t assume patients remember SOC education
     
  • Reinforce plans repeatedly
     

The Bottom Line for Clinicians

If clinicians consistently do these 5 things, HHCAHPS scores improve across multiple measures:

1. Explain the care plan in plain language
    
2. Talk out loud about making the home safer
    
3. Review all medications (including OTCs)
    
4. Discuss medication side effects and next steps
    
5. Close every visit with:
   “What questions do you have, and who will you call if something changes?”