A comprehensive guide to HCAHPS

HCAHPS stands for Hospital Consumer Assessment of Healthcare Providers and Systems, which is a patient satisfaction survey administered by healthcare practitioners and/or facilities. This survey is standardized, national, and publicly reported, and allows comparisons of hospitals on various areas of care that are crucial for patients. Here are some quick facts about HCAHPS that you need to know: 

  • It is centered on the perspective of the patients about their experience at a healthcare facility or with a healthcare practitioner. 

  • It is for patients who have been discharged within 48 hours to 6 weeks. 

  • It is required by the Centers for Medicare and Medicaid Services (CMS), a federal agency under the US Department of Health and Human Services. 

  • The healthcare provider can administer the survey through mail, telephone, a combination of the two, or Interactive Voice Recognition. 

What is the purpose of the HCAHPS survey?

In the USA, patient satisfaction is a thing of supreme importance, and the CMS ensures that reviews are administered and published by the healthcare providers so that people who are looking for quality healthcare services can compare healthcare facilities and make an informed decision. Here’s why the survey is important:

  1. It is a crucial element of measuring the quality of care provided by doctors and hospitals, acting as a true instrument for enhancing accountability and transparency. 

  2. The HCAHPS survey gives the patients a chance to express their perception of the care they received, which is for all internet users to see. Since the results are administered publicly, they directly impact the reputation of the healthcare facility. 

  3. Credibility, usefulness, and practicality are the three core pillars of this survey; and excellent survey performance also benefits the hospitals in a number of ways. In the case of positive results, the government rewards the hospitals in the form of reimbursements, which keeps them financially sound. 

All in all, this survey acts as a checklist for hospitals to check whether they fulfill all elements of patient care and the areas that they need to improve on. 


Composition of The HCAHPS Survey: 


This brings us to our next question: how are HCAHPS scores calculated? 


After the patients are discharged, they are asked questions that cover various areas directed towards their hospital experience. Here are some critical aspects of the hospital experience that need to be covered:


The ratings are developed for all the HCAHPS Items and a summary of those ratings is combined to form one overall metric. While the HCAHPS questions must cater to the aforementioned items, they can be molded as per the hospital requirements. 

When we talk about surveying patients, there lies an eligibility criterion for patients to participate in the HCAHPS survey. 

A patient will be considered eligible if he/she is: 

  • More than 18 years of age when admitted

  • Should have stayed at least one night as an inpatient 

  • Should be non-psychiatric

  • Alive when discharged 

Rating scale of HCAHPS: 






Sample HCAPHS questions 2021: 

Section-1: Care from nurses 

  1. During your stay, how often did the nurses treat you with respect and courtesy?

  2. How soon did you get help from the nurses when you pressed the call button?

  3. How often did the nurses listen patiently and carefully to you?

  4. How often were you explained things in a way you could understand?

Section-2: Care from Doctors 

  1. How often did doctors treat you with respect and politeness?

  2. How often did the doctors listen to you?

  3. How often were you explained things in a way you could comprehend?

Section-3: Hospital Environment 

  1. How frequently were your room and bathroom kept tidy?

  2. During your stay, how frequently was the area around your room quiet?

Section-4: Your experience in the hospital 

  1. During your stay, how often did you require help from nurses or hospital staff in using the bedpan or going to the bathroom?

  2. How often did you get assistance to go to the bathroom or use a bedpan as soon as you needed?

  3. How frequently did you need medicine for pain?

  4. During your stay, how frequently was your pain controlled?

  5. During your stay in the hospital, how often did the staff help you with your pain?

  6. During your stay, were you given any medicine that you hadn’t taken before?

  7. While giving you a new medicine, how often were you told what the medicine was for?

  8. How often were you described the possible side effects of the new medicine?

Section-5: Leaving the hospital 

  1. When you left the hospital, where did you go?

  • Your home

  • Someone else’s home 

  • Another health facility

  1. During your stay, did the hospital staff ask you whether you needed any help when you left the hospital?

  2. Were you given any information regarding the symptoms or health problems to look out for when you left the hospital?

Section-6: Overall Rating 

  1. Using any number from 0 to 10, what number would you give the hospital, provided that 0 is the worst hospital and 10 is the best hospital?

  2. How likely are you to recommend this hospital to your friends and family?

About section:

  1. How would rate your overall health?

  2. What is your academic qualification (Highest grade completed)?

  3. Do you belong to the Hispanic, Latino, or Spanish origin or descent?

  4. Please select your race.

  5. What language do you speak?

On the Hospital Compare website, the HCAHPS results are reported publicly in the form of three boxes: top box, middle-box, and bottom box. Please refer to the following table to see what falls in each of these boxes: 





Composite+Individual Items




Discharge Information




Overall Hospital Rating

9-10 (HIGH)

7-8 (MEDIUM)

0-6 (LOW)

Recommend the Hospital




Care Transition





Since HCAHPS survey is an important metric that reflects greatly on a hospital’s reputation, it is always best for hospitals to do everything possible so that people leave positive reviews. Here are some tips to improve HCAHPS scores: 

  1. Ensure that the nurses introduce themselves, explain their role in the care of the patient, and be empathetic and good listeners. 

  2. Make sure that doctors explain things clearly to the patient and listen to him. 

  3. Make sure that the bathrooms and rooms are kept neat. 

  4. Practice high-quality pain management.

  5. Ensure that the patients are well educated about the medicines and their possible side effects.

  6. Engage in aftercare, understand whether they would need any help post discharge. 


Apart from keeping the above tips in mind, also ensure that the patient’s family is also involved in the treatment of the patient and is kept updated with the health status of their loved one. In the healthcare domain, quality care and good patient experience is a big factor that plays in the favor of any healthcare facility.  

If you are a healthcare provider or a healthcare facility finally entering the world of HCAHPS, keep this guide handy!

Leave a Reply

Your email address will not be published. Required fields are marked *