In collaboration with the VA, NHPCO has developed Veteran-specific questions (formerly known as Family Evaluation of Hospice Care-Veterans – or FEHC-V) to help hospices evaluate the care they have delivered to their Veterans patients.
Veteran Specific Questions (VSQ) is a post-death survey designed to yield actionable information that reflects the quality of hospice care delivery from the perspective of family caregivers.
Refer to the links below for further information about this helpful measurement tool:
VSQ Web Resources
Frequently Asked Questions
What are the Veteran Specific Questions for evaluation of hospice care?
NHPCO’s Veteran Specific Questions (VSQs) allow evaluation of care targeted specifically to Veterans and their family caregivers. The VSQs were developed as an addition to the Family Evaluation of Hospice Care (FEHC), a post-death survey designed to yield actionable information that reflects the quality of hospice care delivery from the perspective of family caregivers.
The Centers for Medicare and Medicaid Services (CMS) has created its own post-death caregiver survey, the CAHPS Hospice survey. Starting in 2015, CMS requires hospices to administer the CAHPS Hospice survey as part of its Hospice Quality Reporting Program. This means that hospices may no longer administer the FEHC survey.*
* Hospices that have fewer than 50 patient deaths in a calendar year are exempt from CMS CAHPS Hospice administration requirements. These hospices may administer the FEHC survey or the CAHPS Hospice survey themselves with the addition of the VSQs.
Can hospices still use the Veteran Specific Questions for evaluation of hospice care and services for Veterans?
The VSQs may be added to the CAHPS Hospice survey in accordance with CMS’s guidelines for adding questions. CMS requires hospices to contract with a vendor for administration of the CAHPS Hospice survey; hospices need to work with their vendor regarding the addition of the VSQs to the CAHPS Hospice survey.
Alternatively, hospices may administer the VSQs separately from the CAHPS Hospice survey. However, CMS wishes to avoid any potential influence on caregivers’ responses to the CAHPS Hospice survey and therefore prohibits administration of any formal caregiver survey prior to administration of the CAHPS Hospice survey. This means that a hospice that wishes to perform its own administration of the VSQs must do so after its contracted vendor has administered the CAHPS Hospice survey each month.
How do I access the Veteran Specific Questions?
All VSQ materials can be accessed here:
- VSQ Data Codes
- VSQ Data Analysis Workbook
- Interviewer Script for the option to administer VSQs by phone
Should the Veteran Specific Questions be mailed to caregivers of all patients?
No. The VSQs should only be mailed to caregivers of patients whom your hospice identified as Veterans.
NOTE: Your hospice will need a system to identify family caregivers of patients who are Veterans.
When should I administer the Veteran Specific Questions?
For those hospices that have arranged for the VSQs to be added to the CAHPS Hospice survey, the hospice’s contracted vendor will be responsible for administering the surveys in accordance with CMS requirements. A hospice that wishes to perform its own administration of the VSQs must do so after its contracted vendor has administered the CAHPS Hospice survey each month. The VSQs may be administered by mail or by phone.
How do I utilize the Veteran Specific Questions for performance improvement?
Hospices that have contracted with a vendor for the addition of the VSQs to the CAHPS survey should work with the vendor to have VSQ results incorporated into CAHPS survey reports provided by the vendor.
Hospices that are administering the VSQs themselves can enter VSQ responses into NPHCO’s VSQ Data Analysis Workbook which will calculate results automatically.
Can I make changes to the Veteran Specific Questions?
NHPCO strongly recommends against changing the wording and order of the VSQs.
What is the VA’s Bereaved Family Survey and how does it compare with Veterans Specific Questions?
The VA’s Bereaved Family Survey (BFS) is a post-death survey intended to assess aspects of family satisfaction with end-of-life care provided by the VA. The BFS is administered to family members of Veterans who died as inpatients in VA facilities.
In contrast, NHPCO’s VSQs are intended to allow hospices to evaluate care provided to Veterans while enrolled in hospice.