Survey Questions

Use the links below to review the National Palliative Care Registry™ survey questions for each care setting. You will also find definitions for key measures and detailed guidance for each survey question.

Starting January 1 2019, there will be new and improved surveys for hospital palliative care, palliative care in long-term care settings, and home palliative care. All are available below and contain an overview of the changes.

  • Hospital

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    Hospital Palliative Care Survey

    Starting January 1, 2019 we will be using a new and improved version of the hospital survey. Find the new version of the hospital survey and an overview of the changes below. Your palliative care program will fill out a separate survey for each of the hospital sites where you are providing care. Hospital surveys are for palliative care programs that provide non-hospice palliative care services in hospitals, both consultation services and/or on inpatient palliative care units.
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    For surveys on years 2008-2017, we used a historical version of the survey. Please use this survey as reference for your historical data collection.
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  • Home

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    Home Palliative Care Survey

    Starting January 1, 2019 we will be using a revised and improved home palliative care survey. This survey is for palliative care programs that provide non-hospice palliative care in patients’ homes, wherever they may live. “Home” includes residential homes, nursing homes, and other long-term care facilities.

    If your palliative care program is integrated into a long-term care facility or is contracted to provide care to the entire residential population that lives there, please use the long-term care survey. If your program sees patients at long-term care facilities because that’s where the patients live, but is not contracted to provide care to the entire residential population, please include these palliative care patients in the home survey.

    Download

    For surveys on years 2008-2017, we used a historical version of the survey. Please use this survey as reference for your historical data collection.
    Download

  • Office/Clinic

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    Office/Clinic Palliative Care Survey

    For palliative care programs that provide non-hospice palliative care services at Clinics, Physician Offices, Federally Qualified Health Centers, End Stage Renal Disease (ESRD) Facilities, Outpatient Physical Therapy/Speech Pathology Facilities, Rural Health Clinics, Comprehensive Outpatient Rehabs, Ambulatory Surgical Centers or Community Mental Health Centers.

    *Only a shortened survey is available at this time.

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  • Long-term Care

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    Long-term Care Palliative Care Survey

    Starting January 1, 2019, we will be using a revised and expanded version of the long-term care survey. You will only need to fill out 1 survey for all of the long-term care sites where your palliative care program provides care. This survey is for palliative care programs that provide non-hospice palliative care services to skilled nursing facilities (SNF) and nursing homes.

    If your palliative care program has a contract to provide care at a long-term care facility and is available to provide care to the entire residential population that lives there, please use the long-term care survey. If your program sees one patient at a long-term care facility because that’s where the patient lives, but is not contracted to provide care to the entire residential population, please include these palliative care patients in the HOME survey.

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