Advanced Practice Provider (APP) Hospice Certification of Terminal Illness (CTI) Research Survey

The Home Health and Hospice Coalition represents 12 professional organizations including Advanced Practice Providers as well as Physicians. Our Coalition invites you to participate in the Advanced Practice Provider (APP) Hospice Certification of Terminal Illness (CTI) Research Survey collaboratively developed to identify barriers in continuity of care for patients of APPs when they are admitted to Hospice. It will provide data and anecdotal stories to be used for advocacy to encourage passage of laws to allow APPs to sign the CTI and for Clinical Nurse Specialists to continue to follow their patients as Primary Care Provider.

Participation in this 25-question survey is completely voluntary and you may change your mind at any time. There is a rare risk that some of the questions may make you uncomfortable, but you may skip questions you don't want to answer. The survey will take approximately 10-15 minutes to complete.

If you are an APP who has referred a patient to hospice, we invite you to participate in completion of the research survey. We are not collecting any identifying information, but as with any research survey, 100% confidentiality cannot be guaranteed. De-identified data will be shared with all 12 organizations and may be shared with future researchers. Completion of the survey implies consent to include your responses in the data analysis.

The survey will remain open from March 21, 2022 until midnight April 3, 2022. If you have referred patients to hospice and you agree to participate you can access the survey using this link:


Take the Survey

It is possible you may receive an invitation to this survey through other organizations in which you hold membership, but we ask that you participate to answer the questions only once. The survey has Institutional Review Board (IRB) Approval through Case Western Reserve University.

If you have any questions, please contact Evelyn Duffy, DNP, AGPCNP-BC, FAANP.

Thank you so much for your participation.