Community Nursing Home Program Interviews

Community Nursing Home Program Interviews

OMB No. 2900-0770
Estimated Burden: 60 minutes

Expiration Date: 9/30/2020

The Paperwork Reduction Act of 1995: This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average 60 minutes. This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this telephone/mail survey will lead to improvements in the quality of service delivery by helping to achieve services. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

Interviewer Name:

Date:

Time Start:

Time End:

Hello [Mr./Ms./Dr. interview participant name],

My name is [interviewer name] and helping me today are/is [additional team member(s)]. We are conducting site visits and interviewing staff to learn about the VA’s Community Nursing Home program at your VA. What we learn from these interviews will be used to understand how the Community Nursing Home referral process and contracting process works at your site, with hopes to make recommendations to improve upon current processes based on what we learn. Your responses are confidential and you will not be identified in any reports, presentations, or publications.

Your participation in this interview is voluntary. If you feel that participating in this interview impacts your work conditions negatively, please feel free to decline. You can stop the interview at any time, and let me know if you would rather not answer a particular question.

Do you have any questions?

In order to make sure we capture all of the information you give us, we would like to record this call. The audio-file for the recording will be stored directly to restricted access file on the VA intranet. Is this okay with you? [Hit record button.] Okay, to confirm, I’m starting the recording. Is this ok with you?

Grounded prompts: If responses are limited or require clarification, probes may be used to elicit more detailed responses. Probes should use words or phrases presented by the participant using one of the following formats:

1. What do you mean by ____________?

2. Tell me more about ____________ ?

3. Can you give me an example of ____________?

4. Can you tell me about a time when ____________?

5. Who____________?

6. When____________?

7. Where ____________?

Background:

• Tell me about your role in the CNH program.

• Length of time with the VA_________

• Length of time in current Role_________

INTERVIEW QUESTIONS	CONCEPTUAL FRAMEWORK DOMAIN
Tell me about the referral process when referring a veteran to a community nursing home. Who is involved? From inpatient stay? Outpatient Clinic? Call directly to CNH coordinator? Tell me about any eligibility for being admitted to a CNH. Probe: How does this differ based on what the Veteran is going to the CNH for (hospice vs. rehab vs. LTC)?	Contextual Factor: Referral Process
Tell me about how a Veteran and/or family select a nursing home. What types of choices do veterans and their families have in selecting a community nursing home? Probe: Tell me an example of how that choice might be influenced (i.e. Potential match with best treating/caring for Veteran’s care needs? VA provider recommendation? Perceived community nursing home quality?) Does the Community Living Center factor into these decisions? Tell me about challenges you’ve run into with veterans and families making choices about selecting a community nursing home. Probe: having to select a nursing home because of lack of availability (i.e. it is the only one with open beds?) Probe: Choosing one due to proximity and despite lower quality? Availability of Community Living Center beds? Can you think of an example of when a veteran switched nursing homes? What did that look like? Tell me how Veterans’ finances may play a role in the CNH they choose.	Contextual Factor: CNH Selection Process
Tell me how the community nursing homes contract with your VA. What factors come into play? Probes: Quality? Star rating? Potential match with best treating/caring for Veteran’s care needs? VA provider recommendation?	Contextual Factors: CNH Selection Barriers
Tell me about the community nursing homes that currently contract with your VA How would you describe the group of community nursing homes that are available to your Veterans? Probes: A wide variety? Some with expertise in special areas? (dementia care, behavioral health needs? End of life care?) Serve rural Vets also? What type of quality? What if any other community nursing homes that the VA isn’t contracting with currently that you would like to see become a part of your VA’s CNH program? Probes: Why is that nursing home not a part of your program? What would be beneficial about adding this nursing home (provides high quality care? Serves a special population? Is in a geographic location that is underserved? )? What does that process look like? Are any in the process of beginning to contract with the VA?	Incentive Characteristics: Financial, non-financial, quality-based
Tell me about what makes up a good relationship between the VA CNH program and the CNHs with which it contracts. What has helped to improve working with CNHs? What has hindered your working relationship with CNHs? How do you determine who the point person is for a Veteran at the nursing home? Probes: Is that always the same or does it vary by Veteran? Is that person usually in the same role in each CNH or does it vary by CNH?	Contextual Factors: Enabling
Tell me what care coordination looks like between CNHs and your VA. What has helped care coordination? What has thwarted care coordination? What would most help care coordination that currently does not exist?	Contextual Factors: Enabling
Do you have any questions for us, or is there anything else you would like to add about your sites CNH program and/or working with CNHs?

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