First Mail Survey Cover Letter

Attachment VII — First Mail Survey Cover Letter
[PRINT ON CMS CONTRACTOR LETTERHEAD]
[Mailed ~ 2 weeks after web survey invitation is sent]
Dear Participant:
We recently invited you to complete the National Provider Survey of Home Health
Agencies, an online survey that is sponsored by the Centers for Medicare & Medicaid
Services (CMS). To date, we have not received your completed survey. We are
enclosing a hard copy of the survey and requesting that you complete the survey before
[DATE].
Every three years, CMS is required by law to assess the quality and efficiency impact of
its use of performance measures (i.e., quality, safety, patient experience) that are being
deployed to improve care for Medicare beneficiaries. As part of the assessment, CMS
is interested in learning about home health agencies’ experiences as they participate in
CMS performance measurement programs and the changes agencies are making to
drive improvements in care. Your home health agency’s response to the survey will
help CMS understand:
• How the CMS performance measures are changing the way in which your home
health agency is delivering care.
• Factors that are driving your agency’s investments in performance improvement.
• Issues your agency faces related to reporting the CMS measures.
• Potential undesired effects associated with the measures.
• Challenges your agency faces related to improvement on the CMS measures.
CMS recognizes that your home health agency devotes significant resources to
collecting data, reporting, and improving your agency’s performance on the CMS
measures provided on the CMS Home Health Compare website. Your feedback is very
important and will be used to improve the functioning of these measurement programs
so that they work well for both providers and their patients.
CMS has asked [CMS CONTRACTOR(s)] to conduct and analyze this web survey.
Completing the survey will take approximately 60 minutes. You may need to consult
with others in your agency to complete the survey. Please complete the enclosed
survey and return it in the enclosed envelope. If you prefer to complete the survey
online, please go to the following URL and enter your PIN:
Survey URL: (SURVEY LINK)
PIN: XXXX
You may complete the online survey in different sessions. Remember to save your
responses. When you log in to complete any remaining questions, you will be taken to
the last unanswered question.

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Please print a copy for yourself before submitting your completed survey. As you
complete the survey, you may want to refer to the Home Health Quality Reporting
Program (HHQRP) measures that are enclosed with the survey and accessible at the
following link:
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/HomeHealthQualityInits/Home-Health-Quality-Measures.html
All of the information you provide will be held in confidence by [CMS CONTRACTOR(s)]
to the extent allowed by law. [CMS CONTRACTOR(s)] will combine your survey
answers with the answers from other home health agencies that complete the survey
and will produce only summary results across all home health agencies. When
presenting survey results to CMS, [CMS CONTRACTOR(s)] will not include your name
or any other information that could identify you or your agency. Please note that:
• Your home health agency’s participation in the survey is voluntary.
• Your decision to participate or not to participate will have no effect on your (or
your organization’s) relationship with CMS.
• You can skip any question you do not want to answer.
• [CMS CONTRACTOR(s)] will not share your information with anyone, except as
required by law.
• [CMS CONTRACTOR(s)] will not share your individual responses with your
employer or with CMS.
Further details about this survey are available at [PLACEHOLDER FOR Reginfo.gov].
[PLACEHOLDER FOR OMB CONTROL NUMBER AND EXPIRATION DATE]
If you have any questions, comments, or concerns about the survey, please contact
[CMS CONTRACTOR CONTACT NAME] at [CONTRACTOR EMAIL ADDRESS] or at
[CONTRACTOR PHONE NUMBER]. If you have any questions about your rights as a
research subject, please contact the [CONTRACTOR’S] Institutional Review Board
(IRB) at [CONTRACTOR IRB PHONE NUMBER] and ask to speak to [IRB CONTACT
NAME].
Thank you in advance for your help with this important survey!
Sincerely,

[NAME OF PROJECT DIRECTOR AT CMS CONTRACTOR]
Survey Project Director
[PROJECT DIRECTOR EMAIL ADDRESS]
[PROJECT DIRECTOR PHONE NUMBER]

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