Telephone Script

Telephone Interview Script
for the HHCAHPS Survey

INTRO1

Hello, may I please speak to [SAMPLE MEMBER NAME]?
<1>
<2>
<3>
<4>
<5>
<6>

YES
[GO TO INTRO2]
NO, NOT AVAILABLE RIGHT NOW
[SET CALLBACK]
NO [REFUSAL]
[GO TO TERMINATE SCREEN]
MENTALLY/PHYSICALLY INCAPABLE
[GO TO PROXY SCRIPT]
WRONG NUMBER
[SELECT CALL OUTCOME FROM LIST
WOULD LIKE TO BE CALLED ON A NEW NUMBER
[CAPTURE NEW
NUMBER]

MISSING/DK

IF ASKED WHO IS CALLING:
This is [INTERVIEWER NAME] calling from RTI International. I’d like to speak to
[SAMPLE RESPONDENT’S NAME] about a study about health care.
INTRO2

Hello, this is [INTERVIEWER NAME] calling on behalf of [HOME HEALTH AGENCY].
[HOME HEALTH AGENCY] is participating in a survey about the care people receive
from their home health agencies. This survey is part of a national effort to measure the
quality of care from home health care agencies. The survey results will be used by
people when choosing a home health care agency.
Your participation in this survey is voluntary and will not affect your health care or any
benefits you receive. The interview will take about 10 minutes to complete. This call may
be monitored or recorded for quality improvement purposes.

INTRO3 AND INTRO4 USED ONLY IF CALLING SAMPLE MEMBER BACK TO COMPLETE A SURVEY
THAT WAS BEGUN IN A PREVIOUS CALL. NOTE THAT THE SAMPLE MEMBER MUST HAVE
ANSWERED AT LEAST ONE QUESTION IN THE SURVEY IN A PRECEDING CALL.
INTRO3

Hello, may I please speak to [SAMPLE MEMBER’S NAME]?
IF ASKED WHO IS CALLING:
This is [INTERVIEWER NAME] calling from RTI International. I’d like to speak to
[SAMPLE MEMBER’S NAME] about a study about health care.
<1>
<2>
<3>
<4>
<5>
<6>

YES, SAMPLE MEMBER IS AVAILABLE AND ON PHONE NOW
[GO TO
INTRO4]
NO, NOT AVAILABLE RIGHT NOW
[SET CALLBACK]
NO [REFUSAL]
[GO TO TERMINATE SCREEN]
MENTALLY/PHYSICALLY INCAPABLE
[GO TO PROXY SCRIPT]
WRONG NUMBER
[SELECT CALL OUTCOME FROM LIST]
WOULD LIKE TO BE CALLED ON A NEW NUMBER
[CAPTURE NEW
NUMBER]

INTRO4

Hello, I am calling to continue the survey that we started in a previous call, regarding the
care that you received from [HOME HEALTH AGENCY].
<1>
<2>
<3>

Q1

CONTINUE WITH INTERVIEW AT FIRST UNANSWERED QUESTION
NO, NOT RIGHT NOW
[GO TO SET CALLBACK]
NO [REFUSAL]
[GO TO TERMINATE SCREEN]

According to our records, you got care from the home health agency, [HOME HEALTH
AGENCY]. Is that right?
<1>
<2>

YES
NO

[GO TO Q2_INTRO]
[GO TO INELIGIBLE SCREEN; END INTERVIEW]

MISSING/DK

Q2_INTRO

As you answer the questions in this survey, think only about your experience with
[HOME HEALTH AGENCY].

Q2

When you first started getting home health care from this agency, did you get the
information you needed about what care and services you would get? Would you say…
<1>
<2>
<3>

Yes,
No, or
Not sure?

MISSING/DK

Q3_INTRO

These next questions are about all the different staff from [HOME HEALTH AGENCY].
Do not include care you got from staff from another home health care agency.

Q3

When you first started getting home health care from this agency, did someone from the
agency talk about ways to help make your home safer? For example, they may have
suggested adding grab bars in the shower or removing tripping hazards. Would you
say…
<1>
<2>
<3>
<4>

Yes,
No,
You don’t know, or
You did not need help with home safety?

MISSING/DK

2

Q4

Q5

Q6

Q7

Q8

Has someone from the agency ever reviewed the prescribed and over-the-counter
medicines you were taking? For example, they might have asked you to show them your
medicines and talked with you about how and when to take each one. Would you say…
<1>
<2>
<3>
<4>

Yes,
No,
You don’t know, or
You don’t take any medicines?

MISSING/DK

[GO TO Q6]

In the last 2 months, did home health staff from this agency talk with you about any side
effects of your medicines? Would you say…
<1>
<2>
<3>
<4>

Yes,
No,
You don’t know, or
You don’t take any medicines?

MISSING/DK

In the last 2 months, how often did home health staff from this agency keep you informed
about when they would arrive at your home? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

In the last 2 months, how often did home health staff from this agency seem to be aware
of all the care or treatment you were getting at home? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

In the last 2 months, how often did home health staff from this agency treat you with
care – for example, when moving you around or changing a bandage? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

3

Q9

Q10

Q11

Q12

Q13

In the last 2 months, how often did home health staff from this agency explain things in
a way that was easy to understand? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

In the last 2 months, how often did home health staff from this agency listen carefully to
you? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

In the last 2 months, how often did home health staff from this agency treat you with
courtesy and respect? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

In the last 2 months, how often did you feel that home health staff from the agency cared
about you as a person? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

In the last 2 months, did home health staff from this agency provide your family or
friends with information or instructions about your care as much as you wanted?
Would you say…
<1>
<2>
<3>
<4>

Yes,
No,
You don’t know, or
You did not want or need this?

MISSING/DK

4

Q14

In the last 2 months, have the services you received from this agency helped you take
care of your health? Would you say…
<1>
<2>
<3>
<4>

Never,
Sometimes,
Usually, or
Always?

MISSING/DK

Q15_INTRO

We want to know your rating of your care from this agency’s home health staff.

Q15

Using any number from 0 to 10, where 0 is the worst home health care possible and 10 is
the best home health care possible, what number would you use to rate your care from
this agency’s home health staff?
READ RESPONSE CHOICES ONLY IF NECESSARY
<00>
<01>
<02>
<03>
<04>
<05>
<06>
<07>
<08>
<09>
<10>

0 WORST HOME HEALTH CARE POSSIBLE
1
2
3
4
5
6
7
8
9
10 BEST HOME HEALTH CARE POSSIBLE

MISSING/DK

Q16_INTRO

The next questions are about the office of [HOME HEALTH AGENCY].

Q16

Have you contacted this agency’s office for help or advice?

Q17

<1>
<2>

YES
NO

MISSING/DK

[GO TO Q18]
[GO TO Q18]

When you contacted this agency’s office, did you get the help or advice you needed?
<1>
<2>

YES
NO

MISSING/DK

5

Q18

Would you recommend this agency to someone who needed home health care? Would
you say…
<1>
<2>
<3>
<4>

Definitely no,
Probably no,
Probably yes, or
Definitely yes?

MISSING/DK

Q19_INTRO

There are only a few questions left. Please listen to all response choices before making a
selection.

Q19

In general, how would you rate your overall health? Would you say that it is…

Q20

Q21

Q22

<1>
<2>
<3>
<4>
<5>

Excellent,
Very good,
Good,
Fair, or
Poor?

MISSING/DK

In general, how would you rate your overall mental or emotional health? Would you say
that it is…
<1>
<2>
<3>
<4>
<5>

Excellent,
Very good,
Good,
Fair, or
Poor?

MISSING/DK

Do you live alone?
<1>
<2>

YES
NO

MISSING/DK

What is the highest grade or level of school that you have completed? Would you say…
<1>
<2>
<3>
<4>
<5>
<6>

8th grade or less,
Some high school, but did not graduate,
High school graduate or GED,
Some college or 2-year degree,
4-year college graduate, or
More than 4-year college degree?

MISSING/DK

6

Q23

Q24

Q25

Q25A

Are you Hispanic or Latino/Latina?
<1>
<2>

YES
NO

MISSING/DK

What is your race? Please choose one or more of the following. Are you....
<1>
<2>
<3>
<4>
<5>

White,
Black or African American,
Asian,
Native Hawaiian or other Pacific Islander, or
American Indian or Alaska Native?

MISSING/DK

What language do you mainly speak at home? Would you say…
<1>
<2>
<3>

English,
[GO TO Q_END]
Spanish, or
[GO TO Q_END]
Some other language?
[GO TO Q25A]

MISSING/DK

What other language do you mainly speak at home? (ENTER RESPONSE BELOW).
{ALLOW UP TO 50 CHARACTERS}

MISSING/DK

INELIGIBLE SCREEN:
Q_INELIG

Thank you for your time. Have a good (day/evening).

REFUSAL SCREEN:
Q_REF

Thank you for your time. Have a good (day/evening).

Q_END

These are all the questions I have for you. Thank you for your time. Have a good
(day/evening).

7