CMS-10275. Attachment B_Comparison of Current and Revised HHCAHPS Survey Instruments

Comparison of Current and Proposed Home Health Care CAHPS^® Survey Instruments

HHCAHPS Survey, current version		HHCAHPS Survey, proposed version		Summary of Changes1
1.	According to our records, you got care from the home health agency, [AGENCY NAME]. Is that right? As you answer the questions in this survey, think only about your experience with this agency. Yes No	1.	According to our records, you got care from the home health agency, [AGENCY NAME]. Is that right? Yes No	Moved text to reduce respondent burden.
2.	When you first started getting home health care from this agency, did someone from the agency tell you what care and services you would get? Yes No Do not remember		N/A	Item removed to reduce respondent burden.
3.	When you first started getting home health care from this agency, did someone from the agency talk with you about how to set up your home so you can move around safely? Yes No Do not remember	2.	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. Yes No I don’t know I did not need help with home safety	Minor changes to wording and response options to improve usability.
4.	When you started getting home health care from this agency, did someone from the agency talk with you about all the prescription and over-the-counter medicines you were taking? Yes No Do not remember	3.	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. Yes No I don’t know I don’t take any medicines	Minor changes to wording and response options to improve usability.
5.	When you started getting home health care from this agency, did someone from the agency ask to see all the prescription and over-the-counter medicines you were taking? Yes No Do not remember		N/A	Item removed to reduce respondent burden.
6.	In the last 2 months of care, was one of your home health providers from this agency a nurse? Yes No		N/A	Item removed to reduce respondent burden.
7.	In the last 2 months of care, was one of your home health providers from this agency a physical, occupational, or speech therapist? Yes No		N/A	Item removed to reduce respondent burden.
8.	In the last 2 months of care, was one of your home health providers from this agency a home health or personal aide? Yes No		N/A	Item removed to reduce respondent burden.
9.	In the last 2 months of care, how often did home health providers from this agency seem informed and up-to-date about all the care or treatment you got at home? Never Sometimes Usually Always I only had one provider in the last 2 months of care	6.	In the last 2 months of care, how often did home health staff from this agency seem to be aware of all the care or treatment you were getting at home? Never Sometimes Usually Always	Minor wording changes to improve usability.
10.	In the last 2 months of care, did you and a home health provider from this agency talk about pain? Yes No		N/A	Item removed to reduce respondent burden.
11.	In the last 2 months of care, did you take any new prescription medicine or change any of the medicines you were taking? Yes No		N/A	Item removed to reduce respondent burden.
12.	In the last 2 months of care, did home health providers from this agency talk with you about the purpose for taking your new or changed prescription medicines? Yes No I did not take any new prescription medicines or change any medicines		N/A	Item removed to reduce respondent burden.
13.	In the last 2 months of care, did home health providers from this agency talk with you about when to take these medicines? Yes No I did not take any new prescriptions medicines or change any medicines		N/A	Item removed to reduce respondent burden.
14.	In the last 2 months of care, did home health providers from this agency talk with you about the side effects of these medicines? Yes No I did not take any new prescriptions medicines or change any medicines	4.	In the last 2 months of care, did home health staff from this agency talk with you about any side effects of your medicines? Yes No I don’t know I don’t take any medicines	Minor wording changes to improve usability.
15.	In the last 2 months of care, how often did home health providers from this agency keep you informed about when they would arrive at your home? Never Sometimes Usually Always	5.	In the last 2 months of care, how often did home health staff from this agency keep you informed about when they would arrive at your home? Never Sometimes Usually Always	Minor wording changes to improve usability.
16.	In the last 2 months of care, how often did home health providers from this agency treat you as gently as possible? Never Sometimes Usually Always	7.	In the last 2 months of care, how often did home health staff from this agency treat you with care – for example, when moving you around or changing a bandage? Never Sometimes Usually Always	Minor wording changes to improve usability.
17.	In the last 2 months of care, how often did home health providers from this agency explain things in a way that was easy to understand? Never Sometimes Usually Always	8.	In the last 2 months of care, how often did home health staff from this agency explain things in a way that was easy to understand? Never Sometimes Usually Always	Minor wording changes to improve usability.
18.	In the last 2 months of care, how often did home health providers from this agency listen carefully to you? Never Sometimes Usually Always	9.	In the last 2 months of care, how often did home health staff from this agency listen carefully to you? Never Sometimes Usually Always	Minor wording changes to improve usability.
19.	In the last 2 months of care, how often did home health providers from this agency treat you with courtesy and respect? Never Sometimes Usually Always	10.	In the last 2 months of care, how often did home health staff from this agency treat you with courtesy and respect? Never Sometimes Usually Always	Minor wording changes to improve usability.
	N/A	11.	In the last 2 months of care, how often did you feel that home health staff from the agency cared about you as a person? Never Sometimes Usually Always	New item identified as important by HHAs and consumers based on stakeholder feedback. The mode experiment data showed it psychometrically fit into an existing HHCAHPS multi-item measure.
	N/A	12.	In the last 2 months of care, did home health staff from this agency provide your family or friends with information or instructions about your care as much as you wanted? Yes No I don’t know I did not want or need this	New item identified as important by HHAs and consumers based on stakeholder feedback. The mode experiment data showed it psychometrically fit into an existing HHCAHPS multi-item measure
	N/A	13.	In the last 2 months of care, how often have the services you received from this agency helped you take care of your health? Never Sometimes Usually Always	New item identified as important by HHAs and consumers based on stakeholder feedback. The mode experiment data showed it psychometrically fit into an existing HHCAHPS multi-item measure
20.	We want to know your rating of your care from this agency’s home health providers. 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 providers? 0 Worst home health care possible 1 2 3 4 5 6 7 8 9 10 Best home health care possible	14.	We want to know your rating of your care from this agency’s home health staff. 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? 0 Worst home health care possible 1 2 3 4 5 6 7 8 9 10 Best home health care possible	Minor wording changes to improve usability.
21.	In the last 2 months of care, did you contact this agency’s office to get help or advice? Yes No	15.	Have you contacted this agency’s office for help or advice? Yes No	Minor wording changes to improve usability.
22.	In the last 2 months of care, when you contacted this agency’s office did you get the help or advice you needed? Yes No I did not contact this agency	16.	When you contacted this agency’s office, did you get the help or advice you needed? Yes No	Minor wording changes to improve usability.
23.	When you contacted this agency’s office, how long did it take for you to get the help or advice you needed? Same day 1 to 5 days 6 to 14 days More than 14 days I did not contact this agency		N/A	Item removed to reduce respondent burden.
24.	In the last 2 months of care, did you have any problems with the care you got through this agency? Yes No		N/A	Item removed to reduce respondent burden.
25.	Would you recommend this agency to your family or friends if they needed home health care? Definitely no Probably no Probably yes Definitely yes	17.	Would you recommend this agency to your family or friends if they needed home health care? Definitely no Probably no Probably yes Definitely yes	No changes to question wording.
26.	In general, how would you rate your overall health? Excellent Very good Good Fair Poor	18.	In general, how would you rate your overall health? Excellent Very good Good Fair Poor	No changes to question wording.
27.	In general, how would you rate your overall mental or emotional health? Excellent Very good Good Fair Poor	19.	In general, how would you rate your overall mental or emotional health? Excellent Very good Good Fair Poor	No changes to question wording.
28.	Do you live alone? Yes No	20.	Do you live alone? Yes No	No changes to question wording.
29.	What is the highest grade or level of school that you have completed? 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 More than 4-year college degree	21.	What is the highest grade or level of school that you have completed? 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 More than 4-year college degree	No changes to question wording.
30.	Are you Hispanic or Latino/a? Yes No		N/A	Question was merged with Q22.
31.	What is your race? Please select one or more. American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White	22.	What is your race or ethnicity? Please mark one or more. American Indian or Alaska Native Asian Black or African American Hispanic or Latino Middle Eastern or North African Native Hawaiian or Pacific Islander White	Additional response categories added.
32.	What language do you mainly speak at home? English Spanish Some other language (open end)	23.	What language do you mainly speak at home? English Spanish Some other language (open end)	No changes to question wording.
33.	Did someone help you complete this survey? Yes No	24.	Did someone help you complete this survey? Yes No	No changes to question wording.
34.	How did that person help you? Read the questions to me Wrote down the answers I gave Answered the questions for me Translated the questions into my language Helped in some other way (open end) No one helped me complete this survey	25.	How did that person help you? Read the questions to me Wrote down the answers I gave Answered the questions for me Translated the questions into my language Helped in some other way (open end) No one helped me complete this survey	No changes to question wording.

1 The changes the HHCAHPS Survey instrument described in this table are proposed for both the mail and telephone versions of the instruments and upon approval translated into the additional languages offered for the HHCAHPS Survey.