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Hospice CAHPS: Are You Ready? Six Ways to Know

By Karen Sorensen, Associate Vice President, National Initiatives, HealthStream

KSorensen12-11-13Even though the Hospice CAHPS Survey does not officially begin until 2015, it’s not too soon to start getting ready for this new CMS-mandated survey. At HealthStream, we’ve been busy preparing for Hospice CAHPS for several months now. As a CMS-approved survey vendor, our CAHPS Project Team has outlined all of the requirements and has worked with CMS to clarify several issues. After thorough capacity, resource and systems planning, HealthStream is ready!

Submission of the 2015 hospice quality measures and CAHPS survey results will impact hospices’ 2017 Medicare payments. The program will start with a mandatory one-month dry run followed by continuous monthly interviewing. The dry run gives hospices and HealthStream the opportunity to work under test circumstances prior to national implementation. HealthStream will offer both the CMS-approved mail and telephone data collection methodologies. 

The Hospice CAHPS Survey

The Hospice CAHPS Survey is designed to measure the experiences of patients who died while receiving hospice care as reported by their informal caregivers. The family caregiver listed in the hospice record is the individual who will first be contacted to participate in the survey. The survey includes 47 questions covering nine quality measures that will be used for eventual public reporting. The quality measures are:

  1. Hospice Team Communication (5 questions)
  2. Getting Timely Care (2 questions)
  3. Treating Family Member With Respect (2 questions)
  4. Providing Emotional Support (2 questions)
  5. Getting Help for Symptoms (4 questions)
  6. Support for Religious & Spiritual Beliefs (1 question)
  7. Information Continuity (1 question)
  8. Understanding the Side Effects of Pain Medication (1 question)
  9. Getting Hospice Care Training (4 questions)

Survey Timing

The patient’s family caregiver will be surveyed two months after the month of the patient’s death. In other words, the caregivers of April decedents will be surveyed in July. The table below illustrates the lag time between a patient’s death and when surveys will begin with their caregiver.

Blog Chart 10.2.14

Monthly Patient/Caregiver Lists

Hospices are required to supply monthly lists containing the following data elements for each decedent who died within a calendar month. Preparing the monthly patient lists that you will send to HealthStream will likely be your first and greatest challenge. HealthStream will provide a detailed file specification and we will work with all of our hospices to ensure they can provide an accurate and timely list. We are already working with the larger information companies, like Cerner, to review how these elements can be extracted.

  • Decedent name
  • Decedent date of birth
  • Decedent date of death
  • Decedent sex
  • Decedent race/ethnicity
  • Decedent primary diagnosis
  • Decedent admission date for final episode of hospice care
  • Decedent payers
  • Decedent last location/setting of care (i.e., home, assisted living facility, nursing home, acute care hospital, freestanding hospice inpatient unit)
  • Caregiver name
  • Caregiver contact information, including mailing address, telephone number(s), email address (if available)
  • Caregiver relationship to decedent (e.g., spouse/partner, child, sibling, other, etc.) 

Sampling

The number of caregivers sampled each month is based on the number of survey-eligible decedents in the prior year. Hospices with 50 to 699 survey-eligible decedents in 2014 will be required to survey all cases (census survey). For hospices with 700 or more survey-eligible decedents in 2014, a sample of 700 will be drawn under an equal-probability design. CMS will allow over sampling for hospices that have 700 or more eligible patients.

For national implementation, CMS has assumed an eligibility rate of 85% and a response rate of 50%. For the larger facilities, they anticipate 300 completed surveys based on an annual sample of 700. 

HealthStream is ready for Hospice CAHPS. Are you? Six Ways to Know:

  • Determine if you will be required to participate. Are you on track to have 50 or more decedents in 2014?
  • Work with HealthStream to determine the methodology that best suits your population.
  • Ensure you are capturing the required data elements and can extract them from your system.
  • Orient staff to the survey questions and create standards of behavior for each question.
  • Appoint an internal champion or team to focus on survey results and improvement efforts.
  • Engage staff in Action Plans.

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