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HHCAHPS Frequently Asked Questions

Besides PECOS, RACs, MICs, MACs, and Z-PICs, the home health industry has been actively involved with CAHPs. Final rules were posted November 10, 2009.
The CAHPs survey was designed to essentially determine the performance and care quality delivered to a home health patient/client as identified by that patient/client. The industry is generally knowledgeable about CAHPS but, below are some of the most frequently asked questions to Select Data personnel.

Question 1: Which home health patients should have a HHCAHPs survey?
Answer 1: Patients whose care is paid by Medicare and Medicaid are eligible for inclusion in the HHCAHPS survey. Agencies must contract with a CMS approved vendor, who will conduct the surveys. Patients/clients have the right to state they do not wish to participate. The agency is not expected to ask the patient/client if they wish to participate. They are encouraged to leave that responsibility to the surveying vendor. For general information, visit the CAHPs website at www.homehealthcahps.org

Question 2: I know we are to include Medicare and Medicaid patients/clients but are there any guidelines?
Answer 2: Yes, for detailed guidance refer to the above website. In general be aware that the survey will consider current and discharged patients who have had at least one skilled visit during a sample month, who are at least 18 years of age, who have had at least two skilled visits from the agency during a 60 day look back period, who are not receiving hospice care, and who are not maternity clients.

Question 3: How many patient/clients should be surveyed?
Answer -3: Agencies are expected to survey 300 patients/clients annually with larger agencies using a sampling method and smaller agencies potentially surveying all clients. Agencies serving less than 60 HHCAHPs eligible patients/clients from 3rd quarter 2010 though 2nd quarter 2011 will be exempt from the HHCAHPs survey requirement. Going forward, the unduplicated patient count from 10/1 through 9/30 will be used to determine HHCAHPs.

Question 4: We are a relatively new agency and don’t have 60 patients. Do we just ignore HHCAHPs?
Answer 4: New agencies (with provider numbers) serving less than 60 patients had to notify CMS by June 16, 2010, with a patient count for the period from 4/1/2009-3/31/2010. The form used for such a count was/is available at www.homehealthcahps.org

Question 5: Can an agency decide not to participate in the HHCAHPs process and use their own survey instead?
Answer 5: HHCAHPs had been identified as a voluntary survey process, however, the final rule makes it clear that non participating agencies will be subject to a two percentage point reduction in the market basket update in 2012.

Question 6: We do not want to have two surveys going to our patients/clients. Can we work with a vendor to develop our own individualized survey tool?
Answer 6: Yes. The HHCAHPs survey consists of 34 survey questions addressing care as it relates to safety, medication, pain management, along with communication and interpersonal interactions. The patients will also be rating the agency overall and the likelihood of referring the agency to another individual. The surveys will also collect data regarding the types of services received as well as ratings regarding the patient’s view of their own overall health. The CAHPs questions are required and cannot be changed or deleted, but agencies may add questions to the survey.

Question 7: If the patient is confused, can the agency answer the questions for them?
Answer 7: No. The patient/client’s family/friends may answer the questions as a proxy, but the agency personnel may NOT answer the CAHPs survey.

Question 8: Can we send the patient lists to our CAHPs vendor quarterly?
Answer 8: CMS expects the data to be sent to the vendor within 21 days after the close of the month.

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