Home Health & Hospice Week

Your patients will soon have a standardized tool for evaluating your services.

For CY 2011, the Centers for Medicare & Medicaid Services wants to "expand the home health quality measures reporting requirements to include the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Home Health Care Survey," according to a proposed rule published in the Aug. 6 Federal Register.

Why: "The HHCAHPS data collection will support the effective and efficient operation of the program because patients' feedback on their perspectives of the home health quality of care from the agency cannot be obtained from any other quality measure in the program," CMS maintains.

Currently, each agency can use any patientsatisfaction tool they want, but that method leaves  CMS without an accurate picture of how well agencies are performing, notes Burtsonville, MD-based health care attorney Elizabeth Hogue. "Giving agencies a standardized tool will allow surveyors to better gauge patient satisfaction," she says.

All agencies using -- and getting graded by -- the same tool will also "increase agencies' credibility" and give patients more faith in their care, Hogue says.

Potential problems: Though industry groups like the National Association for Home Care & Hospice support a standardized tool -- and the CAHPS form itself is endorsed by the National Quality Forum -- many experts are concerned.

For instance, the 34-question tool is longer than may be practical for home care patients and contains many repetitive questions, NAHC points out. The group wants CMS to re-word and consolidate key questions so that patients can easily spot their differences and provide succinct, helpful, and accurate answers.

Also, a frail patient who has trouble reading or writing may either rely on someone else to complete the tool or may skip it altogether -- both of which will skew outcomes, NAHC points out. The tool is also subjective and could be used to punish introverted, brusque staffers in favor of friendly ones, NAHC warns.

Your job: You can still speak up about CMS's plan to use the CAHPS tool, which seems unlikely to change despite industry concerns, predicts Bob Wardell, formerly with the Visiting Nurse Associations of America. Comments on the proposed rule are due by Sept. 28.