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Are you monitoring the agency’s HHCAHPS Star Ratings? There are numerous questions on the survey that the patients must complete, but only selected ones go into the outcome calculation and eventual star rating. The Composite Measure – Specific Care Issues, seems to be one that most agencies struggle with. The specific questions from the survey that go into the measure calculation are as follows:

  • Q3 – 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?
  • Q4 – 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?
  • Q5 – 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?
  • Q10 – In the last 2 months of care, did you and a home health provider from this agency talk about pain?
  • Q12 – 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?
  • Q13 – In the last 2 months of care, did home health providers from this agency talk with you about when to take these medicines?
  • Q14 – In the last 2 months of care, did home health providers from this agency talk with you about the side effects of these medicines?

Some of the key factors in the patients relating to these questions are in bold large print within each question.  Agencies will need to be very specific with field staff regarding the wording of these questions.  They need to be instructed that the wording of these questions must be included in the day to day care of the patient.

For example: Therapist goes into the home for initial Evaluation and during the visit removes a throw rug from the patients living room and tells the patient that he removed it to keep the patient from tripping.

The HHCAHPS friendly action should be:  Therapist goes into the home for initial Evaluation and during the visit removes a throw rug from the patient’s living room and tells the patient that he removed it to for the patient’s SAFETY.  Also, saying things like:  for your SAFETY you need to use your walker when ambulating, for your SAFETY you need to use the grab bars when in the shower, etc.  It cannot be assumed that safety is implied.

When discussing medications with the patient, the field staff need to use prescription and over-the-counter language, not just ask to see medications.  When discussing side effects there needs to be conversations using that terminology, not just printouts handed to the patient or put into their home folders.  When discussing why the patient takes a medication and what the expected outcome is, make sure the field staff are using the term PURPOSE for the medication.

If agencies expect that the patients are going to associate their care with this questionnaire the staff must be diligent about all things pointing to that end result.  If staff don’t talk the talk it is not going to happen.

Agencies should be training staff in content of the questionnaire.  DON’T FORGET to include all field staff members in this process.  The agency’s home health aides are some of the most influential people in the patients’ lives.  The Aides must be trained in what their patients are going to be asked.

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