Home Healthcare Satisfaction (CAHPS) Survey

Data Processing and Coding

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The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Home Health Care Survey is designed to help providers measure client/patient satisfaction. In this ongoing series, we now look at processing and coding your CAHPS survey.

This includes the requirements and guidelines for creating and assigning a unique sample identification (SID) number, decision rules related to processing returned mail survey questionnaires, assignment of survey disposition codes, and quality control measures.

Sample Identification Numbers

A unique numeric or alphanumeric SID number must be assigned to each patient included in the Home Health Care CAHPS (HHCAHPS) Survey sample. Here are some guidelines:

  • The SID number cannot contain any combination of letters or numbers that could link the SID with a particular sample member.
  • It must have a minimum length of 6 and a maximum length of 16 characters.
  • Vendors must assign new SID numbers to the new set of patients sampled each month and cannot reuse the same SID number.
  • If a patient is sampled more than once in a calendar year or across multiple calendar years, the vendor must assign a new SID number to that patient each time.

Decision Rules and Coding Guidelines

Guidelines and procedures for handling ambiguous, missing, or inconsistent survey responses from returned mail survey include:

  • If a response mark falls between two answer choices but is clearly closer to one answer choice than to another, select the response that is closest to the marked response.
  • If two responses are checked for the same question, select the one that appears darkest. If it is not possible to make a determination, leave the response blank and code as “missing”.
  • If a mark is between two answer choices but is not clearly closer to one answer choice, code as “missing.”
  • The only survey items in the HHCAHPS Survey where two or more answers are acceptable are Questions 31 and 34.

    Some of the questions included in the HHCAHPS Survey instrument are “screening” questions—that is, they are designed to determine whether one or more follow-up questions about the same topic are applicable to the respondent. The respondent is directed to the next applicable question. In mail surveys, some respondents may answer the screening question but leave applicable follow-up questions blank.

    • Key or scan the response provided by the respondent. If the screener question is left blank, code it as “Missing.”
    • If the answer to Q1 on the mail survey is “No,” which implies that the respondent is ineligible, but some or all of the rest of the questions in the survey have been answered, key or scan all responses. If the questionnaire meets the completeness criteria, code the questionnaire as a completed survey.
    • If the answer to Q1 on the mail survey is missing, but some or all of the rest of the questions in the survey have been answered, key or scan all of the responses marked, including the “M” response to Q1. If the questionnaire meets the completeness criteria, code the questionnaire as a completed survey.

      Follow-Up Questions

      Enter the response provided by the respondent whenever one is given, regardless of whether the response agrees with the screener question. When follow-up questions are appropriately skipped, the follow-up question response should be coded as “Not Applicable.” When follow-up questions are incorrectly answered, enter the response that the respondent provides.

      Survey Disposition Codes

      Survey disposition codes, which are also referred to as status codes, are used to track the current status of a sampled case as it moves through the survey process. They are coded as follows:

      • Code 110: Completed Mail Survey
      • Code 120: Completed Phone Survey
      • Code 210: Ineligible: Deceased
      • Code 220: Ineligible: Does Not Meet Eligible Population Criteria
      • Code 230: Ineligible: Language Barrier
      • Code 240: Ineligible: Mentally or Physically Incapacitated/No Proxy Available
      • Code 310: Break-Off - This code is assigned if the sample member completes some responses but not enough to meet the completeness criteria.
      • Code 320: Refusal - This code is assigned if the sample member indicates either in writing or verbally that he or she does not wish to participate.
      • Code 330: Bad Address/Undeliverable Mail
      • Code 340: Wrong, Disconnected, or No Telephone Number
      • Code 350: No Response After Maximum Attempts

      Finally, when selecting a vendor for survey implementation, assure that they have quality control measures for every aspect of mail and telephone data processing activities. Assuring accurate responses will, in turn, assure that you are collecting meaningful date that you can act upon.​

      Source: Centers for Medicare and Medicaid Services (CMS)

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