Important information for Vendors: "Lookback Period Visits" Protocol Clarification, Mode Experiment Question, and Slide Correction
folder_openChanges to Protocols and Guidelinescalendar_todayPosted February 4, 2014

CMS and the Coordination Team thank our HHCAHPS vendors for attending the Update training session on January 29, 2014. We wanted to provide responses to two questions that were asked during training and call your attention to some updated slides.

"Lookback Period Visits" Protocol Clarification

• Q: How should it be handled if a patient is sampled (and the case is fielded) but is later deemed ineligible because of updated information from the HHA indicating that the patient did not have the required number of lookback visits? In our situation, the HHA said that the patient had a lookback period visit count of greater than 1, but the updated information indicated that the lookback period visit count was equal to 1.
  
  A: The XML validation program is designed to reject files that have values outside allowed ranges. Therefore, files will be rejected if the lookback period visits variable (lb-visits) has a value of 1 rather than a value of M or 2-999. Vendors that receive updated files from their HHAs with information about the lookback visit count that make a patient who has already been sampled ineligible are advised to code that case as "220-does not meet eligible population criteria." No response data for that case should be submitted to the Data Center because the case is ineligible.
  
  The question then becomes how to code the lookback period visits variable, because the "updated" value of 1 will result in the XML file being rejected. The Coordination Team advises that for this situation, vendors should code the lookback period visits variable with an M for missing, to ensure that the XML file is accepted. Vendors should also document the reason that this case was coded to 220, just as they would document any case coded as ineligible. Sufficient documentation should be maintained to ensure that the vendor is able to explain this situation if asked during a site visit.
  
  Please note that vendors should not change the number of eligible patients that they report on the XML file if patients are identified as ineligible during the survey process or as a result of updated information provided by the HHA. The number of eligible patients should reflect the number of patients that the vendor determined were eligible when selecting the sample. This will allow the vendor to accurately replicate the sample during site visits.

Mode Experiment Question

• Q: Are there any plans to do another mode experiment with fresher (newer) data?
  
  A: CMS may consider conducting another mode experiment in the future. Information will be posted on the HHCAHPS website as soon as it becomes available.

Slide Correction

• The Update training slides have been revised to reflect corrections to the table on slides 34-37. These slides provide an example of how to sample small HHAs, taking into account the mix of short- and long-term stay patients. The slides now reflect the correct application of the 5-month exclusion period during which a patient should be considered ineligible. Previously, the slide had shown a 4-month exclusion period.

If vendors have any questions about the above, please feel free to contact the HHCAHPS Coordination Team at hhcahps@rti.org.