Survey Instruments
     

Updated Survey Instruments Effective with January 1, 2018 and Forward Discharges

Beginning with patients discharged in January 2018, CMS replaced the current Pain Management questions (items 12, 13 and 14 on the HCAHPS Survey) with three new questions that will comprise a new composite measure, “Communication About Pain.”

The new pain items will be required on all surveys administered to patients discharged from January 1, 2018 and forward. This change will affect all survey translations and all survey modes. The official versions of the new Pain Management items for all survey modes and in all language translations have been posted below.

Mail Survey Materials

     Click here to view or download the Updated English survey materials.

     Click here to view or download the Updated Spanish survey materials.

     Click here to view or download the Updated Russian survey materials.

     Click here to view or download the Updated Chinese survey materials.

     Click here to view or download the Updated Vietnamese survey materials.

     Click here to view or download the Updated Portuguese survey materials.


Telephone Scripts

     Click here to view or download the Updated English Telephone Script.

     Click here to view or download the Updated Spanish Telephone Script.

     Click here to view or download the Updated Chinese Telephone Script.

     Click here to view or download the Updated Russian Telephone Script.


Active IVR Scripts

     Click here to view or download the Updated English Active Interactive Voice Response Script.

     Click here to view or download the Updated Spanish Active Interactive Voice Response Script.


Copyright Statement

     Click here to view or download the English copyright statement.

     Click here to view or download the Spanish copyright statement.

     Click here to view or download the Russian copyright statement.

     Click here to view or download the Chinese copyright statement.

     Click here to view or download the Vietnamese copyright statement.

     Click here to view or download the Portuguese copyright statement.


Survey Instruments Effective through December 31, 2017 Discharges

The PDF versions of the survey instruments from the HCAHPS Quality Assurance Guidelines V12.0 are available in English, Spanish, Chinese, Russian, Vietnamese, and Portuguese.

Mail Survey Materials

    Click here to view or download the English survey materials.

    Click here to view or download the Spanish survey materials.

    Click here to view or download the Chinese survey materials.

    Click here to view or download the Russian survey materials.

    Click here to view or download the Vietnamese survey materials.

    Click here to view or download the Portuguese survey materials.


Telephone Scripts

    Click here to view or download the English Telephone Script.

    Click here to view or download the Spanish Telephone Script.

    Click here to view or download the Chinese Telephone Script.

    Click here to view or download the Russian Telephone Script.


Active IVR Scripts

    Click here to view or download the English Active Interactive Voice Response Script.

    Click here to view or download the Spanish Active Interactive Voice Response Script.


The PDF versions of the copyright statement from the HCAHPS Quality Assurance Guidelines V12.0 are available in English, Spanish, Chinese, Russian, Vietnamese, and Portuguese.

Copyright Statement

    Click here to view or download the English copyright statement.

    Click here to view or download the Spanish copyright statement.

    Click here to view or download the Chinese copyright statement.

    Click here to view or download the Russian copyright statement.

    Click here to view or download the Vietnamese copyright statement.

    Click here to view or download the Portuguese copyright statement.

 

This page was last modified on (11/28/17)