The CMS wants more information about the quality of care Medicare beneficiaries get in long-term-care hospitals, so the agency is preparing a new patient-satisfaction survey tailored to the facilities.
If the agency adopts a survey, the findings may be published on the CMS website to help consumers make more informed decisions about long-term-care settings and drive improvements in the quality of care.
“A rigorous, well-designed LTCH Survey will allow us to understand patient experiences throughout their LTCH care, as reported by the patients themselves, if possible, or by family members,” the agency says in a Federal Register notice.
Medicare's HCAHPS survey fuels the government's star ratings for hospitals and is a key component of the value-based purchasing program.
The use of HCAHPS in ratings and payment incentive programs has been somewhat controversial. Some experts say it leads hospitals to focus on things that make patients happy but aren't clinically valuable or even appropriate. Some critics also say the HCAHPS survey is unfair to hospitals that treat disproportionate numbers of patients with complex medical conditions, who are generally less likely to say they were satisfied with their care.
The CMS is also considering a child HCAHPS survey to evaluate the satisfaction of pediatric patients and their parents.
Long-term-care hospitals are certified as acute-care hospitals but specialize in care to beneficiaries who need hospital-level care for an extended period, on average more than 25 days. Their services include critical care, respiratory therapy, head trauma treatment and pain management.
The CMS is collecting feedback on what information should be collected in a long-term-care survey. Comments are due Jan. 19, 2016. Providers have had mixed reactions to the survey proposal so far.
“Collecting survey data entails significant costs for providers,” said Akin Demehin, senior associate director of policy at the American Hospital Association. “CMS must carefully balance the value of survey data with the time and resources needed to collect them.”
Rochelle Zapol, general counsel at National Association of Long-Term Hospitals, said a survey could provide long-term-care hospitals with valuable feedback to help them make sure patients and families are engaged “and promote effective communication and coordination of care.”
Advocates are similarly split. “These surveys can provide important information to help improve the quality of care and services that people receive,” said Rhonda Richards, a senior legislative representative for AARP.
But Jack Halpern, CEO of My Elder Advocate, an organization that helps navigate families through elder long-term-care needs, called the survey idea “just a PR ploy.”
“CMS already has all the information it needs on all the (LTCHs) in the country,” Halpern said. “If CMS acts upon these surveys to improve care, then it would have some meaning.”
In 2011, Medicare spent $5.4 billion on care furnished in 424 long-term-care hospitals nationwide, according to the Medicare Payment Advisory Commission. Medicare beneficiaries account for about two-thirds of the facilities' discharges.
