Attachment B - Crosswalk

Attachment B - Crosswalk.docx

In-Center Hemodialysis CAHPS Survey

Attachment B - Crosswalk

OMB: 0938-0926

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Attachment B:
Crosswalk for Changes to ICH CAHPS Survey: Pilot Test Version (2005) to National Implementation Version (2012)

Crosswalk for Changes to CAHPS® In-Center Hemodialysis Survey: Pilot Test Version (2005) Updated to National Implementation Version (2012)

Pilot Test

Change

Rationale for Change

National Implementation
Item

Section1

Item

Introduction

Title Page

Date and other descriptive

Updated to reflect current status

Title page

Introduction

2

Added “facility name”

Clarification

2

Your Kidney Doctors

8

Deleted2

Moved to supplemental items

Not included

The Dialysis Center Staff

18

Deleted

Moved to supplemental items

Not included

The Dialysis Center Staff

19

Deleted

Moved to supplemental items

Not included

The Dialysis Center Staff

27

Deleted

Moved to supplemental items

Not included

The Dialysis Center Staff

30

Deleted

Moved to supplemental items

Not included

The Dialysis Center Staff

31 and 32

32 substituted for stem of 31

26

The Dialysis Center Staff

31

Stem of 31 became 27

27

The Dialysis Center Staff

37

Deleted

Did not discriminate between facilities in the Pilot test or was regarded as unimportant for QI

Not included

The Dialysis Center Staff

38

Deleted

Moved to supplemental items

Not included

The Dialysis Center Staff

39

Deleted

Moved to supplemental items

Not included

The Dialysis Center

42

Deleted

Moved to supplemental items

Not included

Treatment

50

Added page number to skip statement

Clarification

41

Treatment

51

Added page number to skip statement

Clarification

42

Treatment

53

Stem of 2005 item deleted, substituted item 54

Stem not included

Treatment

54

Combined with item 53

44

(continued)

Crosswalk for Changes to CAHPS® In-Center Hemodialysis Survey: Pilot Test Version (2005) Updated to National Implementation Version (2012) (continued)

Pilot Test

Change

Rationale for Change

National Implementation
Item

Section1

Item

About You

Not included

New item

50

About You

Not included

New item

51

About You

Not included

New item

52

About You

Not included

New item

53

About You

Not included

New item

54

About You

Not included

New item

55

About You

61

Wording change

57

About You

62

Response choices changes

58

About You

Not included

New item

59

About You

63

Altered wording and response choices

61

About You

64

Minor wording change, response choices altered

62

About You

65

Replaced with new item

Clarification

60 and 60a

Notes: Numbering changes are not noted if that is the only change to the item.

1 No items changed section between the 2005 and 2012 versions of the questionnaire.

2 Items were deleted from the survey in order to shorten the instrument. In general, items were deleted because they did not discriminate between facilities in the Pilot test, to improve the flow of the questionnaire, or because they were regarded as of secondary interest for Quality Improvement. Some deleted items were moved to the Supplemental Item set.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleThe National Implementation of the Home Health Care CAHPS Survey
SubjectOMB Supporting Statement for Home Health Care CAHPS Survey
AuthorCenters for Medicare & Medicaid Services
File Modified0000-00-00
File Created2021-01-29

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