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pdfSample Cover Letter for First Questionnaire Mailing
Home Health Care CAHPS Survey
To be Printed on Home Health Agency or Vendor Letterhead
NAME
ADDRESS
CITY, STATE ZIP
Dear NAME:
[Agency Name] is taking part in a national survey to provide the United States Department of
Health and Human Services with information about the quality of health care delivered to people
in their homes. Our records show that you recently received health care services in your home
from [Agency Name]. You, along with a sample of other people who receive home health care,
have been selected to take part in this important survey. Your feedback on the care that you
receive is important, because it will help improve the quality of home health care we provide.
The survey results will help people make more informed decisions when choosing a home health
care provider. Results will be publicly reported on the Internet at Home Health Compare at
http://www.medicare.gov/. The enclosed questionnaire asks for your opinions about the home
health care you received. We hope that you will take a few minutes to complete and return the
questionnaire in the enclosed, postage-paid envelope.
If you need help reading or answering the questions, please ask a family member or friend
to help you. It is important that your answers reflect your own opinions about the home health
care you received, so please do not ask anyone from [Agency Name] for help when completing
the survey.
Your participation in this survey is voluntary and will not affect any health care or benefits you
receive. All information you give in this survey will be held in confidence and is protected by the
Privacy Act. Your answers to the survey will be grouped with answers from all other survey
participants; your name and identifying information will not be linked to your answers when the
data are analyzed. The results from this survey may be shared with the home health agency for
quality improvement purposes. If you have any questions about the survey, please call
NAME toll-free at 1-XXX-XXX-XXXX. Thank you in advance for your participation.
Sincerely,
Name
Home Health Agency Administrator
Enclosures
[PRINT SAMPLE IDENTIFICATION NUMBER HERE]
File Type | application/pdf |
File Title | Protocols and Guidelines Manual |
Subject | Home Health Care CAHPS Survey |
Author | Centers for Medicare & Medicaid Services |
File Modified | 2013-06-21 |
File Created | 2013-06-21 |