Form 1147 2015 902 CMS Compare

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Overview

Welcome and Thank You Text
Current Model Qsts
Current CQs
Current CQs (10-30-14)

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Sheet 1: Welcome and Thank You Text

Model Instance Name:
Medicare Compare Web Sites
MID:	cBlIhVANgskhB8YcgkM1EA==
Date:	11/27/2012
Welcome and Thank You Text
	Directions:
	This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome and Thank you text shown in the boxes below. Please read comments before using any of the text.
					Examples
					Welcome Text Example
	Welcome Text
	Thank you for visiting our web site. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.
					Thank You Text Example
	DEFAULT Thank You Text
	“Thank you for taking our survey - and for helping us serve you better. We appreciate your input!”
	ALTERNATE WEB Thank You Text
	Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website.

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Sheet 2: Current Model Qsts

Model Instance Name:
Medicare Compare Web Sites
MID:		cBlIhVANgskhB8YcgkM1EA==
Partitioned (Y/N)?		Yes
NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research.
Date:		11/27/2012
Medicare Compare Web Sites
Model questions utilize the ACSI methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS
	MQ Label			MQ Label			MQ Label
		Information (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Recommend (1=Very Unlikely, 10=Very Likely)
1	Information - Amount	Please rate the amount of information provided.	16	Satisfaction - Overall	What is your overall satisfaction with the compare web site? (1=Very Dissatisfied, 10=Very Satisfied)	19	Recommend	How likely are you to recommend the compare web site to someone else?
2	Information - Usefulness	Please rate the usefulness of the information provided.	17	Satisfaction - Expectations	How well does the compare web site meet your expectations? (1=Falls Short, 10=Exceeds)			Use Medicare.gov (1=Very Unlikely, 10=Very Likely)
3	Information - Accuracy	Please rate your perception of the accuracy of the information on this compare web site.	18	Satisfaction - Ideal	How does the Medicare quality compare web site compare to your idea of an ideal comparison web site? (1=Not Very Close, 10=Very Close)	20	Use Medicare.gov	How likely are you to visit Medicare.gov (Medicare's web site) for future Medicare-related needs?
		Results(1=Poor, 10=Excellent, Don't Know)						Trust
4	Results - Match	Please rate how well the results provided match your request.				21	Trust - My Best Interests	I can count on Medicare to act in my best interests. (=1 Very Unlikely, 10=Very Likely)
5	Results - Relevance	Please rate the relevance of the results to your specific needs.				22	Trust - Trustworthy	I consider Medicare to be trustworthy. (=1 Very Unlikely, 10=Very Likely)
6	Results - Listing	Please rate the listing/ranking order of compare web site results.				23	Trust - Do What Is Right	Medicare can be trusted to do what is right. (=1 Very Unlikely, 10=Very Likely)
		Look & Feel (1=Poor, 10=Excellent, Don't Know)
7	Look and Feel - Appeal	Please rate the visual appeal of the compare web site.
8	Look and Feel - Balance	Please rate the balance of graphics and text on the compare web site.
9	Look and Feel - Readability	Please rate the readability of the pages on the compare web site.
		Process (1=Poor, 10=Excellent, Don't Know)
10	Process - Streamline	Please rate the how well this web site streamlines the process of finding information.
11	Process - Features	Please rate the features available for finding information.
12	Process - Time	Please rate how well this web site minimizes the amount of time needed to get useful information.
		Site Performance (1=Poor, 10=Excellent, Don't Know)
13	Site Performance - Loading	Please rate how quickly pages load.
14	Site Performance - Consistency	Please rate the consistency of speed from page to page.
15	Site Performance - Errors	Please rate the ability to load pages without getting error messages.

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Sheet 3: Current CQs

Model Instance Name:			red & strike-through: DELETE
Medicare Compare Web Sites			underlined & italicized: RE-ORDER
MID:	cBlIhVANgskhB8YcgkM1EA==		pink: ADDITION
Date:	11/27/2012		blue + -->: REWORDING
Medicare Compare Web Sites CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label	Compare Web Sites
LNH2232		Which Quality Compare Web Site did you use today?	Nursing Home Compare	A, B, C	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Compare Web Site
			Hospital Compare	P, Q
			Home Health Compare	EE, FF, GG, HH
			Dialysis Facility Compare	UU, VV, HHH, JJJ
LNH2233	A	What best describes your role in using the Nursing Home Compare?	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Role	Nursing Home Compare
			Caregiver (family member or friend)
			Caregiver (paid)
			Nursing Home staff member	D
			Discharge Planner
			Researcher
			Other Health Care Provider
			Other (please specify:)	E
LNH2234	E	What other role best describes you while using the Nursing Home Compare?			Text field, <100 char		N	Skip Logic Group*	NH Other_Role	Nursing Home Compare
LNH2235	D	Have you ever used information from Nursing Home Compare to inform an internal quality review or improvements?	Yes	F	Radio button, one-up vertical	Single	Y		NH Inform Improv	Nursing Home Compare
			No
LNH2236	F	What information did you use? Please be specific about your experience.			Text area, no char limit		N	Skip Logic Group*	NH Information Used	Nursing Home Compare
LNH2237	B	What was your primary purpose in visiting Nursing Home Compare today?	Choose a Nursing Home for myself or a family member	G, H, I	Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Purpose	Nursing Home Compare
			Research Nursing Homes for myself or family members, but not choose one today.	G, H, I
			Download data about Nursing Homes	M, N
			Other (please specify:)	P
LNH2238	P	What was your other primary purpose in visiting Nursing Home Compare?			Text area, no char limit		N	Skip Logic Group*	NH Other_Purpose	Nursing Home Compare
LNH2239	G	How helpful was the information you found on Nursing Home Compare in your choice and research?	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	NH Helpful	Nursing Home Compare
			2
			3
			4	J
			5 = Not very helpful / Very unhelpful	J
LNH2240	J	What would have made the information more helpful?			Text area, no char limit		N	Skip Logic Group*	NH More Helpful	Nursing Home Compare
LNH2241	H	Does the information on Nursing Home Compare give you a full picture of the quality of the Nursing Homes?	Yes	K	Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Picture	Nursing Home Compare
			No	L
LNH2242	K	What was most helpful in determining quality?			Text area, no char limit		N	Skip Logic Group*	NH Most Helpful	Nursing Home Compare
LNH2243	L	What information should be added to give a more complete picture of quality?			Text area, no char limit		N	Skip Logic Group*	NH Info Added	Nursing Home Compare
LNH2244	I	Based on your experience with Nursing Home Compare, how confident are you about choosing a Nursing Home using this information?	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	NH Confident	Nursing Home Compare
			2
			3
			4
			5 = Not very confident
LNH2245	M	When you accessed the data, did you:	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Access Data	Nursing Home Compare
			Access the data using data.medicare.gov
LNH2246	N	Have you ever used data.medicare.gov to access data?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH data.medicare	Nursing Home Compare
			No, but I know that it’s available
			No, and I didn’t know that the data was available through data.medicare.gov
LNH2247	C	Have you ever used another web site to compare Nursing Home quality?	Yes	O	Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Another Web site	Nursing Home Compare
			No, but I am aware of other web sites that compare Nursing Home quality.
			No, and I was not aware of other web sites that compare Nursing Home quality.
LNH2248	O	Which web site did you use?			Text area, no char limit		N	Skip Logic Group*	NH Other_Web site	Nursing Home Compare
LNH2249	P	What best describes your role in using the Hospital Compare?	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Role	Hospital Compare
			Caregiver (family member or friend)
			Caregiver (paid)
			Hospital staff member	R, S
			Physician	R, S
			Researcher	R, S
			Other Health Care Provider	R, S
			Other (please specify:)	T
LNH2250	T	What other role best describes you while using the Hospital Compare?			Text field, <100 char		N	Skip Logic Group*	Hosp Other_Role	Hospital Compare
LNH2251	R	In your visit to Hospital Compare, did you:	Review only one measure set or measure.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Measures	Hospital Compare
			Review multiple measure sets.
LNH2252	S	Have you ever used information from Hospital Compare to inform an internal quality review or improvements?	Yes	U	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Inform Improv	Hospital Compare
			No
LNH2253	U	What information did you use? Please be specific about your experience.			Text area, no char limit		N	Skip Logic Group*	Hosp Information Used	Hospital Compare
LNH2254	Q	What was your primary purpose in visiting Hospital Compare today?	Choose a Hospital for myself or a family member	V, W, X	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Purpose	Hospital Compare
			Research Hospitals for myself or family members, but not choose one today.	V, W, X
			Download data about Hospitals	BB, CC
			Other (please specify:)	DD
LNH2255	DD	What was your other primary purpose in visiting Hospital Compare?			Text area, no char limit		N	Skip Logic Group*	Hosp Other_Purpose	Hospital Compare
LNH2256	V	How helpful was the information you found on Hospital Compare in your choice and research?	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	Hosp Helpful	Hospital Compare
			2
			3
			4	Y
			5 = Not very helpful / Very unhelpful	Y
LNH2257	Y	What would have made the information more helpful?			Text area, no char limit		N	Skip Logic Group*	Hosp More Helpful	Hospital Compare
LNH2258	W	Does the information on Hospital Compare give you a full picture of the quality of Hospitals?	Yes	Z	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Picture	Hospital Compare
			No	AA
LNH2259	Z	What was most helpful in determining quality?			Text area, no char limit		N	Skip Logic Group*	Hosp Most Helpful	Hospital Compare
LNH2260	AA	What information should be added to give a more complete picture of quality?			Text area, no char limit		N	Skip Logic Group*	Hosp Info Added	Hospital Compare
LNH2261	X	Based on your experience with Hospital Compare, how confident are you about choosing a Hospital using this information?	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	Hosp Confident	Hospital Compare
			2
			3
			4
			5 = Not very confident
LNH2262	BB	When you accessed the data, did you:	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Access Data	Hospital Compare
			Access the data using data.medicare.gov
LNH2263	CC	Have you ever used data.medicare.gov to access data?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp data.medicare	Hospital Compare
			No, but I know that it’s available
			No, and I didn’t know that the data was available through data.medicare.gov
LNH2264	EE	What best describes your role in using the Home Health Compare?	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Role	Home Health Compare
			Caregiver (family member or friend)
			Caregiver (paid)
			Home Health Agency staff member	II
			Discharge Planner
			Researcher
			Other Health Care Provider
			Other (please specify:)	KK
LNH2265	KK	What other role best describes you while using the Home Health Compare?			Text field, <100 char		N	Skip Logic Group*	HH Other_Role	Home Health Compare
LNH2266	II	Have you ever used information from Home Health Compare to inform an internal quality review or improvements?	Yes	JJ	Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Inform Improv	Home Health Compare
			No
LNH2267	JJ	What information did you use? Please be specific about your experience.			Text area, no char limit		N	Skip Logic Group*	HH Information Used	Home Health Compare
LNH2268	FF	What was your primary purpose in visiting Home Health Compare today?	Choose a Home Health Agency for myself or a family member	LL, MM, NN	Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Purpose	Home Health Compare
			Research Home Health Agencies for myself or family members, but not choose one today.	LL, MM, NN
			Download data about Home Health Agencies	RR, SS
			Other (please specify:)	TT
LNH2269	TT	What was your other primary purpose in visiting Home Health Compare?			Text area, no char limit		N	Skip Logic Group*	HH Other_Purpose	Home Health Compare
LNH2270	LL	How helpful was the information you found on Home Health Compare in your choice and research?	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	HH Helpful	Home Health Compare
			2
			3
			4	OO
			5 = Not very helpful / Very unhelpful	OO
LNH2271	OO	What would have made the information more helpful?			Text area, no char limit		N	Skip Logic Group*	HH More Helpful	Home Health Compare
LNH2272	MM	Does the information on Home Health Compare give you a full picture of the quality of Home Health Agencies?	Yes	PP	Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Picture	Home Health Compare
			No	QQ
LNH2273	PP	What was most helpful in determining quality?			Text area, no char limit		N	Skip Logic Group*	HH Most Helpful	Home Health Compare
LNH2274	QQ	What information should be added to give a more complete picture of quality?			Text area, no char limit		N	Skip Logic Group*	HH Info Added	Home Health Compare
LNH2275	NN	Based on your experience with Home Health Compare, how confident are you about choosing a Home Health Agency using this information?	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	HH Confident	Home Health Compare
			2
			3
			4
			5 = Not very confident
LNH2276	RR	When you accessed the data, did you:	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Access Data	Home Health Compare
			Access the data using data.medicare.gov
LNH2277	SS	Have you ever used data.medicare.gov to access data?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH data.medicare	Home Health Compare
			No, but I know that it’s available
			No, and I didn’t know that the data was available through data.medicare.gov
LNH2278	GG	In your visit to Home Health Compare, did you:	Compare Patient Survey Results for Home Health Agencies		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Measures	Home Health Compare
			Compare Quality Measures for Home Health Agencies
			Compare both Patient Survey Results and Quality Measures for Home Health Agencies
			Compare neither Patient Survey Results nor Quality Measures for Home Health Agencies
LNH2279	HH	When you came to Home Health Compare, were you looking for:	Professional Services, such as a nurse or therapist.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Looking For	Home Health Compare
			Custodial Services, such as a companion or home health aide.
			Both Professional Services and Custodial Services.
			Neither Professional Services nor Custodial Services.
LNH2280	UU	What best describes your role in using the Dialysis Facility Compare?	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Role	Dialysis Facility Compare
			Caregiver (family member or friend)
			Caregiver (paid)
			Dialysis Facility staff member	XX
			Discharge Planner
			Researcher
			Other Health Care Provider
			Other (please specify:)	WW
LNH2281	WW	What other role best describes you while using the Dialysis Facility Compare?			Text field, <100 char		N	Skip Logic Group*	DF Other_Role	Dialysis Facility Compare
LNH2282	XX	Have you ever used information from Dialysis Facility Compare to inform an internal quality review or improvements?	Yes	YY	Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Inform Improv	Dialysis Facility Compare
			No
LNH2283	YY	What information did you use? Please be specific about your experience.			Text area, no char limit		N	Skip Logic Group*	DF Information Used	Dialysis Facility Compare
LNH2284	VV	What was your main reason for going to the Dialysis Facility Compare site today?	Choose a Dialysis Facility for myself or a family member	ZZ, AAA, BBB	Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Purpose	Dialysis Facility Compare
			Get information on dialysis facilities for myself or a family member, but not choose one today	ZZ, AAA, BBB
			Download data about dialysis facilities	FFF, GGG
			Other	HHH
LNH2285	HHH	What was your other primary purpose in visiting Dialysis Facility Compare?			Text area, no char limit		N	Skip Logic Group*	DF Other_Purpose	Dialysis Facility Compare
LNH2286	ZZ	How helpful was the information you found on Dialysis Facility Compare in your choice and research?	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	DF Helpful	Dialysis Facility Compare
			2
			3
			4	CCC
			5 = Not very helpful / Very unhelpful	CCC
LNH2287	CCC	What would have made the information more helpful?			Text area, no char limit		N	Skip Logic Group*	DF More Helpful	Dialysis Facility Compare
LNH2288	AAA	Does the information on Dialysis Facility Compare give you a full picture of the quality of Dialysis Facilities?	Yes	DDD	Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Picture
			No	EEE
LNH2289	DDD	What was most helpful in determining quality?			Text area, no char limit		N	Skip Logic Group*	DF Most Helpful	Dialysis Facility Compare
LNH2290	EEE	What information should be added to give a more complete picture of quality?			Text area, no char limit		N	Skip Logic Group*	DF Info Added	Dialysis Facility Compare
LNH2291	BBB	Based on your experience with Dialysis Facility Compare, how confident are you about choosing a Dialysis Facility using this information?	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	DF Confident	Dialysis Facility Compare
			2
			3
			4
			5 = Not very confident
LNH2292	FFF	When you accessed the data, did you:	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Access Data	Dialysis Facility Compare
			Access the data using data.medicare.gov
LNH2293	GGG	Have you ever used data.medicare.gov to access data?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF data.medicare	Dialysis Facility Compare
			No, but I know that it’s available
			No, and I didn’t know that the data was available through data.medicare.gov
HAR0074902	HHH	What information on this website was most helpful to you?	List of facilities by location		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Most Helpful	Dialysis Facility Compare
			Quality data (e.g., information on best treatment practices, hospitalizations and deaths )
			Facility features (e.g., shifts starting after 5 PM or number of in-center hemodialysis
			Star ratings
			Other	III
HAR0074903	III	What other type of information was most helpful?			Text area, no char limit	single	N	OPS Group*	DF OE Helpful	Dialysis Facility Compare
HAR0074904	JJJ	Did you come to Dialysis Facility Compare to look at the star ratings?	Yes.	KKK, MMM	Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Star Ratings	Dialysis Facility Compare
			No, but I have heard about star ratings.	KKK, MMM
			No, and I haven't heard about star ratings.
HAR0074905	KKK	How did you hear about Dialysis Facility Compare star ratings? Check all that apply.	News article or press release	LLL	Checkbox, one-up vertical	Multi	Y	Skip Logic Group*	DF Source	Dialysis Facility Compare
			Health care provider
			Dialysis publication	LLL
			Social Media
			Other	LLL
HAR0074907	LLL	From which source did you hear about Dialysis Facility Compare star ratings?			Text area, no char limit	Single	N	OPS Group*	DF OE Source	Dialysis Facility Compare
HAR0074906	MMM	How much did the star ratings affect your impression of a dialysis facility?	The star ratings had a big impact on my impression of a dialysis facility.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Star Effect	Dialysis Facility Compare
			The star ratings had some impact on my impression of a dialysis facility.
			The star ratings had no impact on my impression of a dialysis facility.
			The star ratings helped me narrow down which dialysis facilities to research further, but I used other information to make my final choice.
			I’m not sure yet, I’d like to do more research.
LNH2294		Is this your first time using this Quality Compare Web Site?	stations)		Radio button, one-up vertical	single	Y		First Time
			No
LNH2295		What is your age?	Under 18		Radio button, one-up vertical	Single	Y		Age
			18-24
			25-34
			35-44
			45-54
			55-64
			65 or older
			Prefer not to answer
LNH2296		Which of the following best describes the highest level of education you have attained?	I have not graduated from high school.		Radio button, one-up vertical	Single	Y		Education
			High school graduate
			Some college, trade, technical or vocational training
			College graduate
			Post graduate degree
			Prefer not to answer
LNH2297		Where did you learn about this Quality Compare Web Site?	From a Search Engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learn of Web Site
			Saw it on the Medicare.gov web site
			Read about it in an article
			Other, please specify	A
LNH2298	A	Where else did you learn about this?			Text area, no char limit		N	Skip Logic Group	Other_Learn of Web Site
LNH2299		Did you find the information you were looking for?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did You Find
			No	S, T
LNH2300	S	What information were you unable to find?			Text area, no char limit		N	Skip Logic Group	Unable to Find
LNH2301	T	What will you do next?			Text area, no char limit		N	Skip Logic Group	Do Next
LNH2302		What was your experience using the Quality Compare Web Site? (Please select all that apply.)	The Quality Compare Web Site met my needs today		Checkbox, one-up vertical	Multi	Y	Skip Logic Group*	Web Site Experience
			Results were not relevant
			Too many results
			Not enough results
			Returned no results
			Got error message(s) / Session timed out
			Speed was too slow
			I encountered a different experience:	F
LNH2303	F	What other experience did you have while using the Quality Compare Web Site?			Text area, no char limit		N	Skip Logic Group*	Other_Web Site Exp
LNH2304		If you could change or improve one thing about the Quality Compare Web Site, what would it be?			Text area, no char limit		N		Improvement

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Sheet 4: Current CQs (10-30-14)

Model Instance Name:				red & strike-through: DELETE
Medicare Compare Web Sites				underlined & italicized: RE-ORDER
MID:	cBlIhVANgskhB8YcgkM1EA==			pink: ADDITION
Date:	11/27/2012			blue + -->: REWORDING
Medicare Compare Web Sites CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	AnswerIDs (DOT)	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label	Compare Web Sites
LNH2232		Which Quality Compare Web Site did you use today?	LNH2232A01	Nursing Home Compare	A, B, C	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Compare Web Site
			LNH2232A02	Hospital Compare	P, Q
			LNH2232A03	Home Health Compare	EE, FF, GG, HH
			LNH2232A04	Dialysis Facility Compare	UU, VV
LNH2233	A	What best describes your role in using the Nursing Home Compare?	LNH2233A01	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Role	Nursing Home Compare
			LNH2233A02	Caregiver (family member or friend)
			LNH2233A03	Caregiver (paid)
			LNH2233A04	Nursing Home staff member	D
			LNH2233A05	Discharge Planner
			LNH2233A06	Researcher
			LNH2233A07	Other Health Care Provider
			LNH2233A08	Other (please specify:)	E
LNH2234	E	What other role best describes you while using the Nursing Home Compare?				Text field, <100 char		N	Skip Logic Group*	NH Other_Role	Nursing Home Compare
LNH2235	D	Have you ever used information from Nursing Home Compare to inform an internal quality review or improvements?	LNH2235A01	Yes	F	Radio button, one-up vertical	Single	Y		NH Inform Improv	Nursing Home Compare
			LNH2235A02	No
LNH2236	F	What information did you use? Please be specific about your experience.				Text area, no char limit		N	Skip Logic Group*	NH Information Used	Nursing Home Compare
LNH2237	B	What was your primary purpose in visiting Nursing Home Compare today?	LNH2237A01	Choose a Nursing Home for myself or a family member	G, H, I	Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Purpose	Nursing Home Compare
			LNH2237A02	Research Nursing Homes for myself or family members, but not choose one today.	G, H, I
			LNH2237A03	Download data about Nursing Homes	M, N
			LNH2237A04	Other (please specify:)	P
LNH2238	P	What was your other primary purpose in visiting Nursing Home Compare?				Text area, no char limit		N	Skip Logic Group*	NH Other_Purpose	Nursing Home Compare
LNH2239	G	How helpful was the information you found on Nursing Home Compare in your choice and research?	LNH2239A01	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	NH Helpful	Nursing Home Compare
			LNH2239A02	2
			LNH2239A03	3
			LNH2239A04	4	J
			LNH2239A05	5 = Not very helpful / Very unhelpful	J
LNH2240	J	What would have made the information more helpful?				Text area, no char limit		N	Skip Logic Group*	NH More Helpful	Nursing Home Compare
LNH2241	H	Does the information on Nursing Home Compare give you a full picture of the quality of the Nursing Homes?	LNH2241A01	Yes	K	Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Picture	Nursing Home Compare
			LNH2241A02	No	L
LNH2242	K	What was most helpful in determining quality?				Text area, no char limit		N	Skip Logic Group*	NH Most Helpful	Nursing Home Compare
LNH2243	L	What information should be added to give a more complete picture of quality?				Text area, no char limit		N	Skip Logic Group*	NH Info Added	Nursing Home Compare
LNH2244	I	Based on your experience with Nursing Home Compare, how confident are you about choosing a Nursing Home using this information?	LNH2244A01	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	NH Confident	Nursing Home Compare
			LNH2244A02	2
			LNH2244A03	3
			LNH2244A04	4
			LNH2244A05	5 = Not very confident
LNH2245	M	When you accessed the data, did you:	LNH2245A01	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Access Data	Nursing Home Compare
			LNH2245A02	Access the data using data.medicare.gov
LNH2246	N	Have you ever used data.medicare.gov to access data?	LNH2246A01	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH data.medicare	Nursing Home Compare
			LNH2246A02	No, but I know that it’s available
			LNH2246A03	No, and I didn’t know that the data was available through data.medicare.gov
LNH2247	C	Have you ever used another web site to compare Nursing Home quality?	LNH2247A01	Yes	O	Radio button, one-up vertical	Single	Y	Skip Logic Group*	NH Another Web site	Nursing Home Compare
			LNH2247A02	No, but I am aware of other web sites that compare Nursing Home quality.
			LNH2247A03	No, and I was not aware of other web sites that compare Nursing Home quality.
LNH2248	O	Which web site did you use?				Text area, no char limit		N	Skip Logic Group*	NH Other_Web site	Nursing Home Compare
LNH2249	P	What best describes your role in using the Hospital Compare?	LNH2249A01	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Role	Hospital Compare
			LNH2249A02	Caregiver (family member or friend)
			LNH2249A03	Caregiver (paid)
			LNH2249A04	Hospital staff member	R, S
			LNH2249A05	Physician	R, S
			LNH2249A06	Researcher	R, S
			LNH2249A07	Other Health Care Provider	R, S
			LNH2249A08	Other (please specify:)	T
LNH2250	T	What other role best describes you while using the Hospital Compare?				Text field, <100 char		N	Skip Logic Group*	Hosp Other_Role	Hospital Compare
LNH2251	R	In your visit to Hospital Compare, did you:	LNH2251A01	Review only one measure set or measure.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Measures	Hospital Compare
			LNH2251A02	Review multiple measure sets.
LNH2252	S	Have you ever used information from Hospital Compare to inform an internal quality review or improvements?	LNH2252A01	Yes	U	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Inform Improv	Hospital Compare
			LNH2252A02	No
LNH2253	U	What information did you use? Please be specific about your experience.				Text area, no char limit		N	Skip Logic Group*	Hosp Information Used	Hospital Compare
LNH2254	Q	What was your primary purpose in visiting Hospital Compare today?	LNH2254A01	Choose a Hospital for myself or a family member	V, W, X	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Purpose	Hospital Compare
			LNH2254A02	Research Hospitals for myself or family members, but not choose one today.	V, W, X
			LNH2254A03	Download data about Hospitals	BB, CC
			LNH2254A04	Other (please specify:)	DD
LNH2255	DD	What was your other primary purpose in visiting Hospital Compare?				Text area, no char limit		N	Skip Logic Group*	Hosp Other_Purpose	Hospital Compare
LNH2256	V	How helpful was the information you found on Hospital Compare in your choice and research?	LNH2256A01	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	Hosp Helpful	Hospital Compare
			LNH2256A02	2
			LNH2256A03	3
			LNH2256A04	4	Y
			LNH2256A05	5 = Not very helpful / Very unhelpful	Y
LNH2257	Y	What would have made the information more helpful?				Text area, no char limit		N	Skip Logic Group*	Hosp More Helpful	Hospital Compare
LNH2258	W	Does the information on Hospital Compare give you a full picture of the quality of Hospitals?	LNH2258A01	Yes	Z	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Picture	Hospital Compare
			LNH2258A02	No	AA
LNH2259	Z	What was most helpful in determining quality?				Text area, no char limit		N	Skip Logic Group*	Hosp Most Helpful	Hospital Compare
LNH2260	AA	What information should be added to give a more complete picture of quality?				Text area, no char limit		N	Skip Logic Group*	Hosp Info Added	Hospital Compare
LNH2261	X	Based on your experience with Hospital Compare, how confident are you about choosing a Hospital using this information?	LNH2261A01	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	Hosp Confident	Hospital Compare
			LNH2261A02	2
			LNH2261A03	3
			LNH2261A04	4
			LNH2261A05	5 = Not very confident
LNH2262	BB	When you accessed the data, did you:	LNH2262A01	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp Access Data	Hospital Compare
			LNH2262A02	Access the data using data.medicare.gov
LNH2263	CC	Have you ever used data.medicare.gov to access data?	LNH2263A01	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Hosp data.medicare	Hospital Compare
			LNH2263A02	No, but I know that it’s available
			LNH2263A03	No, and I didn’t know that the data was available through data.medicare.gov
LNH2264	EE	What best describes your role in using the Home Health Compare?	LNH2264A01	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Role	Home Health Compare
			LNH2264A02	Caregiver (family member or friend)
			LNH2264A03	Caregiver (paid)
			LNH2264A04	Home Health Agency staff member	II
			LNH2264A05	Discharge Planner
			LNH2264A06	Researcher
			LNH2264A07	Other Health Care Provider
			LNH2264A08	Other (please specify:)	KK
LNH2265	KK	What other role best describes you while using the Home Health Compare?				Text field, <100 char		N	Skip Logic Group*	HH Other_Role	Home Health Compare
LNH2266	II	Have you ever used information from Home Health Compare to inform an internal quality review or improvements?	LNH2266A01	Yes	JJ	Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Inform Improv	Home Health Compare
			LNH2266A02	No
LNH2267	JJ	What information did you use? Please be specific about your experience.				Text area, no char limit		N	Skip Logic Group*	HH Information Used	Home Health Compare
LNH2268	FF	What was your primary purpose in visiting Home Health Compare today?	LNH2268A01	Choose a Home Health Agency for myself or a family member	LL, MM, NN	Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Purpose	Home Health Compare
			LNH2268A02	Research Home Health Agencies for myself or family members, but not choose one today.	LL, MM, NN
			LNH2268A03	Download data about Home Health Agencies	RR, SS
			LNH2268A04	Other (please specify:)	TT
LNH2269	TT	What was your other primary purpose in visiting Home Health Compare?				Text area, no char limit		N	Skip Logic Group*	HH Other_Purpose	Home Health Compare
LNH2270	LL	How helpful was the information you found on Home Health Compare in your choice and research?	LNH2270A01	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	HH Helpful	Home Health Compare
			LNH2270A02	2
			LNH2270A03	3
			LNH2270A04	4	OO
			LNH2270A05	5 = Not very helpful / Very unhelpful	OO
LNH2271	OO	What would have made the information more helpful?				Text area, no char limit		N	Skip Logic Group*	HH More Helpful	Home Health Compare
LNH2272	MM	Does the information on Home Health Compare give you a full picture of the quality of Home Health Agencies?	LNH2272A01	Yes	PP	Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Picture	Home Health Compare
			LNH2272A02	No	QQ
LNH2273	PP	What was most helpful in determining quality?				Text area, no char limit		N	Skip Logic Group*	HH Most Helpful	Home Health Compare
LNH2274	QQ	What information should be added to give a more complete picture of quality?				Text area, no char limit		N	Skip Logic Group*	HH Info Added	Home Health Compare
LNH2275	NN	Based on your experience with Home Health Compare, how confident are you about choosing a Home Health Agency using this information?	LNH2275A01	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	HH Confident	Home Health Compare
			LNH2275A02	2
			LNH2275A03	3
			LNH2275A04	4
			LNH2275A05	5 = Not very confident
LNH2276	RR	When you accessed the data, did you:	LNH2276A01	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Access Data	Home Health Compare
			LNH2276A02	Access the data using data.medicare.gov
LNH2277	SS	Have you ever used data.medicare.gov to access data?	LNH2277A01	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH data.medicare	Home Health Compare
			LNH2277A02	No, but I know that it’s available
			LNH2277A03	No, and I didn’t know that the data was available through data.medicare.gov
LNH2278	GG	In your visit to Home Health Compare, did you:	LNH2278A01	Compare Patient Survey Results for Home Health Agencies		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Measures	Home Health Compare
			LNH2278A02	Compare Quality Measures for Home Health Agencies
			LNH2278A03	Compare both Patient Survey Results and Quality Measures for Home Health Agencies
			LNH2278A04	Compare neither Patient Survey Results nor Quality Measures for Home Health Agencies
LNH2279	HH	When you came to Home Health Compare, were you looking for:	LNH2279A01	Professional Services, such as a nurse or therapist.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	HH Looking For	Home Health Compare
			LNH2279A02	Custodial Services, such as a companion or home health aide.
			LNH2279A03	Both Professional Services and Custodial Services.
			LNH2279A04	Neither Professional Services nor Custodial Services.
LNH2280	UU	What best describes your role in using the Dialysis Facility Compare?	LNH2280A01	Consumer		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Role	Dialysis Facility Compare
			LNH2280A02	Caregiver (family member or friend)
			LNH2280A03	Caregiver (paid)
			LNH2280A04	Dialysis Facility staff member	XX
			LNH2280A05	Discharge Planner
			LNH2280A06	Researcher
			LNH2280A07	Other Health Care Provider
			LNH2280A08	Other (please specify:)	WW
LNH2281	WW	What other role best describes you while using the Dialysis Facility Compare?				Text field, <100 char		N	Skip Logic Group*	DF Other_Role	Dialysis Facility Compare
LNH2282	XX	Have you ever used information from Dialysis Facility Compare to inform an internal quality review or improvements?	LNH2282A01	Yes	YY	Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Inform Improv	Dialysis Facility Compare
			LNH2282A02	No
LNH2283	YY	What information did you use? Please be specific about your experience.				Text area, no char limit		N	Skip Logic Group*	DF Information Used	Dialysis Facility Compare
LNH2284	VV	What was your primary purpose in visiting Dialysis Facility Compare today?	LNH2284A01	Choose a Dialysis Facility for myself or a family member	ZZ, AAA, BBB	Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Purpose	Dialysis Facility Compare
			LNH2284A02	Research Dialysis Facilities for myself or family members, but not choose one today.	ZZ, AAA, BBB
			LNH2284A03	Download data about Dialysis Facilities	FFF, GGG
			LNH2284A04	Other (please specify:)	HHH
LNH2285	HHH	What was your other primary purpose in visiting Dialysis Facility Compare?				Text area, no char limit		N	Skip Logic Group*	DF Other_Purpose	Dialysis Facility Compare
LNH2286	ZZ	How helpful was the information you found on Dialysis Facility Compare in your choice and research?	LNH2286A01	1 = Very helpful		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	DF Helpful	Dialysis Facility Compare
			LNH2286A02	2
			LNH2286A03	3
			LNH2286A04	4	CCC
			LNH2286A05	5 = Not very helpful / Very unhelpful	CCC
LNH2287	CCC	What would have made the information more helpful?				Text area, no char limit		N	Skip Logic Group*	DF More Helpful	Dialysis Facility Compare
LNH2288	AAA	Does the information on Dialysis Facility Compare give you a full picture of the quality of Dialysis Facilities?	LNH2288A01	Yes	DDD	Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Picture
			LNH2288A02	No	EEE
LNH2289	DDD	What was most helpful in determining quality?				Text area, no char limit		N	Skip Logic Group*	DF Most Helpful	Dialysis Facility Compare
LNH2290	EEE	What information should be added to give a more complete picture of quality?				Text area, no char limit		N	Skip Logic Group*	DF Info Added	Dialysis Facility Compare
LNH2291	BBB	Based on your experience with Dialysis Facility Compare, how confident are you about choosing a Dialysis Facility using this information?	LNH2291A01	1 = Very confident		Radio button, scale, no don't know	Single	Y	Skip Logic Group*	DF Confident	Dialysis Facility Compare
			LNH2291A02	2
			LNH2291A03	3
			LNH2291A04	4
			LNH2291A05	5 = Not very confident
LNH2292	FFF	When you accessed the data, did you:	LNH2292A01	Download the database from the site.		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF Access Data	Dialysis Facility Compare
			LNH2292A02	Access the data using data.medicare.gov
LNH2293	GGG	Have you ever used data.medicare.gov to access data?	LNH2293A01	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	DF data.medicare	Dialysis Facility Compare
			LNH2293A02	No, but I know that it’s available
			LNH2293A03	No, and I didn’t know that the data was available through data.medicare.gov
LNH2294		Is this your first time using this Quality Compare Web Site?	LNH2294A01	Yes		Radio button, one-up vertical	single	Y		First Time
			LNH2294A02	No
LNH2295		What is your age?	LNH2295A01	Under 18		Radio button, one-up vertical	Single	Y		Age
			LNH2295A02	18-24
			LNH2295A03	25-34
			LNH2295A04	35-44
			LNH2295A05	45-54
			LNH2295A06	55-64
			LNH2295A07	65 or older
			LNH2295A08	Prefer not to answer
LNH2296		Which of the following best describes the highest level of education you have attained?	LNH2296A01	I have not graduated from high school.		Radio button, one-up vertical	Single	Y		Education
			LNH2296A02	High school graduate
			LNH2296A03	Some college, trade, technical or vocational training
			LNH2296A04	College graduate
			LNH2296A05	Post graduate degree
			LNH2296A06	Prefer not to answer
LNH2297		Where did you learn about this Quality Compare Web Site?	LNH2297A01	From a Search Engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learn of Web Site
			LNH2297A02	Saw it on the Medicare.gov web site
			LNH2297A03	Read about it in an article
			LNH2297A04	Other, please specify	A
LNH2298	A	Where else did you learn about this?				Text area, no char limit		N	Skip Logic Group	Other_Learn of Web Site
LNH2299		Did you find the information you were looking for?	LNH2299A01	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did You Find
			LNH2299A02	No	S, T
LNH2300	S	What information were you unable to find?				Text area, no char limit		N	Skip Logic Group	Unable to Find
LNH2301	T	What will you do next?				Text area, no char limit		N	Skip Logic Group	Do Next
LNH2302		What was your experience using the Quality Compare Web Site? (Please select all that apply.)	LNH2302A01	The Quality Compare Web Site met my needs today		Checkbox, one-up vertical	Multi	Y	Skip Logic Group*	Web Site Experience
			LNH2302A02	Results were not relevant
			LNH2302A03	Too many results
			LNH2302A04	Not enough results
			LNH2302A05	Returned no results
			LNH2302A06	Got error message(s) / Session timed out
			LNH2302A07	Speed was too slow
			LNH2302A08	I encountered a different experience:	F
LNH2303	F	What other experience did you have while using the Quality Compare Web Site?				Text area, no char limit		N	Skip Logic Group*	Other_Web Site Exp
LNH2304		If you could change or improve one thing about the Quality Compare Web Site, what would it be?				Text area, no char limit		N		Improvement