HCAHPS+16 Survey

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Mode Experiment (CMS-10542)

HCAHPS_Cover_Letter

HCAHPS+16 Survey

OMB: 0938-1272

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HCAHPS Cover Letter

Sample Initial Cover Letter for the HCAHPS Survey
(ALL VERSIONS)
[HOSPITAL LETTERHEAD]
[SAMPLED PATIENT NAME] [ADDRESS]
[CITY, STATE ZIP]
Dear [SAMPLED PATIENT NAME]:
Our records show that you were recently a patient at [NAME OF HOSPITAL] and
discharged on [DATE OF DISCHARGE]. Because you had a recent hospital stay,
we are asking for your help. This survey is part of an ongoing national effort to
understand how patients view their hospital experience. Hospital results will be
publicly
reported
and
made
available
on
the
Internet
at
www.medicare.gov/hospitalcompare. These results will help consumers make
important choices about their hospital care, and will help hospitals improve the care
they provide.
Questions 1-25 in the enclosed survey are part of a national initiative sponsored by
the United States Department of Health and Human Services to measure the
quality of care in hospitals. Your participation is voluntary and will not affect your
health benefits.
We hope that you will take the time to complete the survey. Your participation is
greatly appreciated. After you have completed the survey, please return it in the
pre-paid envelope. Your answers may be shared with the hospital for purposes of
quality improvement.
If you have any questions about the enclosed survey, please call the toll-free
number 1-800-xxx- xxxx. Thank you for helping to improve health care for all
consumers.
Sincerely,

[HOSPITAL ADMINISTRATOR]
[HOSPITAL NAME]

2

Sample Follow-up Cover Letter for the HCAHPS Survey (ALL
VERSIONS)
[HOSPITAL LETTERHEAD]

[SAMPLED PATIENT NAME] [ADDRESS]
[CITY, STATE ZIP]
Dear [SAMPLED PATIENT NAME]:
Our records show that you were recently a patient at [NAME OF HOSPITAL] and
discharged on [DATE OF DISCHARGE]. Approximately three weeks ago we sent you a
survey regarding your hospitalization. If you have already returned the survey to us, please
accept our thanks and disregard this letter. However, if you have not yet completed
the survey, please take a few minutes and complete it now.
Because you had a recent hospital stay, we are asking for your help. This survey is part of
an ongoing national effort to understand how patients view their hospital experience.
Hospital results will be publicly reported and made available on the Internet at
www.medicare.gov/hospitalcompare. These results will help consumers make important
choices about their hospital care, and will help hospitals improve the care they provide.
Questions 1-25 in the enclosed survey are part of a national initiative sponsored by the
United States Department of Health and Human Services to measure the quality of care
in hospitals. Your participation is voluntary and will not affect your health benefits. Please
take a few minutes and complete the enclosed survey. After you have completed the
survey, please return it in the pre-paid envelope. Your answers may be shared with the
hospital for purposes of quality improvement.
If you have any questions about the enclosed survey, please call the toll-free number 1800-xxx- xxxx. Thank you again for helping to improve health care for all consumers.
Sincerely,

[HOSPITAL ADMINISTRATOR]
[HOSPITAL NAME]

3


File Typeapplication/pdf
AuthorELIZABETH FLOW-DELWICHE
File Modified2014-11-13
File Created2014-11-13

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