A Note About HCAHPS "Boxes"

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HCAHPS results are publicly reported on Hospital Compare as “top-box,” “bottom-box” and “middle-box” scores. The “top-box” is the most positive response to HCAHPS survey questions. The “top-box” response is "Always” for five HCAHPS composites (Communication with Nurses, Communication with Doctors, Responsiveness of Hospital Staff, Pain Management, and Communication about Medicines) and two individual items (Cleanliness of Hospital Environment and Quietness of Hospital Environment), "Yes" for the sixth composite, Discharge Information, "‘9’ or ‘10’ (high)" for the Overall Hospital Rating item, and "Would definitely recommend” for the Recommend the Hospital item.

The “bottom-box” is the least positive response category for HCAHPS measures. The “bottom-box” response is "Sometimes or never” for five HCAHPS composites (Communication with Nurses, Communication with Doctors, Responsiveness of Hospital Staff, Pain Management, and Communication about Medicines) and two individual items (Cleanliness of Hospital Environment and Quietness of Hospital Environment), "No" for the sixth composite, Discharge Information, "‘6’ or lower (low)" for the Overall Hospital Rating item, and "Would not recommend” for the Recommend the Hospital item.

The “middle-box” captures intermediate responses to HCAHPS survey items. The “middle-box” response is "Usually” for five HCAHPS composites (Communication with Nurses, Communication with Doctors, Responsiveness of Hospital Staff, Pain Management, and Communication about Medicines) and two individual items (Cleanliness of Hospital Environment and Quietness of Hospital Environment), "‘7’ or ‘8’ (medium)" for the Overall Hospital Rating item, and "Would probably recommend” for the Recommend the Hospital item. There is no “middle-box” response in the Discharge Information composite.

HCAHPS On-Line, the official HCAHPS Web site, houses a series of tables that summarize current and historic HCAHPS results. These HCAHPS Tables, available exclusively on HCAHPS On-Line, are based on the HCAHPS data participating hospitals submit to CMS. Before being publicly reported, data are adjusted for the effects of patient-mix and mode of survey administration.

To view the full set of current results on each HCAHPS measure for individual hospitals, please visit the "Survey of Patients’ Hospital Experiences" section of the Hospital Compare Web site (www.hospitalcompare.hhs.gov).

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