A Note About HCAHPS "Boxes"

hcahps

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).

With over 27 years in Healthcare Environmental Services (ES), I lead with a belief that attitude drives outcomes. As a Regional Director at MultiCare Health System, I oversee multi-site ES operations with a focus on people-first leadership, infection control, and operational excellence. I champion a Positive Mental Attitude (PMA) not as a slogan, but as a leadership principle. I believe positivity is contagious, and as a leader, I set the tone. Through consistent, uplifting communication, I create environments where ES teams feel empowered to be helpful, proactive, and proud of their impact. For me, development is a choice, and I invest in training, huddles, and coaching that energize teams, helping them thrive in their current roles and grow toward what’s next. My approach to high standards isn't theoretical, it's practical. Just like we notice when a hotel room is clean and fresh, patients and families immediately sense a space that’s been cared for. Through standardized protocols, team accountability, and a shared mission, I help create clean, safe, and healing environments that directly enhance patient experience and staff well-being. It's a privilege to lead teams that play such a vital role in the patient journey, and to help elevate the perception and performance of ES professionals across our system.

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