Assessment of the Measurement Properties of the NHCAHPS Family Survey: A Rasch Scaling Approach
The introduction of the Consumer Assessment of Healthcare Providers and Systems (CAHPS), a family of survey instruments designed to capture and report people’s experiences obtaining health care could soon add satisfaction as a consistent dimension of quality that skilled nursing facilities (SNFs) are required to assess and report. The SNF setting has not yet been mandated to implement CAHPS for Nursing Homes (NHCAHPS). Given the critical implications (e.g., comparisons of SNFs on NHCAHPS scores) and decisions resulting from performance on the NHCAHPS survey (i.e., Medicare reimbursement) it was imperative to construct a measure of family satisfaction. The data were analyzed with the Rasch rating scale model. Rasch analyses demonstrate that the NHCAHPS Family Survey has adequate reliability, separation, fit, rating scale functioning, and dimensionality. Particular attention was given to the Overall Rating of Care item. According to the Rasch diagnostic indices, the NHCAHPS Family Survey composite domains did not function well. Results are discussed in terms of their application to usefulness by SNF management teams for process improvement and to include in the Five-Star Quality Rating System.
Health Care, Health Care Management, Statistics, Rasch, customer satisfaction, healthcare, CAHPS, NHCAHPS, skilled nursing
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