2007 National Home and Hospice Care Survey

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1 OMB #: Exp.: 07/3/009 Ageny Nme: Ageny ID: 007 Ntionl Home nd Hospie Cre Survey Stffing Questionnire Prepred for the Centers for Disese Control nd Prevention Ntionl Center for Helth Sttistis y Westt 650 Reserh Boulevrd Rokville, MD

2 Der Diretor/Administrtor, The Ntionl Center for Helth Sttistis (NCHS) of the Centers for Disese Control nd Prevention (CDC) is onduting the Ntionl Home nd Hospie Cre Survey on rndomly seleted ntionwide smple of home helth re nd hospie genies. This voluntry survey is uthorized y Federl Lw. We would like some informtion out the stff of your geny, inluding their trining, enefits, nd experiene. Any informtion you provide will e used only for reserh purposes nd will e held in strit onfidene. It will not e relesed to nyone, other thn the genies involved in the survey tht re listed in the Der Diretor letter sent to you previously, without the onsent of the individul or the estlishment in ordne with Setion 308(d) of the Puli Helth Servie At (4 USC 4m) nd the Confidentil Informtion Protetion nd Sttistil Effiieny At (PL ). If you wish to omment on ny question or qulify your nswers, plese feel free to use spe in the mrgins or on the inside of the finl pge. Your omments will e red nd tken into ount. Plese nswer ll of the questions in referene to the geny listed on the front over. NOTICE - Puli reporting urden of this olletion of informtion is estimted to verge 50 minutes per response, inluding the time for reviewing instrutions, serhing existing dt soures, gthering nd mintining the dt needed, nd ompleting nd reviewing the olletion of informtion. An geny my not ondut or sponsor, nd person is not required to respond to olletion of informtion unless it displys urrently vlid OMB ontrol numer. Send omments regrding this urden estimte or ny other spet of this olletion of informtion, inluding suggestions for reduing this urden to: CDC/ATSDR Reports Clerne Offier, 600 Clifton Rod, MS E-, Atlnt, GA 30333, ATTN: PRA ( ). Assurne of Confidentility - All informtion whih would permit identifition of n individul, prtie, or n estlishment will e held onfidentil, will e used only y persons engged in nd for the purpose of the survey nd will not e dislosed or relesed to other persons or used for ny other purpose without the onsent of the individul or the estlishment in ordne with setion 308(d) of the Puli Helth Servie At (4 USC 4m) nd the Confidentil Informtion Protetion nd Sttistil Effiieny At (PL ).

3 A Bkground of Diretor These first few questions sk out the kground of this geny's Diretor/Administrtor.. Does this geny urrently hve Diretor/Administrtor (or ting) on stff? 4. Wht is the highest degree of ny kind tht the geny's Diretor/Administrtor holds? SKIP TO QUESTION 0. Mrk one ox. Diplom Degree in Nursing Assoites Degree in Nursing. Does this geny's Diretor/Administrtor hve nursing degree? 3 Assoites Degree in Helth Cre Administrtion SKIP TO QUESTION 4. 4 Assoites Degree (other helth relted) 5 Assoites Degree (not helth relted) 6 Bhelors Degree in Nursing 3. Wht is the highest nursing degree tht the geny's Diretor/Administrtor holds? 7 Bhelors Degree in Helth Cre Administrtion 8 Bhelors Degree (other helth relted) Mrk one ox. 9 Bhelors Degree (not helth relted) Diplom Degree in Nursing 0 Msters Degree in Nursing Assoites Degree in Nursing Msters Degree in Helth Cre Administrtion 3 Bhelors Degree in Nursing Msters Degree (other helth relted) 4 Msters Degree in Nursing 3 Msters Degree (not helth relted) 9 Other nursing degree (PLEASE SPECIFY) 9 Other (PLEASE SPECIFY)

4 5. Does this geny's Diretor/Administrtor hve Certified Home or Hospie Cre Exeutive (CHCE) ertifition? 8. Altogether, out how long hs he/she worked s Diretor/Administrtor t ny home helth or hospie geny, inluding this one? Write numer in only one ox. 6. Wht other medil speilty ertifitions does this geny's Diretor/Administrtor hve? Mrk ll tht pply. Numer of weeks Numer of months Numer of yers 0 ne Amerin Nurses Credentiling Center (ANCC) ertifition (Nurse Prtitioner, Nursing Cse Mngement, Puli/Community Helth, et.) Certifition from professionl helth re ssoition/orgniztion [for exmple, Certified Hospie nd Pllitive Nurse (CHPN), Certified Rehilittion Registered Nurse (CRRN), et.] 9. Does the geny's Diretor/Administrtor lso serve s the Diretor of Nursing for this geny? This person my e lled the Diretor of Professionl Servies or Clinil Diretor or is the linil led mnger or supervisor nurse. CONTINUE TO QUESTION. SKIP TO QUESTION Aout how long hs he/she een the Diretor/ Administrtor t this geny? Write numer in only one ox. Numer of weeks Numer of months Numer of yers

5 B Bkground of Diretor of Nursing 0. The following questions re out the Diretor of Nursing t this geny. This person my e lled the Diretor of Professionl Servies or Clinil Diretor or is the linil led mnger or supervisor nurse who reports to this geny's Diretor/Administrtor. Does this geny urrently hve Diretor of Nursing (or ting) on stff?. Wht is the highest degree of ny kind the Diretor of Nursing holds? Mrk one ox. Diplom Degree in Nursing Assoites Degree in Nursing 3 Assoites Degree in Helth Cre Administrtion 4 Assoites Degree (other helth relted) SKIP TO QUESTION 6. 5 Assoites Degree (not helth relted) 6 Bhelors Degree in Nursing 7 Bhelors Degree in Helth Cre. Wht is the highest nursing degree the Diretor of Nursing holds? Mrk one ox. Administrtion 8 Bhelors Degree (other helth relted) 9 Bhelors Degree (not helth relted) Diplom Degree in Nursing Assoites Degree in Nursing Bhelors Degree in Nursing Msters Degree in Nursing Other nursing degree (PLEASE SPECIFY) 0 Msters Degree in Nursing Msters Degree in Helth Cre Administrtion Msters Degree (other helth relted) 3 Msters Degree (not helth relted) 9 Other (PLEASE SPECIFY) 3

6 Profile of Nursing Stff C 3. Wht medil speilty ertifitions does this geny's Diretor of Nursing hve? Mrk ll tht pply. Next, we would like to know out the kground nd turnover of this geny's stff. 0 ne Amerin Nurses Credentiling Center (ANCC) ertifition, (for exmple, Nurse Prtitioner, Nursing Cse Mngement, Puli/Community Helth, et.) Certifition from professionl helth re ssoition/orgniztion [for exmple, Certified Hospie nd Pllitive Nurse (CHPN), Certified Rehilittion Registered Nurse (CRRN), et.] 6. Approximtely wht perentges of the RNs urrently on stff hve the following s their highest edution/trining? Write perentge on eh line. If none, plese enter "0." Your entries should equl 00% Perent of RNs % Diplom 4. Aout how long hs he/she een the Diretor of Nursing t this geny? Write numer in only one ox. % Assoite Degree % BS/BSN (4 yers) Numer of weeks Numer of months Numer of yers d % MS/MSN or higher 0 0 % Totl 5. Altogether, out how long hs he/she een the Diretor of Nursing t ny home helth or hospie geny, inluding this one? Write numer in only one ox. Numer of weeks Numer of months Numer of yers 7. Do ny of the RNs urrently on stff hve ny speilty ertifitions? (Exmples inlude: pllitive re, pin mngement, wound nd ostomy re, gerontology, rehilittion, nursing dministrtion, medil-surgil nursing, puli/ommunity helth, et.) SKIP TO QUESTION 9. CONTINUE TO QUESTION 8. 4

7 8. Do ny of the RNs on stff hve the. following ertifitions? Does this geny urrently hve ny RN employees on stff? Mrk one ox in eh row. Do not inlude ontrt workers. SKIP TO QUESTION 3. P llitive Cre Wound nd Ostomy Cre Pin Mngement. How mny? Gerontology Do not inlude ontrt workers. Puli/Community Helth Numer of full-time RN employees 9. Does this geny hve the following types of Numer of prt-time RN employees Advned Prtie Nurses on stff? Inlude oth full-time nd prt-time employees Numer of FTE RN employees Mrk one ox in eh row. 3. Does this geny urrently hve ny Clinil Nurse Speilist LPN/LVN employees on stff? Nurse Prtitioner Do not inlude ontrt workers. 0. Does this geny ever employ or seek to employ ny of the following? Do not inlude ontrt workers. Mrk one ox in eh row. RNs LPNs/LVNs Certified HHAs/CNAs n-ertified Aides SKIP TO QUESTION How mny? Do not inlude ontrt workers. Numer of full-time LPN/LVN employees Numer of prt-time LPN/LVN employees Numer of FTE LPN/LVN employees 5

8 5. Does this geny urrently hve ny 9. Does this geny urrently use ny ertified HHA/CNA employees on stff? ontrt workers for ANY of the following Do not inlude ontrt workers. stff: RNs, LPNs, ertified HHAs/CNAs, or non-ertified ides? SKIP TO QUESTION 7. SKIP TO QUESTION How mny? 30. Does this geny urrently use ny Do not inlude ontrt workers. RN ontrt workers? Numer of full-time ertified HHA/CNA employees Numer of prt-time ertified HHA/CNA employees Numer of FTE ertified HHA/CNA employees 3. SKIP TO QUESTION How mny? 3. Numer of full-time RN ontrt workers 7. Does this geny urrently hve ny non-ertified ide employees on stff? Numer of prt-time RN ontrt workers 8. Do not inlude ontrt workers. SKIP TO QUESTION How mny? Does this geny urrently use ny LPN/LVN ontrt workers? SKIP TO QUESTION 34. Do not inlude ontrt workers. 33. How mny? Numer of full-time non-ertified ide employees Numer of full-time LPN/LVN ontrt workers Numer of prt-time non-ertified ide employees Numer of prt-time LPN/LVN ontrt workers Numer of FTE non-ertified ide employees 6

9 34. Does this geny urrently use ny ertified 39. Does this geny urrently hve ny HHA/CNA ontrt workers? RN vnies? SKIP TO QUESTION 36. SKIP TO QUESTION How mny? 40. How mny? Numer of full-time ertified Numer of full-time RN vnies HHA/CNA employees Numer of prt-time ertified Numer of prt-time RN vnies HHA/CNA employees 36. Does this geny urrently use ny 4. non-ertified ide ontrt workers? Does this geny urrently hve ny LPN/LVN vnies? SKIP TO QUESTION 38. SKIP TO QUESTION How mny? 4. How mny? Numer of full-time non-ertified ide ontrt workers Numer of full-time LPN/LVN vnies Numer of prt-time non-ertified ide ontrt workers Numer of prt-time LPN/LVN vnies 38. Does this geny urrently hve ny vnies for ANY of the following stff: RNs, LPNs/LVNs, ertified HHAs/CNAs, or non-ertified ides? This would inlude vnt positions for employees for whih you re tively reruiting, even if for now you re using ontrt workers Does this geny urrently hve ny ertified HHA/CNA vnies? SKIP TO QUESTION 45. How mny? SKIP TO QUESTION 47. CONTINUE TO QUESTION 39. Numer of full-time ertified HHA/CNA vnies Numer of prt-time ertified HHA/CNA vnies 7

10 45. Does this geny urrently hve ny 50. non-ertified ide vnies? Did this geny hire ny LPN/LVNs in the pst 3 months? SKIP TO QUESTION 47. SKIP TO QUESTION How mny? 5. How mny? Numer of full-time non-ertified ide vnies Numer of full-time LPN/LVNs hired Numer of prt-time non-ertified ide vnies Numer of prt-time LPN/LVNs hired 47. Over the pst 3 months, did this geny hire ANY of the following stff: RNs, LPNs/LVNs, ertified HHAs/CNAs, or non-ertified ides? Do not inlude ontrt workers. SKIP TO QUESTION Did this geny hire ny ertified HHAs/CNAs in the pst 3 months? SKIP TO QUESTION How mny? 48. Did this geny hire ny RNs in the pst 3 months? SKIP TO QUESTION 50. Numer of full-time ertified HHAs/CNAs hired Numer of prt-time ertified HHAs/CNAs hired 54. Did this geny hire ny non-ertified ides in the pst 3 months? 49. How mny? SKIP TO QUESTION 56. Numer of full-time RNs hired Numer of prt-time RNs hired 55. How mny? Numer of full-time non-ertified ides hired Numer of prt-time non-ertified ides hired 8

11 56. Over the pst 3 months, hve ny of the following stff terminted employment: RNs, LPNs/LVNs, ertified HHAs/CNAs, or non-ertified ides? This would inlude oth voluntry nd involuntry termintions (retired, dismissed, resigned). Do not inlude ontrt workers Were there ny ertified HHA/CNA termintions in the pst 3 months? SKIP TO QUESTION 63. How mny? SKIP TO QUESTION 65. Numer of full-time ertified HHA/CNAs terminted 57. Were there ny RN termintions in the pst 3 months? SKIP TO QUESTION Numer of prt-time ertified HHA/CNAs terminted Were there ny non-ertified ide termintions in the pst 3 months? SKIP TO QUESTION How mny? Numer of full-time RNs terminted 64. How mny? Numer of prt-time RNs terminted Numer of full-time non-ertified ides terminted 59. Were there ny LPN/LVN termintions in the pst 3 months? Numer of prt-time non-ertified ides terminted SKIP TO QUESTION How mny? Numer of full-time LPN/LVNs terminted Numer of prt-time LPN/LVNs terminted 9

12 65. Wht is the verge length of orienttion t this geny for the following types of newly hired nursing stff? 67. If hired tody, wht would e the hourly wge of entry-level nursing stff t this geny? For eh employee type, write length of orienttion in pproprite ox. If no orienttion, hek the NONE ox. ne HOURS DAYS WEEKS RNs 0 LPNs/ LVNs 0 d e f Certified HHAs/ 0 g h i CNAs Write in dollr mount in eh ox. Entry-level Hourly Wges $. $. $. $. RNs LPNs/LVNs Certified HHAs/CNAs n-ertified Aides n- 0 ertified j k l Aides 66. Aout wht perentge of this geny's urrent nursing stff hve een employed for more thn yer? Write in perentge in eh ox. If none for stff type, plese enter "0." Perent employed more thn yer % of RNs PLEASE CONTINUE TO NEXT PAGE d % of LPNs/LVNs % of Certified HHAs/CNAs % of n-ertified Aides 0

13 D Profile of Other Ageny Workers 68. Does this geny use ny volunteers to help your urrent ptients or this geny's stff in ny wy? SKIP TO QUESTION 7. Is this geny ever used s linil or 7. trining site for students? SKIP TO QUESTION Wht kinds of servies do they provide? Mrk ll tht pply. Generl offie help Homemker/household servies Personl re (hiruts, nil re, mssge, et.) 73. For wht types of students? Mrk ll tht pply. Home Helth Aide Nurse (RN, LPN) 3 Advne Prtie Nurse (NP, CNS) 4 Physiin Assistnt Trnsporttion servies Visiting with ptients Berevement/fmily support 5 Medil Student/Intern/Resident 6 Therpist (Physil, Speeh, Ouptionl) 7 Soil Worker 7 Reretionl tivities 9 Other (PLEASE SPECIFY) Pet therpy Religious/spiritul tivities Other (PLEASE SPECIFY) 70. Aout how mny volunteer workers urrently provide servies for this geny? Numer of volunteers 7. In totl, how mny of this geny's urrent ptients reeive servies from ny of your volunteer workers? Numer of urrent ptients % Perent of urrent ptients

14 74. Does this geny hve ny of the following 75. Whih of these nursing stff retention/ types of stff or ontrt personnel who provide servies to ptients served y this geny? Plese mrk "" or "" for eh personnel type. Physiins Dentl helth professionls Psyhitrists Psyhologists Nutritionists, Dietitins Ouptionl Therpists Ouptionl Therpy Assistnts Physil Therpists Poditrists reruitment strtegies re used y this geny? Mrk ll tht pply. Employee reognition progrms (employee of the month, stff dinners/lunheons, et.) Reimursement for workshops/onferenes 3 Sign-on onus 4 Reruitment onus 5 Creer ldder positions for Nurses 6 Creer ldder positions for HHAs/CNAs 7 Flexile sheduling or jo shring 8 Bonus/pid time off 9 Stil 0 Tuition (reimursement or diret pyment for employees/new hires) Respirtory Therpists Soil Workers Pyk for unused sik/vtion time 9 Other (PLEASE SPECIFY) Speeh Pthologists/Audiologists Complementry Alterntive Mediine (CAM) Providers

15 E Employee Benefits 76. Wht types of employee enefits re offered to full-time RN nd LPN/LVN stff 77. Wht types of employee enefits re offered to full-time HHA/CNA stff y y this geny? the geny? Mrk ll tht pply. Mrk ll tht pply Fully pid helth insurne pln for employee Fully pid helth insurne pln for employee Fully pid helth insurne pln for employee Fully pid helth insurne pln for employee spouse/dependents spouse/dependents Prtilly pid helth insurne pln for 3 Prtilly pid helth insurne pln for employee employee Prtilly pid helth insurne pln for 4 Prtilly pid helth insurne pln for employee spouse/dependents employee spouse/dependents Other employee insurne pln (dentl, vision, 5 Other employee insurne pln (dentl, vision, disility, life) disility, life) Retirement/pension 6 Retirement/pension 40k pln/tx-deferred nnuity 7 40k pln/tx-deferred nnuity Pid vtion/holidys 8 Pid vtion/holidys Pid sik dys 9 Pid sik dys Pid time off dys for other/personl 0 Pid time off dys for other/personl resons resons Other pid onuses Other pid onuses Milege reimursement/geny r Milege reimursement/geny r Uniforms 3 Uniforms Cell phones/reimursements 4 Cell phones/reimursements Creer promotion/development (workshops, 5 Creer promotion/development (workshops, onferenes, ertifition exm, et.) onferenes, ertifition exm, et.) Edution reimursement 6 Edution reimursement Other (PLEASE SPECIFY) 9 Other (PLEASE SPECIFY) 3

16 F Ageny Informtion Tehnology Cpilities 78. Does this geny urrently hve n Eletroni Medil Reords system? This is omputerized version of the ptient's medil informtion used in the mngement of the ptient's helth re. Exlude eletroni reords used only for illing purposes nd required doumenttion, suh s OASIS files. SKIP TO QUESTION Does this geny hve plns to otin n Eletroni Medil Reords System within the next yer? SKIP TO QUESTION 8. SKIP TO QUESTION With this geny's urrent Eletroni Medil Reords system, plese indite for eh omponent listed elow, whether it is used, ville ut not used, or not ville. Mrk one ox on eh line. Used Aville/ t used t Aville 3 Computerized Physiins Order Entry (CPOE) - presriptions, ls, tests, et Test results (hest x-rys, ls, et.) Ptient demogrphis Eletroni reminders for tests (ls, imging, et.) Clinil Deision Support System (CDSS) ontrinditions, llergies, guidelines, et. Clinil notes Puli helth reporting (notifile diseses) Shring medil reords eletronilly with other genies 8. For eh item elow, plese indite whether or not this geny uses ny of the following Mngement Systems eletronilly? Mrk one ox in eh row. Billing system Inventory ontrol (i.e. r oding) Humn Resoures mngement (personnel reords) Stff mngement (e.g., stffing sheduling, et.) Aounting 4

17 8. For eh item elow, plese indite whether or not this geny uses ny of the following Edution Systems? Mrk one ox in eh row. Stellite Brodst pility (in servie, trining) Stff Internet ess Ptient Internet ess (we site with ptient edutionl mterils) 83. Does this geny use ny telemediine pilities? Telemediine is the use of eletroni ommunition nd informtion tehnologies to provide or support linil re t distne. SKIP TO QUESTION For eh item elow, plese indite whether or not this geny uses ny of the following telemediine pilities? Mrk one ox in eh row. Routine telephone monitoring of ptients' helth, involving onverstion with nurse or other helth re provider/monitor E-mil ess to helth professionls for ptients/regivers Video onsults with helth re professionls Routine video monitoring of ptients' helth, involving onverstion with nurse or other helth re provider/monitor Routine non-video monitoring of ptients' helth, without onverstion (e.g., regulr trnsmission of vitl signs) Other telemediine pility (PLEASE SPECIFY) 85. For out wht perentge of this geny's urrent ptients is telemediine used? Enter perent of urrent ptients or mrk the ne ox. 0 ne % of ptients 5

18 86. Does this geny's stff use ny system for Eletroni Point of Cre Doumenttion? SKIP TO QUESTION. Are these devies used for ny of the following? Mrk one ox in eh row. Inlude PDAs (Personl Digitl Assistnts) teook PCs, or other portle hndheld devies. 9 Computerized Physiins Order Entry (presriptions/phrmy, ls, tests) Test results Eletroni reminders for tests Clinil Deision Support System How mny of your diret re stff use these? guidelines or referene systems E-mil ommunition with geny 0 ne stff/other stff Some Sheduling ppointments/visits All OASIS Other (PLEASE SPECIFY) How mny of your dministrtive stff use these? 0 ne Some All 89. Do ny other stff use these? (PLEASE SPECIFY) PLEASE CONTINUE TO NEXT PAGE 6

19 G 9. Ageny Informtion Other Hs this geny developed written pln for mngement of ptients during n influenz pndemi? 0, not strted, in progress, ompleted 9. Aout wht perentge of this geny's ptient re revenue omes from eh of the following? Write perentge on eh line. If none, plese enter "0." Your entries should equl 00% Perent of revenue % Medire % Mediid Thnk you for your oopertion. % Privte insurne d % Ptient pyments e % Other soures 0 0 % Totl 7

20 WESTAT 650 Reserh Boulevrd Rokville, Mrylnd 0850

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