Home Health Agencies Grading Methodology White Paper
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Health Grades, Inc.
Number of standard level deficiencies on recent survey
Number of standard level deficiencies on prior survey
Number of standard level deficiencies on third survey
Number of standard level deficiencies on fourth survey
Condition level deficiencies repeated in prior and recent licensing surveys
Standard level deficiencies repeated in prior and recent licensing surveys
Surveyor's summary score on the quality of care during the most recent licensing survey
Years in operation
Ownership changes as compared to years in operation
Complaint surveys are surveys completed by the state survey team in response to one complaint
of substandard care or several, general complaints about the home health agency. Licensing
surveys are surveys completed for Medicare certification. Licensing surveys generally occur
once every 36 months but may occur more frequently as warranted based upon the outcomes of a
previous survey. Please see the attached Exhibit A to learn more about home health licensing
surveys and deficiencies.
The data element entitled years in operation is based upon the date the agency was certified to
participate in Medicare. The data element related to ownership changes is expressed as the
number of times ownership of the home health agency had changed relative to years in operation.
An ownership change occurs when another organization or company purchases the home health
agency and control of the agency changes. Management staff may change as a result of an
Surveyor's summary is the evaluation of the quality of care of the home health agency at the
close of the survey. The three options for this evaluation are: (1) care that promoted patients'
potential, (2) care that moderately promoted patients' potential and (3) care that was substandard.
Care that promoted patients' potential is the optimal value while substandard care is least optimal
and indicates poor quality of care.
HealthGrades developed a unique, proprietary weighting system that translated the
aforementioned fifteen data elements (e.g., repeated condition level deficiencies) into numeric
scores. To develop this scoring system, HealthGrades assembled a group of health care
professionals with expertise in home health care. This group included two home health care
administrators, three consultants with home health management experience and a home health
surveyor. Each member of the group was interviewed and asked to assign a weight to each data