Getting to the core of customer satisfaction in skilled nursing and assisted living.
What Is CoreQ?
CoreQ is a set of five measures for skilled nursing care centers (SNCC) and assisted living (AL) communities to use to assess satisfaction among patients, residents, and their families developed by a team including, Nicholas Castle, Ph.D., the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), and providers with input from customer satisfaction vendors and residents. The measures capture short-stay and long-stay resident and family data for SNCCs, and resident and family data for ALs. Based on a core set of customer satisfaction questions to allow consistent measurement across long term and post-acute care settings, CoreQ has been independently tested as valid and reliable. The National Quality Forum (NQF) endorsed all five CoreQ measures. You can read more in the CoreQ Overview.
Similar to many other professions, the happiness and peace of mind of residents and their families is paramount to both AL and SNCC providers. Achieving high customer satisfaction is the root of person-centered care. Research suggests that high customer satisfaction is directly linked to quality of care outcomes. High customer satisfaction data can be used to support participation in preferred provider plans, including Accountable Care Organizations and other organizations that provide health care services in the care continuum.
How is CoreQ calculated?
CoreQ questionnaires use a 5-point Likert Scale: Poor (1), Average (2), Good (3), Very Good (4), Excellent (5). It can be administered as a stand-alone questionnaire or included in a longer questionnaire. It is recommended that CoreQ appear first, when used as part of a longer satisfaction questionnaire. It is important that CoreQ be administered in the order listed, with the exact wording of the questions and scale. Using questions or a scale similar is not the same as CoreQ. For more information on calculations please see the CoreQ Technical Manual.
Who should receive CoreQ?
SNCC Long-Stay Resident and Family: Residents or family that meet the following criteria should be excluded: residents with diagnosis of dementia impairing their ability to answer the questionnaire (defined as having a BIMS score on the MDS as 7 or lower*); on hospice as recorded on the MDS as Hospice (O0100K1 = 1); lived in the SNCC for less than 100 days; have a court-appointed guardian, and family members who reside in another country.
SNCC Short-Stay Discharges: All patients admitted from a hospital to the SNCC, regardless of payor, who were then discharged back to the community (e.g., their home or an assisted living) within 100 days of admission are initially eligible. Patients that meet the following criteria should be excluded: discharged to a hospital, another SNCC, psychiatric facility, Inpatient Rehabilitation Facilities (IRF), or Long Term Care Hospital (LTCH), or on hospice; diagnosis of dementia impairing their ability to answer the questionnaire (defined as having a BIMS score on the MDS as 7 or lower*); have a legal court-appointed guardian; left Against Medical Advice (AMA); and died during their SNCC stay.
Assisted Living Resident and Family: Residents or family members that meet the following criteria should be excluded: residents with diagnosis of dementia impairing their ability to answer the questionnaire (defined as BIMS score of 7 or lower or MMSE score of 12 or lower*); legal court-appointed guardian; on hospice; in the AL for less than two weeks; and family members who reside in another country.
*Note on dementia: Some providers may not have information on cognitive function available to help with sample selection. Administer the survey to all residents and assume that those with cognitive impairment will not complete the survey or have someone else complete on their behalf, which in either case will exclude them from the analysis.
How do I administer CoreQ?
SNCC Long-Stay Residents: The timing and frequency in which CoreQ should be administered can be left up to the provider or vendor with a couple of caveats. For SNCC long-stay residents, the sample selection should be a cross-sectional sample of current residents or family done at a single point in time. It should be administered at least once a year. Use reminders, follow up surveys and other techniques to boost response rate. The month the initial survey was administered should be used as the month associated with CoreQ Long-Stay results.
SNCC Short-Stay Discharges: This should include all individuals discharged from the SNCC back to the community over the next six-month period. CoreQ should be administered/received within two weeks of discharge from the center. The data collection should continue for the next six months, or may stop once you receive 125 or more consecutive valid responses. These must be consecutive returns and cannot be the best 125 responses. The questionnaire should be administered after discharge, not the day of discharge. We encourage the use of reminders, follow up surveys and other techniques to boost response rate. The end month of data collection in the six-month period should be recorded as the month the Short Stay measure was collected.
Assisted Living: This should follow same instructions as for CoreQ Long-Stay.
*Please note it is recommend to have at least 20 valid responses and a 30% minimum response rate.
Survey Completion Window: AHCA/NCAL recommends using only surveys returned within two months from the resident or family member. Responses received after two months need to be excluded from the calculation of the measure.
Calculating Satisfaction Rating for a Center/Community: The number of respondents with an average score greater to or equal to 3.0 on all the CoreQ questions are counted (numerator) and divided by the total number of valid responses to the same questionnaire type (denominator) to yield the center's/community's satisfaction score (e.g. percent of respondents who are satisfied). (See technical manual for details)
What are the Questions?
All CoreQ Measures use the same 5-point Likert Scale:
Poor (1), Average (2), Good (3), Very Good (4), Excellent (5).
SNCC Long-Stay Residents
- In recommending this facility to your friends and family, how would you rate it overall?
- Overall, how would you rate the staff?
- How would you rate the care you receive?
SNCC Long-Stay Family
- In recommending this facility to your friends and family, how would you rate it overall?
- Overall, how would you rate the staff?
- How would you rate the care your family member receives?
SNCC Short-Stay Discharge
- In recommending this facility to your friends and family, how would you rate it overall?
- Overall, how would you rate the staff?
- How would you rate the care you receive?
- How would you rate how well your discharge needs were met?
Assisted Living Resident
- In recommending this facility to your friends and family, how would you rate it overall?
- Overall, how would you rate the staff?
- How would you rate the care you receive?
- Overall, how would you rate the food?
Assisted Living Family
- In recommending this facility to your friends and family, how would you rate it overall?
- Overall, how would you rate the staff?
- How would you rate the care your family member receives?
Customer Satisfaction Vendors
A list of vendors that have added CoreQ to their questionnaires can be found below.
If you are an AHCA/NCAL member and use LTC Trend Tracker, you will find the vendors below that are able to upload your CoreQ data into LTC Trend Tracker for you - just ask them! If you don't see your customer satisfaction vendor on the list, or you are a vendor and would like to learn more or upload to LTC Trend Tracker, please contact us at coreq@ahca.org.