2016 Provider Survey

	Not Familiar	Somewhat Familiar	Familiar	Very Familiar
Home Care	Home Care Not Familiar	Home Care Somewhat Familiar	Home Care Familiar	Home Care Very Familiar
Life Care-Private Duty	Life Care-Private Duty Not Familiar	Life Care-Private Duty Somewhat Familiar	Life Care-Private Duty Familiar	Life Care-Private Duty Very Familiar
Hospice Care	Hospice Care Not Familiar	Hospice Care Somewhat Familiar	Hospice Care Familiar	Hospice Care Very Familiar
Palliative Care	Palliative Care Not Familiar	Palliative Care Somewhat Familiar	Palliative Care Familiar	Palliative Care Very Familiar
Community Care	Community Care Not Familiar	Community Care Somewhat Familiar	Community Care Familiar	Community Care Very Familiar

Not Familiar

Somewhat Familiar

Familiar

Very Familiar

Home Care

Home Care Not Familiar

Home Care Somewhat Familiar

Home Care Familiar

Home Care Very Familiar

Life Care-Private Duty

Life Care-Private Duty Not Familiar

Life Care-Private Duty Somewhat Familiar

Life Care-Private Duty Familiar

Life Care-Private Duty Very Familiar

Hospice Care

Hospice Care Not Familiar

Hospice Care Somewhat Familiar

Hospice Care Familiar

Hospice Care Very Familiar

Palliative Care

Palliative Care Not Familiar

Palliative Care Somewhat Familiar

Palliative Care Familiar

Palliative Care Very Familiar

Community Care

Community Care Not Familiar

Community Care Somewhat Familiar

Community Care Familiar

Community Care Very Familiar

	Poor	Fair	Good	Very Good	Excellent	N/A
Ease of contacting CVNA to discuss patient care matters	Ease of contacting CVNA to discuss patient care matters Poor	Ease of contacting CVNA to discuss patient care matters Fair	Ease of contacting CVNA to discuss patient care matters Good	Ease of contacting CVNA to discuss patient care matters Very Good	Ease of contacting CVNA to discuss patient care matters Excellent	Ease of contacting CVNA to discuss patient care matters N/A
Ease of coordinating CVNA services for your patients	Ease of coordinating CVNA services for your patients Poor	Ease of coordinating CVNA services for your patients Fair	Ease of coordinating CVNA services for your patients Good	Ease of coordinating CVNA services for your patients Very Good	Ease of coordinating CVNA services for your patients Excellent	Ease of coordinating CVNA services for your patients N/A
Ease of monitoring your patient's progress	Ease of monitoring your patient's progress Poor	Ease of monitoring your patient's progress Fair	Ease of monitoring your patient's progress Good	Ease of monitoring your patient's progress Very Good	Ease of monitoring your patient's progress Excellent	Ease of monitoring your patient's progress N/A
CVNA's commitment to continuity of care	CVNA's commitment to continuity of care Poor	CVNA's commitment to continuity of care Fair	CVNA's commitment to continuity of care Good	CVNA's commitment to continuity of care Very Good	CVNA's commitment to continuity of care Excellent	CVNA's commitment to continuity of care N/A
Usefulness of the patient related information provided to you by CVNA	Usefulness of the patient related information provided to you by CVNA Poor	Usefulness of the patient related information provided to you by CVNA Fair	Usefulness of the patient related information provided to you by CVNA Good	Usefulness of the patient related information provided to you by CVNA Very Good	Usefulness of the patient related information provided to you by CVNA Excellent	Usefulness of the patient related information provided to you by CVNA N/A
Degree to which you are involved in decision making about starting or continuing services for your patients	Degree to which you are involved in decision making about starting or continuing services for your patients Poor	Degree to which you are involved in decision making about starting or continuing services for your patients Fair	Degree to which you are involved in decision making about starting or continuing services for your patients Good	Degree to which you are involved in decision making about starting or continuing services for your patients Very Good	Degree to which you are involved in decision making about starting or continuing services for your patients Excellent	Degree to which you are involved in decision making about starting or continuing services for your patients N/A

Poor

Fair

Good

Very Good

Excellent

N/A

Ease of contacting CVNA to discuss patient care matters

Ease of contacting CVNA to discuss patient care matters Poor

Ease of contacting CVNA to discuss patient care matters Fair

Ease of contacting CVNA to discuss patient care matters Good

Ease of contacting CVNA to discuss patient care matters Very Good

Ease of contacting CVNA to discuss patient care matters Excellent

Ease of contacting CVNA to discuss patient care matters N/A

Ease of coordinating CVNA services for your patients

Ease of coordinating CVNA services for your patients Poor

Ease of coordinating CVNA services for your patients Fair

Ease of coordinating CVNA services for your patients Good

Ease of coordinating CVNA services for your patients Very Good

Ease of coordinating CVNA services for your patients Excellent

Ease of coordinating CVNA services for your patients N/A

Ease of monitoring your patient's progress

Ease of monitoring your patient's progress Poor

Ease of monitoring your patient's progress Fair

Ease of monitoring your patient's progress Good

Ease of monitoring your patient's progress Very Good

Ease of monitoring your patient's progress Excellent

Ease of monitoring your patient's progress N/A

CVNA's commitment to continuity of care

CVNA's commitment to continuity of care Poor

CVNA's commitment to continuity of care Fair

CVNA's commitment to continuity of care Good

CVNA's commitment to continuity of care Very Good

CVNA's commitment to continuity of care Excellent

CVNA's commitment to continuity of care N/A

Usefulness of the patient related information provided to you by CVNA

Usefulness of the patient related information provided to you by CVNA Poor

Usefulness of the patient related information provided to you by CVNA Fair

Usefulness of the patient related information provided to you by CVNA Good

Usefulness of the patient related information provided to you by CVNA Very Good

Usefulness of the patient related information provided to you by CVNA Excellent

Usefulness of the patient related information provided to you by CVNA N/A

Degree to which you are involved in decision making about starting or continuing
services for your patients

Degree to which you are involved in decision making about starting or continuing
services for your patients Poor

Degree to which you are involved in decision making about starting or continuing
services for your patients Fair

Degree to which you are involved in decision making about starting or continuing
services for your patients Good

Degree to which you are involved in decision making about starting or continuing
services for your patients Very Good

Degree to which you are involved in decision making about starting or continuing
services for your patients Excellent

Degree to which you are involved in decision making about starting or continuing
services for your patients N/A

	Poor	Fair	Good	Very Good	Excellent	N/A
Reception	Reception Poor	Reception Fair	Reception Good	Reception Very Good	Reception Excellent	Reception N/A
Intake	Intake Poor	Intake Fair	Intake Good	Intake Very Good	Intake Excellent	Intake N/A
Clinical Staff	Clinical Staff Poor	Clinical Staff Fair	Clinical Staff Good	Clinical Staff Very Good	Clinical Staff Excellent	Clinical Staff N/A
Scheduling	Scheduling Poor	Scheduling Fair	Scheduling Good	Scheduling Very Good	Scheduling Excellent	Scheduling N/A
Order Processing	Order Processing Poor	Order Processing Fair	Order Processing Good	Order Processing Very Good	Order Processing Excellent	Order Processing N/A

Poor

Fair

Good

Very Good

Excellent

N/A

Reception

Reception Poor

Reception Fair

Reception Good

Reception Very Good

Reception Excellent

Reception N/A

Intake

Intake Poor

Intake Fair

Intake Good

Intake Very Good

Intake Excellent

Intake N/A

Clinical Staff

Clinical Staff Poor

Clinical Staff Fair

Clinical Staff Good

Clinical Staff Very Good

Clinical Staff Excellent

Clinical Staff N/A

Scheduling

Scheduling Poor

Scheduling Fair

Scheduling Good

Scheduling Very Good

Scheduling Excellent

Scheduling N/A

Order Processing

Order Processing Poor

Order Processing Fair

Order Processing Good

Order Processing Very Good

Order Processing Excellent

Order Processing N/A

	Not Familiar	Somewhat Familiar	Familiar	Very Familiar
Updated telehealth units and program	Updated telehealth units and program Not Familiar	Updated telehealth units and program Somewhat Familiar	Updated telehealth units and program Familiar	Updated telehealth units and program Very Familiar
Web-based physician portal	Web-based physician portal Not Familiar	Web-based physician portal Somewhat Familiar	Web-based physician portal Familiar	Web-based physician portal Very Familiar
Skilled nursing disease management programs	Skilled nursing disease management programs Not Familiar	Skilled nursing disease management programs Somewhat Familiar	Skilled nursing disease management programs Familiar	Skilled nursing disease management programs Very Familiar
Rehab disease management programs	Rehab disease management programs Not Familiar	Rehab disease management programs Somewhat Familiar	Rehab disease management programs Familiar	Rehab disease management programs Very Familiar
Educational series for CEUs	Educational series for CEUs Not Familiar	Educational series for CEUs Somewhat Familiar	Educational series for CEUs Familiar	Educational series for CEUs Very Familiar
Educational series for the community	Educational series for the community Not Familiar	Educational series for the community Somewhat Familiar	Educational series for the community Familiar	Educational series for the community Very Familiar
Lunch and learn about Cornerstone VNA programs	Lunch and learn about Cornerstone VNA programs Not Familiar	Lunch and learn about Cornerstone VNA programs Somewhat Familiar	Lunch and learn about Cornerstone VNA programs Familiar	Lunch and learn about Cornerstone VNA programs Very Familiar
Companion and Hospice Volunteer Program	Companion and Hospice Volunteer Program Not Familiar	Companion and Hospice Volunteer Program Somewhat Familiar	Companion and Hospice Volunteer Program Familiar	Companion and Hospice Volunteer Program Very Familiar
Million Hearts initiative	Million Hearts initiative Not Familiar	Million Hearts initiative Somewhat Familiar	Million Hearts initiative Familiar	Million Hearts initiative Very Familiar
PHQ2-all admissions	PHQ2-all admissions Not Familiar	PHQ2-all admissions Somewhat Familiar	PHQ2-all admissions Familiar	PHQ2-all admissions Very Familiar
PHQ-9 for patients	PHQ-9 for patients Not Familiar	PHQ-9 for patients Somewhat Familiar	PHQ-9 for patients Familiar	PHQ-9 for patients Very Familiar

Not Familiar

Somewhat Familiar

Familiar

Very Familiar

Updated telehealth units and program

Updated telehealth units and program Not Familiar

Updated telehealth units and program Somewhat Familiar

Updated telehealth units and program Familiar

Updated telehealth units and program Very Familiar

Web-based physician portal

Web-based physician portal Not Familiar

Web-based physician portal Somewhat Familiar

Web-based physician portal Familiar

Web-based physician portal Very Familiar

Skilled nursing disease management programs

Skilled nursing disease management programs Not Familiar

Skilled nursing disease management programs Somewhat Familiar

Skilled nursing disease management programs Familiar

Skilled nursing disease management programs Very Familiar

Rehab disease management programs

Rehab disease management programs Not Familiar

Rehab disease management programs Somewhat Familiar

Rehab disease management programs Familiar

Rehab disease management programs Very Familiar

Educational series for CEUs

Educational series for CEUs Not Familiar

Educational series for CEUs Somewhat Familiar

Educational series for CEUs Familiar

Educational series for CEUs Very Familiar

Educational series for the community

Educational series for the community Not Familiar

Educational series for the community Somewhat Familiar

Educational series for the community Familiar

Educational series for the community Very Familiar

Lunch and learn about Cornerstone VNA programs

Lunch and learn about Cornerstone VNA programs Not Familiar

Lunch and learn about Cornerstone VNA programs Somewhat Familiar

Lunch and learn about Cornerstone VNA programs Familiar

Lunch and learn about Cornerstone VNA programs Very Familiar

Companion and Hospice Volunteer Program

Companion and Hospice Volunteer Program Not Familiar

Companion and Hospice Volunteer Program Somewhat Familiar

Companion and Hospice Volunteer Program Familiar

Companion and Hospice Volunteer Program Very Familiar

Million Hearts initiative

Million Hearts initiative Not Familiar

Million Hearts initiative Somewhat Familiar

Million Hearts initiative Familiar

Million Hearts initiative Very Familiar

PHQ2-all admissions

PHQ2-all admissions Not Familiar

PHQ2-all admissions Somewhat Familiar

PHQ2-all admissions Familiar

PHQ2-all admissions Very Familiar

PHQ-9 for patients

PHQ-9 for patients Not Familiar

PHQ-9 for patients Somewhat Familiar

PHQ-9 for patients Familiar

PHQ-9 for patients Very Familiar

Question Title

6. Please rate the quality of patient care that Cornerstone VNA provides:

Poor

Fair

Good

Very Good

Excellent

Poor

Fair

Good

Very Good

Excellent

Feel free to provide comments in the space provided:

Question Title

7. Please indicate your overall satisfaction with Cornerstone VNA:

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

Feel free to provide comments in the space provided:

Question Title

8. How likely is it that you would recommend Cornerstone VNA to a patient or colleague?

Very Unlikely

Unlikely

Neutral

Likely

Very Likely

Very Unlikely

Unlikely

Neutral

Likely

Very Likely

Feel free to provide comments in the space provided:

Question Title

9. Please use this space to share any additional comments or suggestions.

Question Title

10. Thank you for completing our survey!

Name

Practice Name

Email Address

Phone Number

Thank you very much for completing our survey!

About Cornerstone VNA: Cornerstone VNA is a non-profit home, health and hospice agency currently serving Rockingham, Strafford, Belknap and Carroll Counties in New Hampshire and York County in Maine. The team at Cornerstone VNA provides skilled nursing, rehabilitative therapies, social work as well as volunteer and support services through five distinct programs: Home Care, Hospice Care, Palliative Care, Life Care-Private Duty and Community Care. For more than 100 years, Cornerstone VNA has been committed to bringing services to people of all ages, regardless of ability to pay, so that families can stay together at home, even when facing the challenges of aging, surgical recovery, chronic or life-threatening illnesses or end of life care. To learn more about Cornerstone VNA, visit www.cornerstonevna.org or call 800-691-1133.

2016 Provider Survey

Question Title

1. What type of health care provider are you?

Question Title

2. Please rate your familiarity with the following Cornerstone VNA programs:

Question Title

3. Please tell us about your experience with the following:

Question Title

4. Please rate your overall satisfaction with the following at Cornerstone VNA:

Question Title

5. Which of the following are you familiar with at Cornerstone VNA?

Question Title

6. Please rate the quality of patient care that Cornerstone VNA provides:

Question Title

7. Please indicate your overall satisfaction with Cornerstone VNA:

Question Title

8. How likely is it that you would recommend Cornerstone VNA to a patient or colleague?

Question Title

9. Please use this space to share any additional comments or suggestions.

Question Title

10. Thank you for completing our survey!