Payment Program

This family-centered survey questionnaire consists of 68 questions that assess various aspects of care experiences during inpatient pediatric hospital stays. Questions can be used individually to measure specific performance but 35 rating questions can also be summarized into domain scores.

The 68 questions of the survey can be divided into 3 groups:
1. 26 background questions that mostly provide information for comparisons across different demographic and patient groups:

Percentage of patients aged 18 years and older with a diagnosis of end stage renal disease (ESRD) with a catheter after 90 days on hemodialysis who are seen/evaluated by a vascular surgeon or other surgeon qualified in the area of vascular access for permanent vascular access at least once during the 12-month reporting period.

Percentage of end stage renal disease (ESRD) patients aged 18 years and older receiving hemodialysis during the 12-month reporting period and on dialysis >90 days who:

1. have a functional autogenous AVF (defined as two needles used or a single-needle device [NOT one needle used in a two-needle device]) (computed and reported separately);

2. have a functional AV graft (computed and reported separately); or

NSC-11.1 Total number of full-time and part-time Registered Nurse (RN) and Advanced Practice Nurse (APN) voluntary uncontrolled separations occurring during the calendar month
NSC-11.2 Total number of full-time and part-time Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN) voluntary uncontrolled separations occurring during the calendar month
NSC-11.3 Total number of full-time and part-time Unlicensed Assistive Personnel (UAP) voluntary uncontrolled separations occurring during the calendar month

Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or an OB/GYN and who had evidence of the following during the measurement year:
- Body mass index (BMI) percentile documentation
- Counseling for nutrition
- Counseling for physical activity