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Supplemental Items for the CAHPS Hospital Survey: Interpreter Services

Population version: Adult

Related topic: Health Literacy. Hospitals interested in items that assess interpreter services may also want to review and use supplemental items that ask about health literacy.

Use with HCAHPS: These supplemental items were designed to be added to the Adult version of HCAHPS, which is implemented nationally by the Centers for Medicare & Medicaid Services (CMS). While users of HCAHPS are free to incorporate supplemental items in order to meet the needs of their organizations, local markets, and/or audiences, the use of these supplemental items is not part of the national implementation requirements. Additionally, some items cover events that occur with low frequency in the general population. You should include them only if your sample design is likely to yield a sufficient number of responses to those questions for statistical analysis and reporting.

Important instructions regarding the placement of supplemental items in the core questionnaire: Under CMS's rules for national implementation of HCAHPS, you must:

  • Place all supplemental items after the "Â鶹´«Ã½ You" section of the survey.
  • Add a transition statement to indicate a transition from the HCAHPS questions. To find CMS’s mandatory transition statement, please refer to the HCAHPS Quality Assurance Guidelines on and search for "mandatory transition statement." The statement is available in multiple languages.
  • Add a new subheading: "Interpreter Services."
  • Format the subheading to be consistent with existing subheadings.

For a shorter set of questions on this topic, use H-IN1 – H-IN6. Questions H-IN8 – H-IN10 are available to provide additional information if desired.

Why are friends and family members included as interpreters? Testing has shown that respondents often include friends and family members as interpreters even when they are given a definition of "interpreters" that specifically excludes them. In order to collect uniform data from all respondents, question H-IN2 includes friends and family members in the definition of interpreters. Question H-IN5 or questions H-IN8 – H-IN10 can be used to identify the type of interpreter, which provides information you can use to analyze the questions about interpreter services.

Questions and Response Options Placement and Other Instructions
H-IN1. What is your preferred language?
   1 __ English → If English, go to core question 26
   2 __ Spanish
   3 __ [INSERT LANGUAGE]
   4 __ [INSERT LANGUAGE]
   5 __ Another language		  
H-IN2. An interpreter is someone who helps you talk with others who do not speak your language. During this hospital stay, did you need an interpreter to talk with someone at this hospital?
   1 __ Yes
   2 __ No		 After H-IN1

Note: Use with H-IN1
H-IN3. During this hospital stay, did hospital staff tell you that you had a right to interpreter services free of charge?
   1 __ Yes
   2 __ No		 After H-IN2

Note: Use with H-IN1
H-IN4. During this hospital stay, how often did you have an interpreter at this hospital when you needed one?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always		 After H-IN3

Note: Use with H-IN1
H-IN5. During this hospital stay, how often did you use a friend or family member as an interpreter when you talked with hospital staff?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always		 After H-IN4

Note: Use with H-IN1

Note: If you use H-IN5, do not use H-IN8-10
H-IN6. Using any number from 0 to 10, where 0 is the worst interpreter possible and 10 is the best interpreter possible, what number would you use to rate this interpreter?
__ 0 Worst interpreter possible
__ 1
__ 2
__ 3
__ 4
__ 5
__ 6
__ 7
__ 8
__ 9
__ 10 Best interpreter possible		 After H-IN5

Note: Use with H-IN1
H-IN7. During this hospital stay, how often did you have to wait 15 minutes or longer for the interpreter provided by the hospital to come help you?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always		 After H-IN6

Note: Use with H-IN1
H-IN8. During this hospital stay, how often did you use a friend or family member as an interpreter when you talked with hospital staff?
   1 __ Never → If Never, go to core question 26
   2 __ Sometimes
   3 __ Usually
   4 __ Always		 After H-IN7

Note: Use with H-IN1

Note: If you use H-IN8-10, do not use H-IN5
H-IN9. During this hospital stay, did you use a child younger than 18 to help you talk with hospital staff?
   1 __ Yes
   2 __ No		 After H-IN8

Note: Use with H-IN8
H-IN10. During this hospital stay, did you use friends or family members as interpreters because that was what you preferred?
   1 __ Yes
   2 __ No		 After H-IN9

Note: Use with H-IN8
Page last reviewed October 2023
Page originally created April 2016

Internet Citation: Supplemental Items for the CAHPS Hospital Survey: Interpreter Services. Content last reviewed October 2023. Agency for Healthcare Research and Quality, Rockville, MD.
/cahps/surveys-guidance/item-sets/literacy/suppl-interpreter-service-items.html

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