Tell Me Now: Strongly Agree or Agree


During the past few years, Granville Health System (GHS) has reached out to the community for their feedback on their experiences at their community hospital. We will continue to give patients a voice and use these responses to improve the patient experience. I appreciate the feedback that I have received and would encourage our patients and visitors to tell us how we’re doing during their time with us.

We live in a consumer-driven society where feedback is a highly sought-after commodity. Our opinions are continuously sought in everything from an on-line purchase to using a new mobile app.

Everyone wants good reviews and positive buzz. In this regard, health care is no different. Customers (and patients) have many choices and savvy shoppers can drive increased performance.

As you may remember from previous columns, the Centers for Medicare/Medicaid Services (CMS) requires hospitals to survey our patients about the care they received while in the hospital. The purpose of the survey is to create a national standard for collecting and publicly reporting patients’ perspectives of care. This gives customers the ability to make comparisons across hospitals. It’s a good thing – patients can make informed decisions on their care and the competition increases the quality of that care.

In the CMS health care survey, several questions focus on how Granville Health System worked to take into account your wishes about what your care looks like after your hospital stay.

Typically, our care team works with a patient and their family to decide where a patient will go for their care. Some of the options include:

  • home

  • a skilled nursing facility

  • home with home health coming to visit

  • home with Hospice care


These decisions can be overwhelming, both for patients and their families. And they often have to be made when emotions are running high.

The GHS Transitional Care staff works as part of the care team at GHS. This team is made up of nurses, social workers, physicians, nurse practitioners, community paramedics, and other staff. One of the responsibilities of the Transitional Care coordinators is to help patients navigate through these decisions. They provide highly personalized services to align resources, start conversations, and establish follow-up care.

Many factors go into making a decision about where a patient will go and what type of care they will receive after a hospital discharge. One of these factors is a patient’s insurance coverage. Each insurance plan has benefits and criteria for the activation of these benefits. Our team will contact the insurance company and help a patient to sort through their options within the insurance coverage.

Other factors that affect a patient’s post-discharge plan include their medical condition, medical history, the wishes of the patient and their family, and their support structure at home.

In summary, taking a patient’s wishes into account is only part of the formula for making decisions about a patient’s care after a hospital stay. Our care team does take a patient’s wishes into account however, their job is to bring all these factors together to make the best decision for the health of the patient.

On the survey, when asking how well we took a patient’s wishes into account, the answer choices are “Strongly Agree”, “Agree”, “Strongly Disagree” and “Disagree”. CMS only recognizes “Strongly Agree”. Any other response indicates to CMS that GHS did not take the patient’s preferences into account. No partial credit is given for working with the patient and their family.

Of course, our staff would like to receive a “Strongly Agree” from every single patient. I realize that most people are not a “Strongly Agree” or “Strongly Disagree” type – I get that. I’m not given to wild extremes myself.

But here is what CMS doesn’t tell you -- any answer less than “Strongly Agree” is simply thrown out. An answer of “Agree” is the same as saying “Strongly Disagree”. The measurement of service and the reimbursement rate from CMS is the same for every answer less than “Strongly Agree”.

Additionally, the Health System’s performance on this question is reflected in Medicare’s reimbursement to the hospital.

Some of our staff have said, “that’s not fair” and I personally don’t disagree, but GHS doesn’t set the payment schedule and criteria. This Health System, like all hospitals, must learn to work with their communities to get the desired results because, in the end, reimbursement rates do matter to hospitals. Decisions made in Raleigh and in Washington have a real and immediate impact on all North Carolina hospitals, including Granville Health System.

Here’s how you can help. If you don’t understand your options, please ask questions. If you are being told you can’t go to the nursing facility of your choice, please ask for the reasons. If you’ve been told you can’t get home health nursing services, ask questions about how those decisions are being made. Our providers and staff have committed to helping our patients understand their care options after discharge. We’d like for our patients to be engaged in understanding all their options.

The goal of GHS is not just to receive a “Strongly Agree” from you on a telephone survey. Following a patient’s wishes in planning their care after discharge is simply the right thing to do for our patients and our community.

We’re pleased to form a partnership with our patients as we work to get them healthy and keep them healthy. Our goal is to work alongside our patients and their families to make good decisions about patient care.

Thank you for sharing your experiences at GHS. Please continue to stop me in the community to share your feedback with me. I always appreciate hearing from you. You can also always contact me directly by email at

Back to News Listing