CAHPS® Hospice Survey

Technical Specifications
     

Quick Links: CAHPS Hospice Survey Vendor Authorization Form | Authorization Form for Changing Survey Vendors | CAHPS Hospice Survey Data Warehouse Form | CAHPS Hospice Survey XML File Specification Version 2.2 | CAHPS Hospice Survey XML File Specification Version 3.1


CAHPS Hospice Survey Vendor Authorization Form 

Hospice agencies must authorize an approved CAHPS Hospice Survey vendor to submit data on their behalf for the administration of the CAHPS Hospice Survey. In order to authorize a survey vendor, a hospice representative must complete the CAHPS Hospice Survey Vendor Authorization Form and submit it to the RAND Corporation one calendar quarter (90 days) prior to the first time data will be submitted to the CAHPS Hospice Survey Data Warehouse. The individual who completes this form for the hospice will be considered the CAHPS Hospice Survey Administrator for that hospice. Hospices should also designate, on the form, an individual within the hospice organization to serve as the main point of contact with the CAHPS Hospice Survey Project Team and to review data submissions by the survey vendor.

Click here to download the CAHPS Hospice Survey Vendor Authorization Form.

The CAHPS Hospice Survey Vendor Authorization Form must be signed and dated in the presence of a notary public, notarized, and sent to the RAND Corporation. Please note, when completing a CAHPS Hospice Survey Vendor Authorization Form pertaining to multiple hospice agencies, it would be appropriate to attach a list to the form (signed and dated by the Survey Administrator) of all the hospices (names and CMS Certification Numbers [CCN]). On the form itself, please note that “a document containing a list of “XX” number of hospice agencies is attached to the form” in the spaces provided.

If sent via U.S. Mail, send to:

RAND Corporation
ATTN: Melissa A. Bradley
CAHPS Hospice Survey
1200 South Hayes Street
Arlington, VA 22202

If sent via Federal Express, UPS or other overnight delivery service, send to:

RAND Corporation
ATTN: Melissa A. Bradley
CAHPS Hospice Survey
1200 South Hayes Street
Arlington, VA 22202
Phone: 703-413-1100, extension 5614

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Authorization Form for Changing Survey Vendors

If an organization chooses to de-authorize its CAHPS Hospice Survey vendor, the organization should contact the CAHPS Hospice Survey Project Team for assistance. This change can only take effect at the beginning of a quarter, and the timing of receipt of the request may affect when the change may be made. The quarter is based on the calendar year (CY) and will correspond to the month of patient death. For example, Quarter 1 2017 begins with January 2017 patient deaths (caregivers to be surveyed April 2017). In order to change survey vendors, the hospice’s CAHPS Hospice Survey Administrator must complete the Authorization Form for Changing Survey Vendors and submit it to the RAND Corporation one calendar quarter (90 days) prior to the first time data will be submitted to the CAHPS Hospice Survey Data Warehouse by the new survey vendor.

Please note, your current authorized survey vendor must submit all CAHPS Hospice Survey results that they have collected on behalf of your hospice to the CAHPS Hospice Survey Data Warehouse by the designated date in order for your organization to be compliant.

Click here to download the fillable Authorization Form for Changing Survey Vendors.

The Authorization Form for Changing Survey Vendors must be signed and dated in the presence of a notary public, notarized, and sent to the RAND Corporation. 

If sent via U.S. Mail, send to:

RAND Corporation
ATTN: Melissa A. Bradley
CAHPS Hospice Survey
1200 South Hayes Street Arlington, VA 22202

If sent via Federal Express, UPS or other overnight delivery service, send to:

RAND Corporation
ATTN: Melissa A. Bradley
CAHPS Hospice Survey
1200 South Hayes Street Arlington, VA 22202
Phone: 703-413-1100, extension 5614

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CAHPS Hospice Survey Data Warehouse Form

All hospices and approved survey vendors must have user account information and be granted access to the CAHPS Hospice Survey Data Warehouse. The CAHPS Hospice Survey Data Warehouse is maintained by the RAND Corporation. Download, complete, and submit the CAHPS Hospice Survey Data Warehouse Form as an email attachment to CAHPShospicetechsupport@rand.org or by fax to the CAHPS Hospice Survey Data Support Team (703) 413-8111. Your form must be received one calendar quarter (90 days) prior to the first time data will be submitted to the CAHPS Hospice Survey Data Warehouse.

Survey vendors require access to the CAHPS Hospice Survey Data Warehouse in order to submit data files in accordance with the requirements of the survey file layouts by the data submission deadlines. The survey vendor will be able to review the CAHPS Hospice Survey Data Submission Reports and confirm successful upload of contracted hospices’ data files to the CAHPS Hospice Survey Data Warehouse.

Hospices require access to the CAHPS Hospice Survey Data Warehouse in order to monitor data submission activities. The hospice will be able to review data submission reports to ensure that their survey vendor has submitted data on time and without data problems.

Organization’s completing the CAHPS Hospice Survey Data Warehouse Form must provide contact information for two individuals that will be granted access to the CAHPS Hospice Survey Data Warehouse. These individuals will be designated as the Data Administrator and the Back-up Data Administrator.

Click here to download the CAHPS Hospice Survey Data Warehouse Form.

Please note the same form is used by approved survey vendors and hospices.

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CAHPS Hospice Survey XML File Specification Version 2.2

The XML File Specification Version 2.2 (V2.2) was used for the August 10, 2016, November 9, 2016 and February 8, 2017 data submission deadlines containing CAHPS Hospice Survey results for Quarters 1-3 2016 decedents.

The XML File Specification V2.2 must be used for the May 10, 2017 data submission deadline containing CAHPS Hospice Survey results for Quarter 4 2016 decedents (patients that died in October, November and December 2016).

Click here to download the CAHPS Hospice Survey XML File Specification V2.2.

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CAHPS Hospice Survey XML File Specification Version 3.1

The XML File Specification Version 3.1 (V3.1) must be used beginning with the August 9, 2017 data submission deadline containing CAHPS Hospice Survey results for Quarter 1 2017 decedents (patients that died in January, February and March 2017).

Click here to download the CAHPS Hospice Survey XML File Specification V3.1.

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This page was last modified on 04/11/2017