Technical Specifications

CAHPS® Hospice Survey

Technical Specifications
     

Quick Links: CAHPS Hospice Survey Vendor Authorization Form | CAHPS Hospice Survey Data Warehouse Form |  CAHPS Hospice Survey XML File Specification Version 7.1 


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 or switch to a new 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 by that vendor.

If a hospice wishes to change CAHPS Hospice Survey vendors, it may do so ONLY at the beginning of a calendar quarter.

  • Note: A quarter is based on the calendar year (CY) and will correspond to the month of patient death. For example, Quarter 1 2022 begins with January 2022 patient deaths (caregivers to be surveyed April 2022).

The individual who completes this form for the hospice will be considered the CAHPS Hospice Survey Administrator for that hospice.

  • This form must be signed and dated in the presence of a notary public, notarized and sent to the RAND Corporation.
  • Hospices may also designate, on the form, an additional individual within the hospice organization to serve as the main point of contact with the CAHPS Hospice Survey Project Team.

Please note, when completing the CAHPS Hospice Survey Vendor Authorization Form pertaining to multiple hospice agencies, it is appropriate to attach a list to the form (signed and dated by the CAHPS Hospice Survey Administrator) of all the applicable hospices (hospice names and CMS Certification Numbers [CCNs]). Please check the box on the form indicating that a separate document is attached and indicate the number of hospice names and CCNs listed on the separate sheet.

Click here to download the CAHPS Hospice Survey Vendor Authorization Form. Please type in the required fields to complete the form, save the completed form, and print the completed form. The completed form must be signed and dated in the presence of a notary public, notarized, and sent to the RAND Corporation.

Send the completed form to:

RAND Corporation
ATTN: Survey Research Group - Data Reduction
CAHPS Hospice Survey
1776 Main Street
Santa Monica, CA 90401

Phone: 310-393-0411, extension 5599

Note: After submission of the CAHPS Hospice Survey Vendor Authorization Form, no further action is required by the hospice to notify CMS of their survey vendor selection. The RAND Corporation communicates to CMS which hospice agencies have authorized a survey vendor to administer the CAHPS Hospice Survey on their behalf. The RAND Corporation notifies vendors of hospices who have authorized them for data collection. Vendors cannot submit data for hospices that have not authorized them.

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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. 

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 must also have a user account 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.

Organizations 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. Complete contact information is required to authorize a user account. 

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.

Please note: By submitting a new form, your organization is indicating a change to its Data Administrator and/or Back-up Data Administrator.  Administrators listed on prior Data Warehouse Access Forms will no longer have access to the Data Warehouse.

Click here to download the CAHPS Hospice Survey Data Warehouse Form. Please type in the required fields to complete the form, save the completed form, and submit the completed CAHPS Hospice Survey Data Warehouse Form as an email attachment to CAHPShospicetechsupport@rand.org.

The completed form may also be submitted by mail or Fedex to:

RAND Corporation, CAHPS Hospice Survey
ATTN: Survey Research Group - Data Reduction
1776 Main Street
Santa Monica, CA 90401

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

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CAHPS Hospice Survey XML File Specification Version 7.1

The XML File Specification Version 7.0 (V7.0) has been revised with an update made to the<ineligible-postsample> sub-element of hospice data.  This updated version must be used beginning with the August 11, 2021 data submission containing CAHPS Hospice Survey results for Quarter 1 2021 decedents (patients that  pass away  in January, February, and March 2021).

Click here to download the CAHPS Hospice Survey XML File Specification V7.1.

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This page was last modified on 10/04/2021