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 4.0CAHPS Hospice Survey XML File Specification Version 5.0


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. 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.

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 4 2018 begins with October 2018 patient deaths (caregivers to be surveyed January 2019).

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 is appropriate to attach a list to the form (signed and dated by the CAHPS Hospice Survey Administrator) of all the 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.

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 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.

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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, by mail or by FedEx. 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 4.0

The XML File Specification Version 4.0 (V4.0) must continue to be used through the May 8, 2019 data submission deadline, containing CAHPS Hospice Survey results for Quarter 4 2018 decedents (patients that pass away in October, November and December 2018).

Click here to download the CAHPS Hospice Survey XML File Specification V4.0.

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CAHPS Hospice Survey XML File Specification Version 5.0

The XML File Specification Version 5.0 (V5.0) must be used beginning with the August 14, 2019 data submission deadline containing CAHPS Hospice Survey results for Quarter 1 2019 decedents (patients that pass away in January, February and March 2019).

Click here to download the CAHPS Hospice Survey XML File Specification V5.0.

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This page was last modified on 09/19/2018