The ICH Facility ICH CAHPS Survey Vendor Authorization Form

In-center hemodialysis (ICH) facilities can perform the following functions on the online Vendor Authorization located at the following link on the ICH CAHPS website:
https://ichcahps.org/ForFacilities/AuthorizeaVendor.aspx

• Authorize a survey vendor for the first time.
• Change/Switch to a different vendor for one or more facilities.
• Change or correct the Survey Period for an existing vendor authorization.
• View a list of facilities for which you have already authorized a vendor.

A brief description and the steps in each of these functions are provided below. Note that an automatic e-mail will be sent to the ICH facility’s Survey Administrator confirming that the vendor authorization has been completed immediately after that authorization has been submitted.

Please contact the ICH CAHPS Survey Coordination Team at 1-866-245-8083 or via e-mail at This email address is being protected from spambots. You need JavaScript enabled to view it. if you have any questions or problems completing this form. 

1. To Authorize a Survey Vendor for the First Time

ICH facilities should select this function for one or more facilities for which a Survey Vendor has never been authorized. To authorize a vendor for one or more facilities for the first time, follow the steps below:  

1. Select “Select a vendor for the first time” from the “Select Action” drop-down list.
2. Select your vendor from the drop-down list.
3. Select “Beginning Survey Period,” which is the first survey period in which you are authorizing this vendor to submit data on this facility’s behalf.
4. Select the ICH facility(s) to which this vendor authorization applies by checking the box next to each facility CCN/name.
5. Click the “Submit” button. 

To authorize the same survey vendor for more than one facility. Select “Survey Vendor” and then click the box to the left of each facility for which this survey vendor is authorized. Click the “Submit” button. 

To select different survey vendors for different facilities. If you are selecting a different survey vendor for different facilities, authorize a survey vendor for the set of facilities that will have the same vendor and click the “Submit” button. Then, repeat the steps for the next survey vendor you need to authorize. Note that you must click the Submit button after each vendor selection to record your authorization.

2. To Change/Switch to a Different Vendor for One or More Facilities

ICH facilities can change/switch to a different survey vendor, but the newly authorized survey vendor cannot begin collecting and submitting data on the facility’s behalf until the beginning of the next survey period. ICH facilities changing to a different vendor, however, can change the authorization form to authorize the new vendor at any time, but that authorization will not be effective until the beginning of the next survey period. 

To authorize a different vendor, follow the steps below.

1. Select the “Switch to a different vendor” option from the “Select Action” drop-down list.
2. Select your new authorized vendor from the vendor drop-down list.
3. Select the correct Beginning Survey Period for your new vendor. NOTE: Your new vendor authorization Beginning Survey Period must be for a period later than the current vendor authorization Beginning Survey Period you are switching from. 
4. If applicable, select the Ending Survey Period for your new vendor.
5. Select the ICH facility(s) to which the authorization applies. 
6. Click the “Submit” button 

3. Change or Correct the Survey Period for an Existing Vendor Authorization

This function will allow ICH facilities to change or correct information in an existing vendor authorization, including the survey period that an authorized vendor is to begin submitting data on the facility’s behalf. Follow the steps below to correct or change the information in an existing authorization.

1. Select “Change/correct an existing authorization” from the “Select Action” drop-down list.
2. Select the new Beginning or Ending Survey Period for your existing vendor authorization.
3. Select the ICH facility(s) to which this authorization applies by checking the box next to each facility CCN/name.
4. Click the “Submit” button. 

4. View a List of All Facilities for Which You Have Authorized a Vendor 

This function allows you to access and review a report that contains information about your vendor authorizations, including current and previously submitted authorizations. This report will show a list of facilities/CCNs for which you have authorized a survey vendor, the authorized survey vendor’s name, and the survey period in which the vendor is authorized to submit data on the facility’s behalf. A green checkmark will appear beside the most recent authorization for each CCN.

To see your Vendor Authorization Report, click “View list of current vendor authorizations” from the “Select Action” drop-down list.