Information Collection

Development Of Outcome-based Quality Measures For Home Health Services

IC 113912 under ICR 198911-0938-005 · OMB 0938-0519.

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Information Collection (IC) Details

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IC Title:	DEVELOPMENT OF OUTCOME-BASED QUALITY MEASURES FOR HOME HEALTH SERVICES	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-P-11				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 34,300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	80,000	79,999	1
Annual IC Time Burden (Hours)	42,182	42,181	1
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.