National Voluntary Hospital Reporting Initiative--Hospital Quality Measures

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10109 National Voluntary Hospital Reporting Initiative--Hospital Quality Measures	Form and Instruction	Modified	Available
Form CMS-10109 National Voluntary Hospital Reporting Initiative--Hospital Quality Measures	Form and Instruction	New	Available
List of APU measures FY 2007.doc	Supplementary Document	Uploaded 2007-01-11	Available
Supporting Statement Part B.doc	Supporting Statement B	Uploaded 2006-10-03	Available
CMS-10109.Supporting Statement.9-20-06.doc	Supporting Statement A	Uploaded 2006-10-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
8762	National Voluntary Hospital Reporting Initiative--Hospital Quality Measures	Form and Instruction	Modified
45693	National Voluntary Hospital Reporting Initiative--Hospital Quality Measures	Form and Instruction	New

ICR Details

OMB Control No: 0938-0918	ICR Reference No: 200610-0938-008
Status: Historical Active	Previous ICR Reference No: 200510-0938-012
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: National Voluntary Hospital Reporting Initiative--Hospital Quality Measures
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/16/2007
	Date Received in OIRA: 10/16/2006
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	36 Months From Approved	12/31/2008
Responses	14,800	0	16,000
Time Burden (Hours)	583,776	0	238,000
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose is to collect data to produce valid, reliable, comparable and salient quality measures to provide a potent stimulus for clinicians and providers to improve the quality of care they provide. This voluntary reporting initiative in which hospitals may participate is a significant step toward a more informed public and a means to sustain health care quality improvement. The data is currently being collected from hospitals by CMS. The hospitals submitting data have volunteered to participate in public reporting.

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Authorizing Statute(s): PL: Pub.L. 109 - 171 5001 Name of Law: Hospital Quality Improvement
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 33458	06/09/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 57513	09/29/2006
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
National Voluntary Hospital Reporting Initiative--Hospital Quality Measures	CMS-10109, CMS-10109, CMS-10109	CMS-10109.final praoryx ,   CMS-10109.final praqnet ,   CMS-10109.CART Summary
National Voluntary Hospital Reporting Initiative--Hospital Quality Measures	CMS-10109, CMS-10109, CMS-10109	CMS-10109.CART Summary ,   CMS-10109.final praoryx ,   CMS-10109.final praqnet

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	14,800	16,000	0	-1,200	0	0
Annual Time Burden (Hours)	583,776	238,000	0	345,776	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The increase in burden is due to an increase in the number of data elements being submitted.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/12/2006

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