Information Collection Request

CAHPS Home Health Care Survey

ICR 201007-0938-011 · OMB 0938-1066 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
HomeHealthCAHPS_OMB_PartB revised 6-24-10.pdf Supporting Statement B Uploaded 2010-07-22 Available
HomeHealthCAHPS_OMB_PartA revised 7-8-10.pdf Supporting Statement A Uploaded 2010-07-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
193913 CAHPS Home Health Care Survey Other-CAHPS Mail and Phone Survey and Survey Questionnaires New
188901 CAHPS Home Health Care Survey (CMS-10275) Other-CAHPS Mail and Phone Survey and Survey Questionnaires Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2012 36 Months From Approved 07/31/2012
2,706,000 0 2,706,000
541,200 0 541,200
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
CAHPS Home Health Care Survey
CAHPS Home Health Care Survey (CMS-10275)



Reginfo record details
  No