Information Collection

CAHPS Home Health Care Survey

IC 193913 under ICR 201007-0938-011 · OMB 0938-1066.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1066 can be found here:

Documents and Forms

Document Name Document Type
HomeHealthCAHPS_OMB_PartC revised 6-24-10.pdf Other-CAHPS Mail and Phone Survey an

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CAHPS Home Health Care Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Other-CAHPS Mail and Phone Survey and Survey Questionnaires			HomeHealthCAHPS_OMB_PartC revised 6-24-10.pdf		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,890	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9,890	9,890
Annual IC Time Burden (Hours)	158,240	158,240
Annual IC Cost Burden (Dollars)	39,560,000	39,560,000

Documents for IC

Title	Document	Date Uploaded
No associated records found

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