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Federal forms, ICRs, and supporting documents

Information Collection

Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration: ONGOING DATA (CMS-10240)

IC 182817 under ICR 201009-0938-004 · OMB 0938-1039.

Documents and Forms
Document Name
Document Type
Other-Application, Survey, Data coll
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration: ONGOING DATA (CMS-10240)
 
No Removed
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Application, Survey, Data collection Form, Statistical Methods CMS-10240 pra-attachments.doc Yes Yes Paper Only

Health Health Care Services

 

250 50
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -1,000 0 0 1,000
Annual IC Time Burden (Hours) 0 0 -17,220 0 0 17,220
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10240 nhvbp-paperburden CMS-10240 nhvbp-paperburden.xls 10/11/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.