CAHPS Home Health Care Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
UPD HHCAHPS_Mode Exp_AnalysisReport_final_revised_15july2010_psg (2).doc	Supplementary Document	Uploaded 2011-02-03	Available
PRAsummaryHHCAHPS12-2010.docx	Supplementary Document	Uploaded 2010-12-15	Available
PRAsummaryHHCAHPS12-2010.docx	Supplementary Document	Uploaded 2010-12-15	Available
UPD 1_19 4_46HomeHealthCAHPS_OMB_PartB _Lynch comments_19jan2011--WA edits rev.docx	Supporting Statement B	Uploaded 2011-02-03	Available
UPD 1_20 HomeHealthCAHPS_OMB_PartA send to OMB 20Jan2011_lynch_WA_edits.doc	Supporting Statement A	Uploaded 2011-02-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
195477	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

OMB Control No: 0938-1066	ICR Reference No: 201011-0938-018
Status: Historical Active	Previous ICR Reference No: 200904-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: CAHPS Home Health Care Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/14/2011
	Date Received in OIRA: 11/30/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2014	36 Months From Approved	07/31/2012
Responses	2,715,890	0	2,706,000
Time Burden (Hours)	699,440	0	541,200
Cost Burden (Dollars)	39,560,000	0	0

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Abstract: As part of the DHHS Transparency Initiative on Quality Reporting, CMS plans to implement a process to measure and publicly report patients' experiences with home health care they receive from Medicare-certified home health agencies through the data collection effort described in this request: the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Home Health Care Survey. The Home Health Care CAHPS Survey, which was developed and tested by the Agency for Healthcare Research and Quality (AHRQ) and is part of the family of CAHPS surveys, is a standardized survey for home health patients to assess their home health care providers and the quality of the home health care they receive. Prior to the Home Health Care CAHPS survey, there was no national standard for collecting data about home health care patients' experience with their home health care. This is a revision to the original PRA package which covered the voluntary implementation of the survey among Medicare-certified agencies and a randomized mode experiment to test the impact of different modes of data collection on survey responses. This is a revised PRA package because it now includes the burden to the home health agencies (HHAs) to contract with an approved HHCAHPS survey vendor to administer the HHCAHPS survey on their behalf.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: US Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AP88	Final or interim final rulemaking	75 FR 70372	11/17/2010

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Federal Register Notices & Comments

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
CAHPS Home Health Care Survey (CMS-10275)
CAHPS Home Health Care Survey

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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	2,715,890	2,706,000	0	9,890	0	0
Annual Time Burden (Hours)	699,440	541,200	0	158,240	0	0
Annual Cost Burden (Dollars)	39,560,000	0	0	39,560,000	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: No

Burden Reduction Due to:

Short Statement: The HHAs have some burden in the HHCAHPS that was NOT included in the original (new) PRA collection package that was approved by OMB 7-18-09. The HHAs must do the following in regard to HHCAHPS: (1) Contract with an approved HHCAHPS survey vendor to administer the HHCAHPS survey and to submit the HHCAHPS survey data to the Data Center on the HHAs' behalf; (2) Register for credentials to access the private secure links on the HHCAHPS website, www.homehealthcahps.org; (3) When registering for credentials to access the private links on www.homehealthcahps.org, the system will automatically generate a customized Consent Form for the HHAs. Each HHA must print this Consent Form and mail the completed signed and notarized Consent Form to the HHCAHPS Coordination Team; (4) Authorize an HHCAHPS survey vendor to collect and submit the HHCAHPS survey data to the Data Center; (5) Stay informed about HHCAHPS by checking www.homehealthcahps.org at least twice a week; (6) Prepare a monthly patient information file containing information that the survey vendor needs for sampling and fielding the survey; and (7) Submit the monthly patient information file to the survey vendor by the date specified or agreed to by your contracted survey vendor.

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Annual Cost to Federal Government: $1,765,634

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

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: 11/30/2010

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