National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS)

National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) CMS-10102

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0981 can be found here:

Documents and Forms

Document Name Document Type
BL draft4, 10-6-10, Final -- Apx. A - HCAHPS instrument.doc Other-Apx. A - HCAHPS instrument
BL edit3, 10-7-10, Final -- Apx. B. - Psychometrics.docx Other-Apx. B. - Psychometrics

Information Collection (IC) Details

IC Title:	National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-Apx. A - HCAHPS instrument			BL draft4, 10-6-10, Final -- Apx. A - HCAHPS instrument.doc		Yes	Yes	Paper Only
Other-Apx. B. - Psychometrics			BL edit3, 10-7-10, Final -- Apx. B. - Psychometrics.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,480,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,480,000	0	-340,000	2,820,000
Annual IC Time Burden (Hours)	289,342	0	-40,598	329,940
Annual IC Cost Burden (Dollars)	15,100,000	15,100,000	0	0

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.