Hospice Voluntary Quality Data Reporting Form

Hospice Voluntary Quality Data Reporting Program

OMB: 0938-1153

IC ID: 200291

Information Collection (IC) Details

View Information Collection (IC)

Hospice Voluntary Quality Data Reporting Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10390 User Guide for Hospice Quality Reporting Data Entry Site HospiceQualityReporting-UserGuide.pdf Yes Yes Fillable Printable

Health Health Care Services

 

1,766 0
   
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 1,766 1,766 0 0 0 0
Annual IC Time Burden (Hours) 442 442 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

© 2024 OMB.report | Privacy Policy