RCHD Evaluation Interview Protocols and Annual Progress Report Tool -- private hospitals

Evaluation of the Rural Community Hospital Demonstration

OMB: 0938-1253

IC ID: 210347

Information Collection (IC) Details

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RCHD Evaluation Interview Protocols and Annual Progress Report Tool -- private hospitals
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10508 Data Collection Protocols RCHD_OMB_protocols_7Nov2013.docx Yes Yes Fillable Fileable

Health Health Care Services

 

15 8
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   64 %

  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 23 0 23 0 0 0
Annual IC Time Burden (Hours) 168 0 168 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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