Quality Measures and Procedures for Hospital Reporting of Quality Data

Documents and forms in this information collection

Document Name	Document Type
Form CMS-10210 Data Accuracy and Completeness Acknowledgemenmt Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 HVBP Review and Corrections Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 HVBP Appeal Request Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Validation Template CAUTI Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Validation Template MRSA Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Validation Template CLABSI Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Validation Template CDI Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Request for Withholding Data from Public Reporting Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Reconsideration Request Form electronic Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Extroadinary Circumstances Disaster Waiver Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Healthcare Associated Infection Exception Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 HVBP Appeal Request Form Screen Shot Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 HVBP Review and Correction Rquest Form Screen Shot Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 HIQR Notice of Participation Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Reconsideration Request Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
CMS-10210 Data Accuracy and Completeness Acknowledgemenmt DACAForm2015_Final.doc	Form and Instruction
CMS-10210 HVBP Review and Corrections Form VBP Review and Corrections Request Form_03_2013.doc	Form and Instruction
CMS-10210 HVBP Appeal Request Form VBP Appeal Request Form_03_2013.doc	Form and Instruction
CMS-10210 Validation Template CAUTI Validation TemplateCatheter-Associated Urinary Tract Infection (CAUTI).xlsx	Form and Instruction
CMS-10210 Validation Template MRSA Validation Template for MRSA.xlsx	Form and Instruction
CMS-10210 Validation Template CLABSI Validation Template for CLABSI_BloodCultureTemplate.xlsx	Form and Instruction
CMS-10210 Validation Template CDI Validation Template for CDI.xlsx	Form and Instruction
CMS-10210 Request for Withholding Data from Public Reporting Request for withholding.doc	Form and Instruction
CMS-10210 Reconsideration Request Form electronic ReconsiderationRequest_English.pdf	Form and Instruction
CMS-10210 Extroadinary Circumstances Disaster Waiver ExtraordinaryCircumstance_Disaster Waiver.docx	Form and Instruction
CMS-10210 Healthcare Associated Infection Exception Form HealthcareAssociatedInfection_ExceptionForm.doc	Form and Instruction
CMS-10210 HVBP Appeal Request Form Screen Shot HVBP Appeal Request Form_03_2013.pdf	Form and Instruction
CMS-10210 HVBP Review and Correction Rquest Form Screen Shot HVBP Review and Corrections Request Form_03_2013.pdf	Form and Instruction
CMS-10210 HIQR Notice of Participation Form Notice of Participation.docx	Form and Instruction
CMS-10210 Reconsideration Request Form ReconsiderationRequest_English.docx	Form and Instruction

            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.