HCAHPS+27 Survey

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Mode Experiment (CMS-10542)

OMB: 0938-1272

IC ID: 216207

Information Collection (IC) Details

View Information Collection (IC)

HCAHPS+27 Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10542 HCAHPS Survey+27 Supplemental Items HCAHPS+27_2014-11-10.pdf No   Fillable Printable
Form CMS-10542 Phone Script HCAHPS_Script.pdf No   Fillable Printable
Other-Cover Letter HCAHPS_Cover_Letter.pdf No   Paper Only

Health Health Care Services

 

1,830 0
   
Individuals or Households
 
   0 %

  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 1,830 0 1,830 0 0 0
Annual IC Time Burden (Hours) 450 0 450 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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