Quality Measures and Procedures for Hospital Reporting of Quality Data

(CMS-10210) Hospital Reporting Initiative--Hospital Quality Measures

OMB: 0938-1022

IC ID: 204350

Documents and Forms

Document Name Document Type
Form CMS-10210 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
CMS-10210 Data Accuracy and Completeness Form DACAForm2016_121714.pdf Form and Instruction
CMS-10210 Hospital VPB Review and Corrections Form HVBP_RevwCrrctnsReqForm_032013.pdf Form and Instruction
CMS-10210 Extraordinary Circumstances Form Extraordinary Circumstances Form - Final 03.03.2015-fF.pdf Form and Instruction
CMS-10210 Inpatient Withholding Data form IP-WithldngReqFormPR_Jul2015.pdf Form and Instruction
CMS-10210 IQR Measure Exception Form IQR_MeasureExceptionForm_02.23.2015-FF.pdf Form and Instruction
CMS-10210 IQR Notice of Participation Form IQR_NOP_AgreementText_022615.pdf Form and Instruction
CMS-10210 IQR Reconsideration Request Form IQR_ReconReqForm_V4_022615,0.pdf Form and Instruction
CMS-10210 CAUTI Validation Template VAL_FY17_CAUTI_Validation Template_201410.xlsx Form and Instruction
CMS-10210 CDI Validation Template VAL_FY17_CDI_Validation Template_201410.xlsx Form and Instruction
CMS-10210 CLABSI Validation Template VAL_FY17_CLABSI_Validation Template_201410.xlsx Form and Instruction
CMS-10210 MRSA Validation Template VAL_FY17_MRSA_Validation Template_201410.xlsx Form and Instruction
CMS-10210 Validation Review for Reconsideration Request ValidnReviewReq_062212.pdf Form and Instruction
CMS-10210 VBP Appeal Request Form VBP Appeal Request Form_03_2013.doc Form and Instruction
HIQR Information Collection Forms Crosswalk_3.10.2015_NO4.6.2015_CLEAN.docx HIQR Forms Crosswalk IC Document