Information Collection

2018 MOPS Hospitals

IC 231154 under ICR 201606-0607-003 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 2018 MOPS Hospitals	Form and Instructi
1 Questionnaire MOPSHP_CONTENT_FOR_COGNITIVE TESTING_FINAL.xlsx	Form and Instruction
2018 MOPS OMB Letter.docx OMB Memo	IC Document
Attachment A MOPS Hospitals protocol clinical managers.docx Clinical Managers Protocol	IC Document
Attachment B MOPS Hospitals Protocol CFO.docx Chief Financial Officers Protocol	IC Document

IC Title:

2018 MOPS Hospitals

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Questionnaire	MOPSHP_CONTENT_FOR_COGNITIVE TESTING_FINAL.xlsx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	2018 MOPS OMB Letter.docx	04/23/2018
Clinical Managers Protocol	Attachment A MOPS Hospitals protocol clinical managers.docx	04/23/2018
Chief Financial Officers Protocol	Attachment B MOPS Hospitals Protocol CFO.docx	04/23/2018

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