OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

(CMS-10685) E-mail Feedback Regarding Psychiatric Facility Quality Measure Strategies

IC 233421 under ICR 201611-0938-004 · OMB 0938-1185.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

(CMS-10685) E-mail Feedback Regarding Psychiatric Facility Quality Measure Strategies
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10685 LAN member best practices email D1 LAN Member Best Practices Email.docx Yes Yes Fillable Fileable

Health Health Care Services

 

179 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 179 0 179 0 0 0
Annual IC Time Burden (Hours) 15 0 15 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10685 GenIC Supporting Statement CMS-10685 Generic_Clearance_Submission_Template_D1V_IPF_Measure_Feedback.doc 10/04/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.