HCAHPS Survey (Patients)

National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) (CMS-10102)

OMB: 0938-0981

IC ID: 8843

Information Collection (IC) Details

View Information Collection (IC)

HCAHPS Survey (Patients)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10102 HCAHPS Survey Instrument (Mail) and Supporting Materials CMS-10102 HCAHPS V12.0 Appendix A - HCAHPS Mail Survey Materials (Non-sub change 4-26-17).pdf Yes Yes Fillable Fileable

Health Health Care Services

 

3,100,000 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 3,100,000 0 0 0 0 3,100,000
Annual IC Time Burden (Hours) 413,230 0 0 0 0 413,230
Annual IC Cost Burden (Dollars) 18,875,000 0 0 0 0 18,875,000

Title Document Date Uploaded
Crosswalk Attachment B - Crosswalk.docx 07/07/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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