National Implementation

National Implementation of the Hospice Experience of Care Survey (CAHPs Hospice Survey - CMS-10537)

OMB: 0938-1257

IC ID: 212899

Information Collection (IC) Details

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National Implementation
 
No Modified
 
Voluntary
 
42 CFR 418

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10537 Hospice Experience of Care Survey - Mail CMS-10537 - Appendix cahps-hospice mail_QNR_2017.pdf No   Printable Only
Form CMS-10537 CAHPS Hospice Survey - Telephone CMS-10537 - Appendix cahps-hospice-telephone_QNR_2017.pdf No   Printable Only

Health Health Care Services

 

951,482 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 951,482 0 0 408,456 0 543,026
Annual IC Time Burden (Hours) 166,508 0 0 71,479 0 95,029
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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