Hospital-Acquired Condition Reduction Program-NHSN HAI Measures Validation

Quality Measures and Administrative Procedures for the Hospital-Acquired Condition Reduction Program for the FY 2019 IPPS Program Year (CMS-10668)

OMB: 0938-1352

IC ID: 231482

Information Collection (IC) Details

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Hospital-Acquired Condition Reduction Program-NHSN HAI Measures Validation
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10668 Cauti Validation Template FY2021_CAUTI_Validation Template_4.12.2018FINAL(508).xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10668 CDI Validation Template FY2021_CDI_Validation Template_4.12.2018.FINAL(508).xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10668 CLABSI Validation Template FY2021_CLABSI_Validation Template_4.12.2018.FINAL(508).xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10668 MRSA Validation Template FY2021_MRSA_Validation Template_4.12.2018.FINAL(508).xlsx Yes Yes Fillable Fileable

Health Health Care Services

 

600 222
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 600 0 600 0 0 0
Annual IC Time Burden (Hours) 43,200 0 43,200 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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