Documentation of information of deaths related to 2 point soft wrist restaints

Report of a Hospital Dealth Associated with Restraint or Seclusion (CMS-10455)

OMB: 0938-1210

IC ID: 236196

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Documentation of information of deaths related to 2 point soft wrist restaints
 
No New
 
Required to Obtain or Retain Benefits
 
42 CFR 482 section 13

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

Automated Survey Processing Environment (ASPEN)  71 FR 29644

2,556 1,917
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 2,556 0 2,556 0 0 0
Annual IC Time Burden (Hours) 426 0 426 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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