Quality Measures and Procedures for Hospital Reporting of Quality Data

Documents and forms in this information collection

Document Name	Document Type
Form CMS-10210 Data Accuracy and Completeness Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Hospital VPB Review and Corrections Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Extraordinary Circumstances Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Hospital Compare Request Form for Withholding/Footnoting Data for Public Reporting Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 IQR Measure Exception Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 IQR Notice of Participation Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 IQR Reconsideration Request Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 CAUTI Validation Template Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 CDI Validation Template Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 CLABSI Validation Template 1Q18-2Q18 Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 MRSA Validation Template Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Validation Review for Reconsideration Request Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 VBP Appeal Request Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 HVBP CMS Independent Review Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
Form CMS-10210 Validation Educational Review Form Quality Measures and Procedures for Hospital Reporting of Quality Data	Form and Instruction
CMS-10210 Data Accuracy and Completeness Form IPPS_Data Accuracy Completeness Acknowledgement (April 2019) (508).pdf	Form and Instruction
CMS-10210 Hospital VPB Review and Corrections Form HVBP_Review_and_Corrections_Request_Form_Final_April2018.(508)ff.pdf	Form and Instruction
CMS-10210 Extraordinary Circumstances Form CMS Quality Program ECE Request Form (April 2019)(508).pdf	Form and Instruction
CMS-10210 Hospital Compare Request Form for Withholding/Footnoting Hospital Compare Withholding Footnoting Request Form (April 2019)(508).pdf	Form and Instruction
CMS-10210 IQR Measure Exception Form IPPS Measure Exception Form CY2020 Data (April 2019)(508).pdf	Form and Instruction
CMS-10210 IQR Notice of Participation Form IQR NOP and PR NOP Text (April 2019)(508).pdf	Form and Instruction
CMS-10210 IQR Reconsideration Request Form Quality Reporting Reconsideration Request Form (April 2019)(508).pdf	Form and Instruction
CMS-10210 CAUTI Validation Template FY2022_CAUTI_Validation Template_April 2019 (508).xlsx	Form and Instruction
CMS-10210 CDI Validation Template FY2022_CDI_Validation Template_April 2019 (508).xlsx	Form and Instruction
CMS-10210 CLABSI Validation Template 1Q18-2Q18 FY2022_CLABSI_Validation Template_April 2019 (508).xlsx	Form and Instruction
CMS-10210 MRSA Validation Template FY2022_MRSA_Validation Template_April 2019 (508).xlsx	Form and Instruction
CMS-10210 Validation Review for Reconsideration Request IQR Validation Reconsideration Request Form (April 2019)(508).pdf	Form and Instruction
CMS-10210 VBP Appeal Request Form HVBP Appeal Request Form Final April2018.(508)ff.pdf	Form and Instruction
CMS-10210 HVBP CMS Independent Review Form HVBP CMS Independent Review Form_April2018_Final.(508)ff.pdf	Form and Instruction
CMS-10210 Validation Educational Review Form Quality Reporting Validation Educational Review Form (Apr 2018)ff(508).pdf	Form and Instruction
Summary of HIQR Information Collection Forms - FY2020 IPPS Final Rule - HIQR PRA Package (July 2019).docx Summary of Updates on HIQR Collection Forms	IC Document

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