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PACE Quality Data Without RCA
Programs of All-Inclusive Care for the Elderly (PACE) PACE Quality Data Monitoring and Reporting (10525)
OMB: 0938-1264
IC ID: 213217
OMB.report
HHS/CMS
OMB 0938-1264
ICR 202009-0938-014
IC 213217
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1264 can be found here:
2023-12-08 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
PACE Quality Monitoring and Reporting Guidance 2020.pdf
Instruction
HPMS PACE Quality Monitoring User Guide.pdf
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
PACE Quality Data Without RCA
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
PACE Quality Monitoring and Reporting Guidance 2020.pdf
Yes
Yes
Printable Only
Instruction
HPMS PACE Quality Monitoring User Guide.pdf
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
134
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
1,092
0
0
612
480
0
Annual IC Time Burden (Hours)
146,328
0
0
-7,272
153,600
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.