Information Collection

PACE Quality Data With RCA

IC 214270 under ICR 202009-0938-014 · OMB 0938-1264.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1264 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PACE Quality Monitoring and Reporting Guidance 2020.pdf	Instruction
HPMS PACE Quality Monitoring User Guide.pdf	Instruction

IC Title:

PACE Quality Data With 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:

table that charts list of 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	No	Printable Only
Instruction			HPMS PACE Quality Monitoring User Guide.pdf		Yes	No	Printable Only

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 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	51	-429	480
Annual IC Time Burden (Hours)	27,336	-122,664	150,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.