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

View Information Collection (IC)

Hospital-Acquired Condition Reduction Program-NHSN HAI Measures Validation
 
No Unchanged
 
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 FY22_CAUTI_ValTemp_3_4Q_021720.xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10668 CDI Validation Template FY22_CDI_ValTemp_3_4Q_021720.xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10668 CLABSI Validation Template FY22_CLABSI_ValTemp_3_4Q_021720.xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10668 MRSA Validation Template FY22_MRSA_ValTemp_3_4Q_021720.xlsx Yes Yes Fillable Fileable

Health Health Care Services

 

400 222
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 400 0 -200 0 0 600
Annual IC Time Burden (Hours) 28,800 0 -14,400 0 0 43,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Zipcode Crosswalk Cohort 2 Catchement Area ZIP Code Crosswalk (1).xlsx 05/01/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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