Information Collection

CMS-10437.GenIC #26 - Nursing Home Career Outreach Tracker

IC 262594 under ICR 202011-0938-009 · OMB 0938-1247.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1247 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10427 (GenIC#2 Nursing Home Career Outreach Tracker CMS-10437.GenIC #26 - Nursing Home Career Outreach Tracker	Form and Instruction
CMS-10427 (GenIC#2 Nursing Home Career Outreach Tracker CMS-10437.GenIC#26 - Attachment 3 Nursing Home Career Survey Instrument 07242023 (PRA edits).docx	Form and Instruction
CMS-10437.GenIC#26 Attachment 4 NHS quant burden hrs.docx CMS-10437.GenIC#26 Attachment 4 NHS quant burden hrs	IC Document
CMS-10437.GenIC#26 Attachment 1 NHS quant.docx CMS-10437.GenIC#26 Attachment 1 NHS quant	IC Document

IC Title:

CMS-10437.GenIC #26 - Nursing Home Career Outreach Tracker

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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
Form and Instruction	CMS-10427 (GenIC#26)				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10437.GenIC#26 Attachment 4 NHS quant burden hrs		09/28/2023
CMS-10437.GenIC#26 Attachment 1 NHS quant		09/28/2023

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

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