Information Collection

Management and Organizational Practices Survey-Hospitals (MOPS-HP)

IC 245945 under ICR 202102-0607-003 · OMB 0607-1016.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form MOPS-HP Management and Organizational Practices Survey-Hospitals (MOPS-HP)	Form
Attachment C - Initial Letter to Respondents.docx	Other-Initial Letter to Respondents
Attachment C - Initial Letter to Respondents.docx	Other-Initial Letter to Respondents
Attachment D - Due Date Reminder Letter.docx	Other-Due Date Reminder Letter
Attachment D - Due Date Reminder Letter.docx	Other-Due Date Reminder Letter
Attachment E - Reminder Letter.docx	Other-Reminder Letter
Attachment E - Reminder Letter.docx	Other-Reminder Letter
Attachment F - Screenshot of Introductory Centurion Screen.docx	Other-Screenshots - Intro Page & Bur
Attachment F - Screenshot of Introductory Centurion Screen.docx	Other-Screenshots - Intro Page & Bur
MOPS-HP MOPS-HP Questionnaire Attachment A - MOPS-HP Questionnaire.pdf	Form
MOPS-HP MOPS-HP Questionnaire Attachment A - MOPS-HP Questionnaire.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	MOPS-HP	MOPS-HP Questionnaire	Attachment A - MOPS-HP Questionnaire.pdf	Yes	Yes	Fillable Fileable
Other-Initial Letter to Respondents			Attachment C - Initial Letter to Respondents.docx	Yes	Yes	Fillable Fileable
Other-Due Date Reminder Letter			Attachment D - Due Date Reminder Letter.docx	Yes	Yes	Fillable Fileable
Other-Reminder Letter			Attachment E - Reminder Letter.docx	Yes	Yes	Fillable Fileable
Other-Screenshots - Intro Page & Burden Statement			Attachment F - Screenshot of Introductory Centurion Screen.docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	3,200	3,200
Annual IC Time Burden (Hours)	2,400	2,400
Annual IC Cost Burden (Dollars)	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.