Information Collection

Rural Health Network Development Performance Improvement and Measurement System (PIMS)

IC 215502 under ICR 202104-0906-001 · OMB 0906-0010.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0010 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Rural Health Network Development Performance Improvement and Measurement System (PIMS) Form and Instruction
1 RHND PIMS 3-25-21.pdf FORM_RHND PIMS 3-25-21.pdf Form and Instruction
1 RHND PIMS 3-25-21.pdf FORM_RHND PIMS 3-25-21.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Rural Health Network Development Performance Improvement and Measurement System (PIMS)	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
Form and Instruction	1	RHND PIMS 3-25-21.pdf	FORM_RHND PIMS 3-25-21.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 44	Number of Respondents for Small Entity: 44

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	44	-7	51
Annual IC Time Burden (Hours)	264	-42	306
Annual IC Cost Burden (Dollars)	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.