Information Collection Request

Requirements for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program (CMS-10432)

ICR 202104-0938-005 · OMB 0938-1171 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10432 Inpatient Psychiatric Facility Quality Reporting Program Form and Instruction Modified Missing upstream
CMS-10432 - Supporting Statement A (2021 CMS-1750-P version 9) Clean.docx Supporting Statement A Uploaded 2021-04-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
202349 Inpatient Psychiatric Facility Quality Reporting Program Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 11/30/2022
10,375,900 13,517,629
2,595,609 3,381,086
0 0





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table that charts list of burden
IC Title Form No. Form Name
Inpatient Psychiatric Facility Quality Reporting Program CMS-10432, CMS-10432 IPF Screenshots (see Supporting Statement A, section 12,under the list of Information Collection Instruments and Instruction/Guidance Documents) ,   Notice of Participation

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,375,900 13,517,629 0 -2,985,318 -156,411 0
Annual Time Burden (Hours) 2,595,609 3,381,086 0 -746,330 -39,147 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No