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Annual Hospital Interview (Revised)
National Hospital Care Survey
OMB: 0920-0212
IC ID: 243666
OMB.report
HHS/CDC
OMB 0920-0212
ICR 202110-0920-008
IC 243666
( )
Documents and Forms
Document Name
Document Type
Form 0920
Annual Hospital Interview (Revised)
Form
0920 Annual Hospital Interview (revised)
Att A - 2020 Annual Hospital Interview (Revised).docx
Form
0920 Annual Hospital Interview (revised)
Att A - 2020 Annual Hospital Interview (Revised).docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Hospital Interview (Revised)
Agency IC Tracking Number:
0920-0212-20RX
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
0920
Annual Hospital Interview (revised)
Att A - 2020 Annual Hospital Interview (Revised).docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
598
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
0
0
0
-598
0
598
Annual IC Time Burden (Hours)
0
0
0
-1,196
0
1,196
Annual IC Cost Burden (Dollars)
0
0
0
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.
