HIT documentation

Omnibus COVID-19 Health Care Staff Vaccination (IFC) (CMS-10801)

OMB: 0938-1414

IC ID: 250940

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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HIT documentation
 
No Unchanged
 
Mandatory
 
42 CFR 486.525(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

337 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 20,000 0 20,000 0 0 0
Annual IC Time Burden (Hours) 1,666 0 1,666 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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