Information Collection Request

Quality Measures and Administrative Procedures for the Hospital-Acquired Condition Reduction Program (CMS-10668)

ICR 202208-0938-021 · OMB 0938-1352 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10668 Hospital-Acquired Condition Reduction Program-NHSN HAI Measures Validation Form and Instruction Unchanged Missing upstream
CMS-10668 HACRP Supporting Statement B_Final.docx Supporting Statement B Uploaded 2022-08-24 Missing upstream
CMS-10668 HACRPSupporting Statement A_062122_clean.docx Supporting Statement A Uploaded 2022-08-24 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
231482 Hospital-Acquired Condition Reduction Program-NHSN HAI Measures Validation Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 08/31/2022
400 400
28,800 28,800
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Hospital-Acquired Condition Reduction Program-NHSN HAI Measures Validation CMS-10668, CMS-10668, CMS-10668, CMS-10668 Cauti Validation Template ,   CDI Validation Template ,   CLABSI Validation Template ,   MRSA Validation Template

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 400 400 0 0 0 0
Annual Time Burden (Hours) 28,800 28,800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No