Information Collection Request
Hospital Wage Index Occupational Mix Survey (CMS-10079)
ICR 202210-0938-014 · OMB 0938-0907 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0907 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10079 Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64 |
Form and Instruction | Modified | Repair queued |
 CMS-10079_Supporting_Statement_A.docx |
Supporting Statement A | Uploaded 2022-10-26 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8747 |  Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64 |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0907 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201909-0938-007 |
| Agency Tracking No | CM-FFS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |