Information Collection Request
National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) (CMS-10639)
ICR 202211-0938-005 · OMB 0938-1340 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1340 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10639 National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) |
Form and Instruction | Unchanged | Repair queued |
| Form CMS-10639 National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) |
Form and Instruction | Unchanged | Repair queued |
 CMS-10639 Supporting Statement B NHSN CY 2023 (10-20-2022).docx |
Supporting Statement B | Uploaded 2022-11-09 | Available |
| CMS-10639 Supporting Statement B NHSN CY 2023 (10-20-2022).docx |
Supporting Statement B | Uploaded 2022-11-09 | Repair queued |
| CMS-10639 Supporting Statement A NHSN CY 2023 (10-20-2022).docx |
Supporting Statement A | Uploaded 2022-11-09 | Available |
| CMS-10639 Supporting Statement A NHSN CY 2023 (10-20-2022).docx |
Supporting Statement A | Uploaded 2022-11-09 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 224551 |  National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) |
Form and Instruction | Unchanged | |
| 224551 | National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) |
Form and Instruction | Unchanged |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1340 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202207-0938-012 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 2022-11-10 |
| Requested Expiration Date | 1969-12-31 |