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Rural Emergency Hospital Quality Reporting (REHQR) Program
Rural Emergency Hospital Quality Reporting (REHQR) (CMS-10870)
OMB: 0938-1454
IC ID: 262060
OMB.report
HHS/CMS
OMB 0938-1454
ICR 202309-0938-004
IC 262060
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1454 can be found here:
2024-10-11 - Revision of a currently approved collection
2023-12-26 - New collection (Request for a new OMB Control Number)
Documents and Forms
Document Name
Document Type
Form CMS Quality Progra
Rural Emergency Hospital Quality Reporting (REHQR) Program
Form and Instruction
CMS Quality Progra CMS Quality Program ECE Request Form_CY 2024_vFinal
CMS Quality Program ECE Request Form_CY 2024_vFinal.docx
Form and Instruction
CMS Quality Progra CMS Quality Program ECE Request Form_CY 2024_vFinal
CMS Quality Program ECE Request Form_CY 2024_vFinal.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Rural Emergency Hospital Quality Reporting (REHQR) Program
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
CMS Quality Program ECE Request Form_CY 2024_vFina
CMS Quality Program ECE Request Form_CY 2024_vFinal
CMS Quality Program ECE Request Form_CY 2024_vFinal.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
746
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
187,992
187,992
0
0
0
0
Annual IC Time Burden (Hours)
9,101
9,101
0
0
0
0
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.