Information Collection

TA User Feedback for Program and User Support and Quality Measure Tool Development for CAHPS® and SOPS

IC 251010 under ICR 202310-0935-001 · OMB 0935-0179.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 TA User Feedback for Program and User Support and Quality Measure Tool Development for CAHPS® and SOPS	Form and Instruction
1 Proposed Approach for Task 3 CAHPS TA User Feedback 12-16-2021.docx	Form and Instruction
1 Proposed Approach for Task 3 CAHPS TA User Feedback 12-16-2021.docx	Form and Instruction
2 Proposed Approach for Task 7 SOPS TA User Feedback 12-16-2021.docx	Form and Instruction
2 Proposed Approach for Task 7 SOPS TA User Feedback 12-16-2021.docx	Form and Instruction
CAHPS SOPS TA Feedback OMB Submission 12-16-2021.docx Supporting Statement	IC Document
CAHPS SOPS TA Feedback OMB Submission 12-16-2021.docx Supporting Statement	IC Document
OMB Cover Letter.docx Cover Letter	IC Document
OMB Cover Letter.docx Cover Letter	IC Document

IC Title:

TA User Feedback for Program and User Support and Quality Measure Tool Development for CAHPSÂ® and SOPS

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Proposed Approach for Task 3	CAHPS TA User Feedback 12-16-2021.docx		Yes	Yes	Fillable Fileable
Form and Instruction	2	Proposed Approach for Task 7	SOPS TA User Feedback 12-16-2021.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 240

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	CAHPS SOPS TA Feedback OMB Submission 12-16-2021.docx	01/04/2022
Cover Letter	OMB Cover Letter.docx	01/04/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.