Hospice Quality Reporting Program (CMS-10390)

Forms and Documents

Document Name	Status
Form CMS-10390 Submission of Hospice Quality Reporting Program Quality Data using a web based data entry form Form and Instruction	Modified
CMS-10390 HQRP HIS Supporting Statement A_final 8-7-23.docx Supporting Statement A	2023-11-20

IC Document Collections

IC ID	Document Title	Status
203679	Submission of Hospice Quality Reporting Program Quality Data using a web based data entry form Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1153	ICR Reference No: 202311-0938-004
Status: Received in OIRA	Previous ICR Reference No: 202211-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Hospice Quality Reporting Program (CMS-10390)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/20/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	02/29/2024
Responses	2,763,850	4,688
Time Burden (Hours)	1,323,883	636,312
Cost Burden (Dollars)	0	0

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Abstract: The Hospice Item Set (HIS) is used for the collection of quality measure data related to the Hospice Quality Reporting Program (HQRP), and the HIS V1.00.0 specified the collection of data items that supported seven Consensus Based Entity (CBE) endorsed Quality Measures (QMs) for hospice. On April 1, 2017, hospices began using an updated HIS V2.00.0, which includes the same items from the HIS V1.00.0 along with the addition of several new items for use in new measures, measure refinement, patient record matching, and future public reporting. Data collected from the HIS are used to calculate the seven CBE-endorsed QMs and the CBE-endorsed Hospice and Palliative Care Composite Process Measure – Comprehensive Assessment at Admission QM. During the FY 2021 rule, the Hospice Visits when Death is Imminent measure pair was removed and replaced with the claims-based Hospice Visits in Last Days of Life (HVLDL) measure. The reduction in provider burden and costs occurred when CMS replaced the HIS-based HVWDII quality measure via the HIS-PRA package that OMB approved on February 16, 2021 (OMB Control Number: 0938-1153). CMS is requesting to extend the existing expiration date (February 29, 2024) for an additional 3 years.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 3004 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 61593	11/06/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 80723	11/20/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Submission of Hospice Quality Reporting Program Quality Data using a web based data entry form	CMS-10390, CMS-10390, CMS-10390	Hospice Item Set - Descriptions ,   Hospice Item Set - Admissions ,   Hospice Item Set - Discharge

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ICR Summary 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	2,763,850	4,688	0	2,759,162	0	0
Annual Time Burden (Hours)	1,323,883	636,312	0	687,571	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This information request is being submitted as an extension. Burden hours have been updated as a result of updated data related to hospice admissions, staff wages, and total number of hospices. Burden calculations were previously based on 2018 data and are now based on 2022 data. The previously approved burden hours are 636,312. The number of participating hospices increased from 4,688 to 5,640. The number of Hospice Item Set admissions per year increased from 1,328,417 to 2,763,850. The adjusted hourly wages for a registered nurse increased from $72.60 to $85.60 per hour and the hourly wage for a medical secretary increased from $35.66 to $39.68 per hour. The updated annual burden hours are 1,323,883 hours.

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Annual Cost to Federal Government: $1,583,500

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/20/2023

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