Information Collection

PACE Quality Data With RCA

IC 214270 under ICR 202312-0938-001 · OMB 0938-1264.

Documents and Forms

Document Name Document Type
PACE Quality Monitoring & Reporting Guidance March 2021.pdf Instruction
PACE Quality Monitoring & Reporting Guidance March 2021.pdf Instruction
HPMS PACE Quality Monitoring User Guide.pdf Instruction
HPMS PACE Quality Monitoring User Guide.pdf Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PACE Quality Data With RCA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			PACE Quality Monitoring & Reporting Guidance March 2021.pdf		Yes	No	Printable Only
Instruction			HPMS PACE Quality Monitoring User Guide.pdf		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 152	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	64	13	51
Annual IC Time Burden (Hours)	38,912	11,576	27,336
Annual IC Cost Burden (Dollars)	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.