Rural Emergency Hospital Quality Reporting (REHQR) Program

Rural Emergency Hospital Quality Reporting (REHQR) (CMS-10870)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1454 can be found here:

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
0938-1022 CMS Quality Program ECE Request Form_CY 2024_clean (REHQ CMS Quality Program ECE Request Form_CY 2024_clean (REHQR).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Rural Emergency Hospital Quality Reporting (REHQR) Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0938-1022	CMS Quality Program ECE Request Form_CY 2024_clean (REHQR)	CMS Quality Program ECE Request Form_CY 2024_clean (REHQR).docx		Yes	Yes	Fillable Fileable

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	187,992	187,992
Annual IC Time Burden (Hours)	9,101	9,101
Annual IC Cost Burden (Dollars)	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.