National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) (CMS-10639)

ICR 202401-0938-004

OMB: 0938-1340

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-10639 National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) Form and Instruction	Unchanged
Form CMS-10639 National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) Form and Instruction	Unchanged
CMS-10639 Supporting Statement A NHSN CY 2024 (10-26-2023).docx Supporting Statement A	2024-01-19
CMS-10639 Supporting Statement A NHSN CY 2024 (10-26-2023).docx Supporting Statement A	2024-01-19
CMS-10639 Supporting Statement B NHSN CY 2024 (10-26-2023).docx Supporting Statement B	2024-01-19
CMS-10639 Supporting Statement B NHSN CY 2024 (10-26-2023).docx Supporting Statement B	2024-01-19

IC Document Collections

IC ID	Document Title	Status
224551	National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) Form and Instruction	Unchanged
224551	National Healthcare Safety Network (NHSN) Data Validation Study for the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) Form and Instruction	Unchanged