Information Collection Request
National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) (CMS-10102)
ICR 202404-0938-026 · OMB 0938-0981 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0981 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10102 HCAHPS Survey (Patients) |
Form and Instruction | Modified | Missing upstream |
| Form CMS-10102 HCAHPS Survey (Patients via Hospital Data Collection) |
Form and Instruction | Modified | Missing upstream |
 CMS-10102 SUPPORTING STATEMENT A 5-1-2024.docx |
Supporting Statement A | Uploaded 2024-05-02 | Repair queued |
| CMS-10102 SUPPORTING STATEMENT B - 03-07-24.docx |
Supporting Statement B | Uploaded 2024-05-01 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8843 |  HCAHPS Survey (Patients) |
Form and Instruction | Modified | |
| 202110 | HCAHPS Survey (Patients via Hospital Data Collection) |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0981 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202311-0938-009 |
| Agency Tracking No | CM-CPC IPPS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |