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Federal forms, ICRs, and supporting documents

Information Collection

Hospital Quality Reporting User Language Card Sort (CMS-10871)

IC 267563 under ICR 202405-0938-010 · OMB 0938-1397.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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Hospital Quality Reporting User Language Card Sort (CMS-10871)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10871 HQR User Language Card Sort CMS-10871 CMS Generic Clearance for HQR User Language Card Sort.docx Yes Yes Fillable Fileable

Health Health Care Services

 

75 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 75 0 75 0 0 0
Annual IC Time Burden (Hours) 18 0 18 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement CMS-10871 CMS Generic Clearance for HQR User Language Card Sort.docx 05/09/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.