OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Nursing Home SOPS Data File Submission

IC 201035 under ICR 202410-0935-001 · OMB 0935-0195.

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

View Information Collection (IC)

Nursing Home SOPS Data File Submission
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form 4 Nursing Home SOPS Data File Submission Attachment D - Nursing Home Data File Submission.docx Yes Yes Fillable Fileable

Health Health Care Services

 

50 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 50 0 10 0 0 40
Annual IC Time Burden (Hours) 50 0 10 0 0 40
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment K - NH Submission Home Page Attachment K - NH Submission Home Page.docx 01/31/2012
Attachment I - Emails - NH SOPS Data Submission Attachment I - Emails - NH SOPS Data Submission.doc 01/31/2012
Attachment L - NH Questionnaire Upload Page Attachment L - NH Questionnaire Upload Page.docx 01/31/2012
Attachment M - NH SOPS Data Submission Specs Attachment M - NH SOPS Data Submission Specs.pdf 01/31/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.