OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

National Hospital Care Survey

OMB 0920-0212 ยท HHS/CDC.

OMB 0920-0212

The National Center for Health Statistics (NCHS) is to assess the health of the population through the creation of a dataset that contains information on health care utilization as well as the demographic characteristics, medical conditions, and treatment of patients who use hospitals for inpatient and ambulatory medical care in the United States. The Centers for Disease Control and Prevention (CDC), requests a three-year approval for a revision to continue the National Hospital Care Survey (NHCS) (OMB No. 0920-0212, expires 12/31/2024). Although there are no new questions added to the data collection survey, the COVID-19 questions from the Annual Hospital Interview (AHI) have been removed. Despite an increase in sample size, the burden hours have decreased as fewer hospitals now need to complete the one-time initial intake questionnaire (see section 12 for more information about these changes). The use of the resulting data is to provide government, professional, scientific, academic, and commercial institutions, and private research organizations, as well as private citizens with information that can be used to monitor public health and to investigate research questions about health care utilization and delivery over time. Inpatient and ambulatory data will be collected from a sample of 601 hospitals via Uniform Billing (UB)-04 administrative claims or electronic health record (EHR) data. Additionally, hospital-level characteristics for all sampled hospitals are gathered through an Annual Hospital Interview. The target subpopulation of the NHCS is inpatient discharges, and patient visits made to Emergency Departments (EDs) and Outpatient Departments (OPDs) of non-Federal, non-institutional hospitals with six or more beds staffed for inpatient use in the 50 states and the District of Columbia. Findings will be released in NCHS reports, dashboards, journal articles, and research papers as well as released to researchers for analysis.

The latest form for National Hospital Care Survey expires 2027-09-30 and is listed under ICR 202407-0920-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-0212 Att P_Initial Hospital Intake QuestionnaireForm and Instruction
Form 0920-0212 Att S_Quarterly Transmission of EHR DataForm and Instruction
Form 0920-0212 Att C_Annual Hospital InterviewForm and Instruction
Form 0920-0212 Att R_Monthly Transmission of UB-04 DataForm and Instruction
Form 0920-0212 Att Q_Recruitment Survey PresentationForm and Instruction
Att E - NHCS Overview Flyer.pdf Supplementary Document
Att W - SORN Privacy Act System Notice 09-20-0164.pdf Supplementary Document
Att V - SORN Privacy Act System Notice 09-20-0167.pdf Supplementary Document
Att U - ERB Memo - Protocol Determination Verification Status for NHCS.pdf Supplementary Document
Att T - NHCS Confidentiality Letter.docx Supplementary Document
Att O - ERB Approval Notice for NHCS.pdf Supplementary Document
Att L - NHCS Infographic Flyer (Southwest).pdf Supplementary Document
Att K - NHCS Infographic Flyer (West).pdf Supplementary Document
Att J - NHCS Infographic Flyer (East).pdf Supplementary Document
Att I - NHCS Infographic Flyer (South).pdf Supplementary Document
Att H - NHCS Infographic Flyer (Rural).pdf Supplementary Document
Att G - NHCS Infographic Flyer (Childrens).pdf Supplementary Document
Att F - NHCS Infographic Flyer (General).pdf Supplementary Document
Att D - NHCS Introductory Letter.pdf Supplementary Document
Att N - EHR Variable List.xlsx Supplementary Document
Att M - Currently Approved UB04 Data Elements.docx Supplementary Document
Att D - NHCS Introductory Letter.pdf Supplementary Document
Att B - Published 60-Day FRN NHCS 5.7.24.pdf Supplementary Document
Att A - Legislative Authority to Collect Data on Hospital Utilization.rtf Supplementary Document
0920-0212 Statement B 07.09.24.docxSupporting Statement B
0920-0212 Statement A 07.26.24.docxSupporting Statement A
Att P_Initial Hospital Intake Questionnaire Form and Instruction
Att S_Quarterly Transmission of EHR Data Form and Instruction
Att C_Annual Hospital Interview Form and Instruction
Att R_Monthly Transmission of UB-04 Data Form and Instruction
Att Q_Recruitment Survey Presentation Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202407-0920-002 Revision of a currently approved collection 2024-07-26
202110-0920-008 Revision of a currently approved collection 2021-11-04 Approved without change
202009-0920-013 No material or nonsubstantive change to a currently approved collection 2020-09-17 Approved without change
202003-0920-011 No material or nonsubstantive change to a currently approved collection 2020-04-30 Approved without change
201901-0920-008 Revision of a currently approved collection 2019-01-30 Approved without change
201511-0920-007 Revision of a currently approved collection 2015-11-19 Approved without change
201502-0920-011 Revision of a currently approved collection 2015-03-03 Withdrawn and continue
201408-0920-007 Revision of a currently approved collection 2014-09-12 Withdrawn and continue
201302-0920-001 Revision of a currently approved collection 2013-02-01 Approved without change
201104-0920-011 No material or nonsubstantive change to a currently approved collection 2011-04-14 Approved without change
201102-0920-003 Revision of a currently approved collection 2011-02-01 Approved without change
200909-0920-005 No material or nonsubstantive change to a currently approved collection 2009-09-14 Approved without change
200808-0920-008 Revision of a currently approved collection 2008-08-26 Approved without change
200802-0920-014 No material or nonsubstantive change to a currently approved collection 2008-02-25 Approved without change
200612-0920-001 No material or nonsubstantive change to a currently approved collection 2006-12-12 Approved without change
200507-0920-002 Revision of a currently approved collection 2005-07-12 Approved without change
200207-0920-001 Extension without change of a currently approved collection 2002-07-10 Approved with change
200011-0920-011 No material or nonsubstantive change to a currently approved collection 2000-11-09 Approved without change
199909-0920-003 Extension without change of a currently approved collection 1999-09-07 Approved without change
199611-0920-001 Extension without change of a currently approved collection 1996-11-18 Approved without change
199511-0920-003 Extension without change of a currently approved collection 1995-11-29 Approved without change
199211-0920-001 Revision of a currently approved collection 1992-11-16 Approved without change
199006-0920-002 Revision of a currently approved collection 1990-06-27 Approved without change
198905-0920-011 No material or nonsubstantive change to a currently approved collection 1989-05-04 Approved with change
198904-0920-025 No material or nonsubstantive change to a currently approved collection 1989-04-27 Approved with change
198904-0920-018 No material or nonsubstantive change to a currently approved collection 1989-04-06 Approved with change
198904-0920-015 No material or nonsubstantive change to a currently approved collection 1989-04-07 Approved with change
198802-0920-006 Revision of a currently approved collection 1988-02-05 Approved without change

OMB Details

Att P_Initial Hospital Intake Questionnaire

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-0212NHCS Initial Hospital Intake QuestionnaireFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.