OMB control number

Avoiding Readmissions in Hospitals Serving Diverse Patients

OMB 0935-0173 · HHS/AHRQ.

OMB 0935-0173

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form Form #10 Intensive training	Form and Instruction
Form Form #9 Master trainer training	Form and Instruction
Form Form #8 Medical record review	Form and Instruction
Form Form #7 Administration of patient survey by hospital staff	Form and Instruction
Form Form #6 Patient survey	Form and Instruction
Form Form #5 Post implementation semi-structured interview	Form and Instruction
Form Form #4 Base-line semi-structured interview	Form and Instruction
Form Form #3 Monthly semi-structured interview	Form and Instruction
Form Form #2 Baseline key contact semi-structured interview	Form and Instruction
Form Form #1 Baseline needs assessment	Form and Instruction
Supporting Statement PART B-- Avoiding Readmissions 12 15 2010.doc	Supporting Statement B
Attachment N -- Response to Public Comment.doc	Supplementary Document
Attachment L -- Federal Register Notice.pdf	Supplementary Document
Attachment B -- Electronic template for the After Hospital Care Plan (example) .doc	Supplementary Document
Attachment A -- Healthcare Research and Quality Act of 1999.pdf	Supplementary Document
Supporting Statement PART A -- Avoiding Readmissions 12 15 10 Response to OMB.doc	Supporting Statement A
Intensive training	Form and Instruction
Master trainer training	Form and Instruction
Medical record review	Form and Instruction
Administration of patient survey by hospital staff	Form and Instruction
Patient survey	Form and Instruction
Post implementation semi-structured interview	Form and Instruction
Base-line semi-structured interview	Form and Instruction
Monthly semi-structured interview	Form and Instruction
Baseline key contact semi-structured interview	Form and Instruction
Baseline needs assessment	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201009-0935-002	New collection (Request for a new OMB Control Number)	2010-09-30		Approved with change