OMB control number

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Mode Experiment (CMS-10542)

OMB 0938-1272 · HHS/CMS.

OMB 0938-1272

Latest forms, documents, and information collections
Document	Type
Form CMS-10542 Phone Script	Form
Form CMS-10542 HCAHPS Survey+44 Supplemental Items	Form
Form CMS-10542 Phone Script	Form
Form CMS-10542 HCAHPS Survey+27 Supplemental Items	Form
Form CMS-10542 Phone Script	Form
Form CMS-10542 HCAHPS Survey+16 Supplemental Items	Form
Form CMS-10542 Phone Script	Form
Form CMS-10542 HCAHPS Survey+9 Supplemental Items	Form
Form CMS-10542 Phone Script	Form
Form CMS-10102 HCAHPS Only ARM, Mode Experiment	Form
Response to Public Comments for HCAHPS.docx	Supplementary Document
201502-0938-011_CMS-10542 - HCAHPS OMB Supporting Statement B 20150224_C 20150420 (2).doc	Supporting Statement B
201502-0938-011_CMS-10542 - Supporting Statement A rev 02-27-2015 by OS -- CLEAN.doc	Supporting Statement A
HCAHPS+44 Survey	Other-Cover Letter
HCAHPS+44 Survey	Form
HCAHPS+44 Survey	Form
HCAHPS+27 Survey	Other-Cover Letter
HCAHPS+27 Survey	Form
HCAHPS+27 Survey	Form
HCAHPS+16 Survey	Other-Cover Letter
HCAHPS+16 Survey	Form
HCAHPS+16 Survey	Form
HCAHPS+9 Survey	Other-Cover Letter
HCAHPS+9 Survey	Form
HCAHPS+9 Survey	Form
HCAHPS Survey	Form
HCAHPS Survey	Other-Cover Letter
HCAHPS Survey	Form

Historical document collections
Reference	Filing	Received	Concluded	Action
201502-0938-011	New collection (Request for a new OMB Control Number)	2015-03-03		Approved without change