View Information Collection (IC)

View Information Collection (IC)

IC Title:	ECON - Respondent Debriefings for the Management and Organizational Practices Survey - Hospitals (MOPSHP)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Form	Attachment C_MOPS HP form.pdf		No		Fillable Fileable
Form and Instruction	2	Screenshots	Attachment D_MOPS-HP Screenshots_draft 10.6.21.pdf		No		Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	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	30	0	30	0	0	0
Annual IC Time Burden (Hours)	17	0	17	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	OMB Clearance Request MOPS-HP respondent debriefings_draft 10.6.21.docx	10/12/2021
Protocol	Attachment A_Protocol MOPS-HP_draft 10.6.21.docx	10/12/2021
Consent Form	Attachment B_Consent Form MOPS-HP_draft 10.6.21.docx	10/12/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.