View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Inpatient Psychiatric Facility Quality Reporting Program
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10432 SUB-1 Measure SUB collection form FY2018 Passback_Program Responses v3 -- CLEAN.pdf Yes Yes Fillable Printable
Form CMS-10432 TOB & IMM Measures TOB IMM collection form FY 2018.docx Yes Yes Fillable Printable
Form CMS-10432 EHR & Patient Exp of Care Measures EHR Pt Experience 2018 Passback_Program Responses v3 -- CLEAN.pdf Yes Yes Fillable Printable
Form CMS-10432 Transition Record Measures Transfer Measure collection form FY 2018.pdf Yes Yes Fillable Printable
Form CMS-10432 Screening for Metabolic Disorders Measure Screening for Metabolic Disorders collection form FY 2018.docx Yes Yes Fillable Printable
Instruction FY 2018 IPF_FY2016_NonMeasureData_PprTool_20150701_FINAL(508).docx Yes Yes Fillable Printable

Health Health Care Services

 

1,617 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 672,672 0 -115,692 -115,692 0 904,056
Annual IC Time Burden (Hours) 1,483,760 0 -227,623 -227,622 0 1,939,005
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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