View Information Collection Request (ICR) Package
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View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-0981
ICR Reference No:
201807-0938-015
Status:
Historical Active
Previous ICR Reference No:
201705-0938-003
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CM-CPC
Title:
National Implementation of Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) (CMS-10102)
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
11/30/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/31/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2021
36 Months From Approved
11/30/2018
Responses
3,108,400
0
3,104,200
Time Burden (Hours)
417,990
0
417,430
Cost Burden (Dollars)
0
0
35,675,000
Abstract:
The intent of the HCAHPS initiative is to provide a standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care. While many hospitals collect information on patient satisfaction, there is no national standard for collecting or publicly reporting this information that would enable valid comparisons to be made across all hospitals.
Authorizing Statute(s):
PL:
Pub.L. 109 - 171 1886(b)(3)(B)
Name of Law: Deficit Reduction Act of 2005
PL:
Pub.L. 111 - 148 3001
Name of Law: Affordable Care Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
83 FR 21296
05/09/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 32667
07/13/2018
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
HCAHPS Survey (Patients via Hospital Data Collection)
CMS-10102, CMS-10102, CMS-10102
HCAHPS Survey Instrument (Mail) and Supporting Materials
,
HCAHPS Survey Instrument (Telephone Script)
,
HCAHPS Survey Instrument (AVIR Script)
HCAHPS Survey (Patients)
CMS-10102, CMS-10102, CMS-10102
HCAHPS Survey Instrument (Mail) and Supporting Materials
,
HCAHPS Survey Instrument (Telephone Script)
,
HCAHPS Survey Instrument (AVIR Script)
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
3,108,400
3,104,200
0
0
4,200
0
Annual Time Burden (Hours)
417,990
417,430
0
0
560
0
Annual Cost Burden (Dollars)
0
35,675,000
0
0
-35,675,000
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Using more recent data we are adjusting the number of individuals surveyed from 3,100,000 to 3,104,200 participants (an increase of 4,200 survey respondents). As our estimated response time remains unchanged (8 minutes), the increased number of survey participants necessitates an adjustment of our total time estimate from 413,230 to 413,790 hours (an increase of 560 hours). We are not adjusting our hospital burden estimates. Labor costs were mistakenly added to the ROCIS burden table. Costs are removed from that table, but continue to be set out in section 12 of Supporting Statement A.
Annual Cost to Federal Government:
$3,230,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
07/31/2018
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