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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:
0938-1257
ICR Reference No:
202304-0938-011
Status:
Active
Previous ICR Reference No:
202005-0938-014
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CPI
Title:
CAHPS Hospice Survey CMS-10537)
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:
07/19/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/18/2023
Terms of Clearance:
There are inconsistency in the number of and which languages that the different Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are translated. To ensure CMS is assessing patients’ and their families’ experiences in a culturally competent and linguistically appropriate manner, prior to the re-submission of the information collection CAHPS Hospice Survey (0938-1257), the agency will assess the translation needs across the population and consistently translate ALL CAHPS surveys as appropriate . This request is supported by the principles and priorities set forth in the memorandum titled “Improving Access to Public Benefits Programs Through the Paperwork Reduction Act” (April 13, 2022) and the Executive Order 13985 on “Advancing Racial Equity and Support for Underserved Communities Through the Federal Government” (January 20, 2021).
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2026
36 Months From Approved
12/31/2023
Responses
1,140,695
0
1,032,004
Time Burden (Hours)
198,481
0
180,004
Cost Burden (Dollars)
0
0
0
Abstract:
Hospice currently serves approximately 42% of dying patients in the United States. Medicare covers most hospice patients under a benefit created in 1983 to provide palliative care at the end of life. Despite its 30-year history as a Medicare benefit, to date no single survey has been systematically administered by all hospices across the country to assess experiences of hospice care. This submission requests approval for national implementation of the CAHPS® Hospice Survey and as well as approval for a mode experiment to test for mode effects, if any, when the survey is implemented. The CAHPS® Hospice Survey will sample caregivers of patients who died while under hospice care. Survey administration will start between 2 and 3 months after the death of the patient. The sample will be provided by the hospice program. This information will ultimately be used to improve hospice care throughout the country. The mod experiment is intended to determine what mode effects, if any, are found while implementing the survey. Three modes will be tested: mail-only, telephone-only, and mixed-mode (mail with telephone follow up). The mode experiment will occur simultaneously with the first year of National Implementation of the survey, which is also covered as part of this submission.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 3004
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:
88 FR 7446
02/03/2023
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 23429
04/17/2023
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
National Implementation
CMS-10537, CMS-10537
Hospice Experience of Care Survey -
,
CAHPS Hospice Survey - Telephone
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
1,140,695
1,032,004
0
0
108,691
0
Annual Time Burden (Hours)
198,481
180,004
0
0
18,477
0
Annual Cost Burden (Dollars)
0
0
0
0
0
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:
The hourly burden has increased by 18,477 hours from the last OMB submission. There is an increase in the number of annual responses resulting from an increase in our estimate of the number of hospices and respondents.
Annual Cost to Federal Government:
$1,984,691
Does this IC contain surveys, censuses, or employ statistical methods?
No
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?
No
Agency Contact:
Stephan McKenzie 410 786-1943 stephan.mckenzie@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:
04/18/2023
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