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View ICR - OIRA Conclusion

OMB Control No: 0938-1153	ICR Reference No: 202409-0938-004
Status: Active	Previous ICR Reference No: 202407-0938-018
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Hospice Quality Reporting Program (CMS-10390)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/17/2025
	Date Received in OIRA: 09/05/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2028	36 Months From Approved	01/31/2026
Responses	5,527,450	0	2,763,850
Time Burden (Hours)	3,811,348	0	1,323,883
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	5,527,450	2,763,850	2,763,600
Annual Time Burden (Hours)	3,811,348	1,323,883	2,487,465
Annual Cost Burden (Dollars)	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: Because HOPE contains a new timepoint and several new data elements in its admission timepoint, the burden hours and costs have increased from the previous Hospice Item Set. Burden increases mainly stem from the addition of the HUV timepoint, which adds an additional 22 minutes of clinical time and 5 minutes of administrative time. The expansion of the HOPE Admission timepoint (when compared to HIS Admission) also accounts for an increase in burden hours (27 additional minutes). Thus, burden hours increased by 2,487,466 hours.

Annual Cost to Federal Government: $1,583,500

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: Jamaa Hill 301 492-4190

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