Information Collection Request
Hospice Quality Reporting Program (CMS-10390)
ICR 202211-0938-006 · OMB 0938-1153 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1153 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form and Instruction |
Modified |
Supporting Statement A | 2022-11-14 |
Form CMS-10390 Submission of Hospice Quality Reporting Program Quality Data using a web based data entry form
CMS-1754-F - Supporting Statement Final.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 203679 | Modified |
Submission of Hospice Quality Reporting Program Quality Data using a web based data entry formICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1153 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202104-0938-013 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |