Information Collection Request

National Hospital Care Survey

ICR 202110-0920-008 · OMB 0920-0212 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0212 Initial Hospital Intake Questionnaire Form and Instruction Modified Repair queued
Form 0920 Annual Hospital Interview (Revised) Form Removed Repair queued
Form 0920-0212 National Hospital Care Survey (Abstraction Form) Form Removed Repair queued
Form 0920-0212 Prepare and Transmit EHR for Inpatient and Ambulatory Form and Instruction Modified Repair queued
Form 0920-0212 Annual Hospital Interview Form and Instruction Modified Repair queued
Form 0920-0212 Prepare and transmit UB-04 or State File for Inpatient and Ambulatory Form and Instruction Modified Repair queued
Form 0920-0212 Recruitment Survey Presentation Form and Instruction Modified Repair queued
NHCS-30day-FRN_08.27.2021.docx Supplementary Document Uploaded 2021-11-04 Repair queued
Att M - Proposed Confidentiality Letter.docx Supplementary Document Uploaded 2021-11-04 Repair queued
Att J - Recruitment Survey Presentation.docx Supplementary Document Uploaded 2021-11-04 Repair queued
Att H - ERB Approval Notice for NHCS.pdf Supplementary Document Uploaded 2021-11-04 Repair queued
Att G - EHR Variable List.xlsx Supplementary Document Uploaded 2021-11-04 Repair queued
Att F - Currently Approved UB04 Data Elements.docx Supplementary Document Uploaded 2021-11-04 Repair queued
Att E - NHCS Overview Flyer.docx Supplementary Document Uploaded 2021-11-04 Available
Att E - NHCS Overview Flyer.docx Supplementary Document Uploaded 2021-11-04 Repair queued
Att D - NHCS Introductory Letter.pdf Supplementary Document Uploaded 2021-11-04 Repair queued
Att A - Legislative Authority to Collect Data on Hospital Utilization.rtf Supplementary Document Uploaded 2021-11-04 Repair queued
0920-0212_Statement A_COVID-nonsub_09.08.2020.docx Supplementary Document Uploaded 2020-09-17 Repair queued
COVID-19 OMB Memo_NHCS.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-09-17 Missing upstream
Nonsubstantive Change PCORTF_Opioid_04_08_2020 SK.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-04-30 Repair queued
Att M - Summary Update.docx Supplementary Document Uploaded 2019-01-29 Repair queued
Att K - Confidentiality Letter.docx Supplementary Document Uploaded 2019-01-29 Repair queued
Att G - ERB Approval Notice for NHCS.pdf Supplementary Document Uploaded 2019-01-29 Repair queued
Att E- EHR Variable List.pdf Supplementary Document Uploaded 2019-01-29 Repair queued
Att D - Currently Approved UB04 Data Elements.docx Supplementary Document Uploaded 2019-01-29 Repair queued
Att C - Introductory Letter to Hospitals.docx Supplementary Document Uploaded 2019-01-29 Repair queued
Att B2 - 60-day Federal Register Notice Comments.docx Supplementary Document Uploaded 2019-01-29 Repair queued
Att B1- 60-Day FRN for NHCS 120718.pdf Supplementary Document Uploaded 2019-01-29 Repair queued
Att A - Legislative Authority to Collect Data on Hospital Utilization.rtf Supplementary Document Uploaded 2019-01-29 Repair queued
0920-0212_Statement B_06.28.2021.docx Supporting Statement B Uploaded 2021-11-04 Missing upstream
0920-0212_Statement A_07.01.2021.docx Supporting Statement A Uploaded 2021-11-04 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
6666 Initial Hospital Intake Questionnaire Form and Instruction Modified
243666 Annual Hospital Interview (Revised) Form Removed
241648 PCORFIT Telephone Script Other-WORD Removed
240789 National Hospital Care Survey (Abstraction Form) Form Removed
186285 Prepare and Transmit EHR for Inpatient and Ambulatory Form and Instruction Modified
186283 Annual Hospital Interview Form and Instruction Modified
186282 Prepare and transmit UB-04 or State File for Inpatient and Ambulatory Form and Instruction Modified
186281 Recruitment Survey Presentation Form and Instruction Modified
ICR Details
0920-0212 202110-0920-008
Received in OIRA 202009-0920-013
HHS/CDC 0920-0212
National Hospital Care Survey
Revision of a currently approved collection   No
Regular 11/04/2021
  Requested Previously Approved
36 Months From Approved 03/31/2022
6,604 7,110
7,184 8,294
0 0

The National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), requests a three-year approval for a revision to continue the National Hospital Care Survey (NHCS) (OMB No. 0920-0212, expires 03/31/2022). There are no changes to the data collection survey.

US Code: 42 USC 242k Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  86 FR 38094 07/19/2021
86 FR 57835 10/19/2021
No

  Total Request 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 6,604 7,110 0 122 -628 0
Annual Time Burden (Hours) 7,184 8,294 0 104 -1,214 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The proposed burden for the NHCS is 7,184 hours per data collection year. Because additional sample hospitals have been recruited for NHCS since the last approval request, fewer hospitals still need the initial two steps of recruitment.

$8,700,000
Yes Part B of Supporting Statement
    Yes
    Yes
No
No
No
Yes
Odion Clunis 770 488-0045 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/04/2021