Medicare Rural Hospital Flexibility Grant Program Performance Measures

ICR 201905-0915-004

OMB: 0915-0363

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2019-05-22
Supplementary Document
2019-05-22
Supplementary Document
2019-05-22
Supplementary Document
2019-05-22
Supporting Statement A
2019-05-22
IC Document Collections
ICR Details
0915-0363 201905-0915-004
Active 201603-0915-001
HHS/HSA 19326
Medicare Rural Hospital Flexibility Grant Program Performance Measures
Extension without change of a currently approved collection   No
Regular
Approved without change 07/09/2019
Retrieve Notice of Action (NOA) 06/05/2019
Agency will update the expiration date on forms within 2 weeks of approval.
  Inventory as of this Action Requested Previously Approved
07/31/2022 36 Months From Approved 07/31/2019
45 0 45
3,150 0 3,150
0 0 0

The Flex Program enables state designated entities to support critical access hospitals (CAHs) in quality improvement, quality reporting, performance improvement, and benchmarking; to assist facilities seeking designation as critical access hospitals; and to create a program to establish or expand the provision of rural emergency medical services (EMS). These initiatives are meant to ensure residents in rural communities have access to high quality health care services. These initiatives cover the following program areas: quality improvement; financial and operational improvement; population health and EMS improvement; critical access hospital (CAH) conversion; and integration of innovative care models. Flex program performance measures were developed with stakeholder feedback to provide aggregate program data required by Congress under the Government Performance and Results Modernization Act of 2010. The information collected is used for identifying and understanding programmatic improvement across program areas, as well as guiding future iterations of the Flex Program and prioritizing areas of need and support.

PL: Pub.L. 111 - 352 2142 Name of Law: GPRA Modernization Act of 2010
  
None

Not associated with rulemaking

  84 FR 1751 02/05/2019
84 FR 24527 05/28/2019
No

1
IC Title Form No. Form Name
Medicare Rural Hospital Flexibility Grant Program Performance Measures 1 Attachment C Flex screenshots.docx

  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 45 45 0 0 0 0
Annual Time Burden (Hours) 3,150 3,150 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$234,774
No
    No
    No
No
No
No
Uncollected
Elyana Bowman 301 443-3983 enadjem@hrsa.gov

  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.
06/05/2019


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