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National Hospital Care Survey (Abstraction Form)
National Hospital Care Survey
OMB: 0920-0212
IC ID: 240789
OMB.report
HHS/CDC
OMB 0920-0212
ICR 202110-0920-008
IC 240789
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0212 can be found here:
2024-07-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-0212
National Hospital Care Survey (Abstraction Form)
Form
0920-0212 Validation of Enhanced Algorithms to Identify Opioid Use
Abstraction Form_03_13_2020_FINAL_OMB.docx
Form
0920-0212 Validation of Enhanced Algorithms to Identify Opioid Use
Abstraction Form_03_13_2020_FINAL_OMB.docx
Form
Nonsubstantive Change PCORTF_Opioid_03_16_2020.docx
Request for Change
IC Document
Nonsubstantive Change PCORTF_Opioid_03_16_2020.docx
Request for Change
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Hospital Care Survey (Abstraction Form)
Agency IC Tracking Number:
0920-0212-20LO
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
0920-0212
Validation of Enhanced Algorithms to Identify Opioid Use and Co-Occurring Disorders in National Hospital Care Survey (NHCS)
Abstraction Form_03_13_2020_FINAL_OMB.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0167 Health Resources Utilization Statistics
FR Citation:
83 FR 37693
Number of Respondents:
5
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
0
0
0
-5
0
5
Annual IC Time Burden (Hours)
0
0
0
-5
0
5
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Request for Change
Nonsubstantive Change PCORTF_Opioid_03_16_2020.docx
04/29/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.