National Hospital Care Survey

OMB 0920-0212

This request is for a nonsubstantive change to the approved data collection for the National Hospital Care Survey (NHCS) (OMB No. 0920-0212, expiration date: 3/31/2022). The change is to allow the addition of six new survey questions related to the novel coronavirus disease (COVID-19) to the NHCS Annual Hospital Interview (AHI). These questions will be added as soon as possible to the 2020 NHCS and will continue to be included in future years of NHCS, if data collection on COVID-19 remains applicable. The questions will help provide an understanding on experiences of the provision of health care by hospitals during the ongoing COVID-19 pandemic in the United States. .

The latest form for National Hospital Care Survey expires 2022-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-0212 Att P_Initial Hospital Intake Questionnaire Form and Instruction
Form 0920-0212 Att S_Quarterly Transmission of EHR Data Form and Instruction
Form 0920-0212 Att C_Annual Hospital Interview Form and Instruction
Form 0920-0212 Att R_Monthly Transmission of UB-04 Data Form and Instruction
Form 0920-0212 Att Q_Recruitment Survey Presentation Form and Instruction
Att E - NHCS Overview Flyer.pdf Supplementary Document
Att W - SORN Privacy Act System Notice 09-20-0164.pdf Supplementary Document
Att V - SORN Privacy Act System Notice 09-20-0167.pdf Supplementary Document
Att U - ERB Memo - Protocol Determination Verification Status for NHCS.pdf Supplementary Document
Att T - NHCS Confidentiality Letter.docx Supplementary Document
Att O - ERB Approval Notice for NHCS.pdf Supplementary Document
Att L - NHCS Infographic Flyer (Southwest).pdf Supplementary Document
Att K - NHCS Infographic Flyer (West).pdf Supplementary Document
Att J - NHCS Infographic Flyer (East).pdf Supplementary Document
Att I - NHCS Infographic Flyer (South).pdf Supplementary Document
Att H - NHCS Infographic Flyer (Rural).pdf Supplementary Document
Att G - NHCS Infographic Flyer (Childrens).pdf Supplementary Document
Att F - NHCS Infographic Flyer (General).pdf Supplementary Document
Att D - NHCS Introductory Letter.pdf Supplementary Document
Att N - EHR Variable List.xlsx Supplementary Document
Att M - Currently Approved UB04 Data Elements.docx Supplementary Document
Att D - NHCS Introductory Letter.pdf Supplementary Document
Att B - Published 60-Day FRN NHCS 5.7.24.pdf Supplementary Document
Att A - Legislative Authority to Collect Data on Hospital Utilization.rtf Supplementary Document
0920-0212 Statement B 07.09.24.docx Supporting Statement B
0920-0212 Statement A 07.26.24.docx Supporting Statement A
Att P_Initial Hospital Intake Questionnaire Form and Instruction
Att S_Quarterly Transmission of EHR Data Form and Instruction
Att C_Annual Hospital Interview Form and Instruction
Att R_Monthly Transmission of UB-04 Data Form and Instruction
Att Q_Recruitment Survey Presentation Form and Instruction

All Historical Document Collections

202407-0920-002	Revision of a currently approved collection	2024-07-26
202110-0920-008 Approved without change	Revision of a currently approved collection	2021-11-04
202009-0920-013 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-09-17
202003-0920-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-04-30
201901-0920-008 Approved without change	Revision of a currently approved collection	2019-01-30
201511-0920-007 Approved without change	Revision of a currently approved collection	2015-11-19
201502-0920-011 Withdrawn and continue	Revision of a currently approved collection	2015-03-03
201408-0920-007 Withdrawn and continue	Revision of a currently approved collection	2014-09-12
201302-0920-001 Approved without change	Revision of a currently approved collection	2013-02-01
201104-0920-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2011-04-14
201102-0920-003 Approved without change	Revision of a currently approved collection	2011-02-01
200909-0920-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2009-09-14
200808-0920-008 Approved without change	Revision of a currently approved collection	2008-08-26
200802-0920-014 Approved without change	No material or nonsubstantive change to a currently approved collection	2008-02-25
200612-0920-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2006-12-12
200507-0920-002 Approved without change	Revision of a currently approved collection	2005-07-12
200207-0920-001 Approved with change	Extension without change of a currently approved collection	2002-07-10
200011-0920-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2000-11-09
199909-0920-003 Approved without change	Extension without change of a currently approved collection	1999-09-07
199611-0920-001 Approved without change	Extension without change of a currently approved collection	1996-11-18
199511-0920-003 Approved without change	Extension without change of a currently approved collection	1995-11-29
199211-0920-001 Approved without change	Revision of a currently approved collection	1992-11-16
199006-0920-002 Approved without change	Revision of a currently approved collection	1990-06-27
198905-0920-011 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-05-04
198904-0920-025 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-04-27
198904-0920-018 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-04-06
198904-0920-015 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-04-07
198802-0920-006 Approved without change	Revision of a currently approved collection	1988-02-05

OMB Details

Initial Hospital Intake Questionnaire

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-0212

Initial Hospital Intake Questionnaire 2019

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.