Information Collection

Hospital, Hospital-skilled Nursing Facility Complex, Cost Report

IC 166112 under ICR 198006-0938-008 · OMB 0938-0056.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

HOSPITAL, HOSPITAL-SKILLED NURSING FACILITY COMPLEX, COST REPORT

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	SSA-2551	No	No
Form	2551 A THRU	No	No
Form	SSA-2551	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	50	-6,950	7,000
Annual IC Time Burden (Hours)	2,000	-278,000	280,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.