ANY FUTURE
REQUESTS FOR OMB CLEARANCE SHOULD ADDRESS HOW THIS DATA WIL BE USED
FOR POLICY MAKING AND OTHER FEDERAL PURPOSES.
Inventory as of this Action
Requested
Previously Approved
10/31/1985
10/31/1985
550
0
0
107,800
0
0
0
0
0
THIS COST REPORT IDENTIFIES SPECIFIC
ITEMS OF COSTS AND STATISTICAL INFORMATION PERTAINING TO THE
FREESTANDING ESRD FACILITY'S OPERATIONS. THE INFORMATION COLLECTED
WILL BE USED FOR RATESETTING PURPOSES FOR INCENTIVE RATE
REIMBURSEMENT FOR THESE FACILITIES.
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.