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Report Of Nursing Home Care

IC 147347 under ICR 198409-2900-009 · OMB 2900-0157.

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REPORT OF NURSING HOME CARE
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-1204B No No


    

120,000 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 120,000 0 0 0 0 120,000
Annual IC Time Burden (Hours) 20,000 0 0 0 0 20,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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