INFO. COLLECTION REQ'MTS. IN 42 CFR PART 405.1722, 1736 CONDITIONS OF PARTICIPATION FOR OUTPATIENT CLINICS 405.1716, 405.1717, 405.1720, 405.1721

ICR 198509-0938-018

OMB: 0938-0336

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0336 198509-0938-018
Historical Active 198504-0938-011
HHS/CMS
INFO. COLLECTION REQ'MTS. IN 42 CFR PART 405.1722, 1736 CONDITIONS OF PARTICIPATION FOR OUTPATIENT CLINICS 405.1716, 405.1717, 405.1720, 405.1721
No material or nonsubstantive change to a currently approved collection   No
Emergency 09/20/1985
Approved with change 09/20/1985
Retrieve Notice of Action (NOA) 09/20/1985
  Inventory as of this Action Requested Previously Approved
07/31/1986 07/31/1986 07/31/1986
753 0 753
38,538 0 2,883
0 0 0

THIS INFORMATION IS NEEDED TO DETERMINE WHETHER THE CLINIC IS IN COMPLIANCE WITH PUBLISHED HEALTH AND SAFETY REQUIREMENTS. RESPONDENTS ARE OUTPAITENT CLINICS.

None
None


No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 753 753 0 0 0 0
Annual Time Burden (Hours) 38,538 2,883 0 0 35,655 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
09/20/1985


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