Information Collection

Information Collection Requirements In Standards For Intermediate Care Facilities For The Mentally Retarded (icf/mr), 42cfr442, Subpart G

IC 113560 under ICR 198612-0938-002 · OMB 0938-0366.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0366 can be found here:

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Information Collection (IC) Details

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IC Title:	INFORMATION COLLECTION REQUIREMENTS IN STANDARDS FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED (ICF/MR), 42CFR442, SUBPART G	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-47				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 145,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	145,000	145,000
Annual IC Time Burden (Hours)	600,648	600,648
Annual IC Cost Burden (Dollars)	0	0

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Title	Document	Date Uploaded

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