Information Collection Requirements in the Hospice Care Regulation--HCFA-R-30, 42 CFR 418.22, 418.24, 418.28, 418.56(b), 418.56(e)(1), 418.56(e)(3), 481.58, 418.70(d), 418.70(e)

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Information Collection (IC) Details

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IC Title:	Information Collection Requirements in the Hospice Care Regulation--HCFA-R-30, 42 CFR 418.22, 418.24, 418.28, 418.56(b), 418.56(e)(1), 418.56(e)(3), 481.58, 418.70(d), 418.70(e)	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-30				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,927	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,927	1,927
Annual IC Time Burden (Hours)	3,977,762	3,977,762
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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