Information Collection

Medicare and Medicaid Programs: Use of the OASIS as Part of the CoPs for HHS and Supporting Regulations in 42 CFR 484.11 and 484.20

IC 37906 under ICR 200510-0938-016 · OMB 0938-0761.

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Information Collection (IC) Details

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IC Title:	Medicare and Medicaid Programs: Use of the OASIS as Part of the CoPs for HHS and Supporting Regulations in 42 CFR 484.11 and 484.20	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	R-209				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,582	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	93,621	0	93,621
Annual IC Time Burden (Hours)	921,271	0	921,271
Annual IC Cost Burden (Dollars)	20,000	-19,539,000	19,559,000

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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.