Information Collection

Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instructions and Supporting Regs.

IC 43658 under ICR 200606-0938-008 · OMB 0938-0454.

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Information Collection (IC) Details

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IC Title:	Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instructions and Supporting Regs.	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	CMS-R-5				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,458,549	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	981,642	292,070	689,572
Annual IC Time Burden (Hours)	547,578	105,785	441,793
Annual IC Cost Burden (Dollars)	0	0	0

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