OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Evaluation fo Home Health Independence Demonstration: Survey of Home Health Agencies

IC 45506 under ICR 200610-0938-001 · OMB 0938-1006.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Evaluation fo Home Health Independence Demonstration: Survey of Home Health Agencies
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10201 Survey of Home Health Agencies final revised HHI Agency Survey- aug 31 2006.doc No No Paper Only

Health Health Care Services

 

108 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 108 108 0 0 0 0
Annual IC Time Burden (Hours) 54 54 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.