Evaluation of Home Health Independence Demonstration: Home Health Agency Survey

Evaluation of Home Health Independence Demonstration: Home Health Agency Survey

OMB: 0938-1006

IC ID: 45507

Information Collection (IC) Details

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Evaluation of Home Health Independence Demonstration: Home Health Agency Survey
 
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

 

12 0
   
State, Local, and Tribal Governments
 
   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 12 12 0 0 0 0
Annual IC Time Burden (Hours) 6 6 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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