Skilled Nursing Facility and Silled Nursing Facility Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, and 413.106

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0463 can be found here:

Documents and Forms

Document Name Document Type
CMS-2540 pr2_35_toc.doc Other-Section Outline
CMS-2540 pr2_3500_to_3512.doc Instruction
CMS-2540 pr2_3500_to_3512revised.doc Instruction
CMS-2540 pr2_3513_to_3524.1_(cont).doc Instruction
CMS-2540 pr2_3525_to_3534.4.doc Instruction
CMS-2540 pr2_3535_to_3553.2.doc Instruction
CMS-2540 pr2_3553.2_(cont)_to_3564.4.doc Instruction
CMS-2540 pr2_3565_to_3571_(cont).doc Instruction
CMS-2540 pr2_3595.doc Instruction
CMS-2540-96 Cost Reports CMS-2540 R132540f (version 2).xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Skilled Nursing Facility and Silled Nursing Facility Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, and 413.106	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 413.20 42 CFR 413.24

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Section Outline			CMS-2540 pr2_35_toc.doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3500_to_3512.doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3500_to_3512revised.doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3513_to_3524.1_(cont).doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3525_to_3534.4.doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3535_to_3553.2.doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3553.2_(cont)_to_3564.4.doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3565_to_3571_(cont).doc	Yes	Yes	Paper Only
Instruction			CMS-2540 pr2_3595.doc	Yes	Yes	Paper Only
Form	CMS-2540-96	Cost Reports	CMS-2540 R132540f (version 2).xls	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,037	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	15,037	2,037	13,000
Annual IC Time Burden (Hours)	2,947,252	467,252	2,480,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.