Home Health Medicare Conditions of Participation (CoP) Information Collection Requirements as outlined in Regulations -- 42 CFR 484.10, 484.12, 484.14, 484.16,....

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0365 can be found here:

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Information Collection (IC) Details

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IC Title:	Home Health Medicare Conditions of Participation (CoP) Information Collection Requirements as outlined in Regulations -- 42 CFR 484.10, 484.12, 484.14, 484.16,....	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 484.12 42 CFR 484.55 42 CFR 484.10 42 CFR 484.11 42 CFR 484.14 42 CFR 484.16 42 CFR 484.18 42 CFR 484.20 42 CFR 484.36 42 CFR 484.48 42 CFR 484.52

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,354	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	9,354	1,932	7,422
Annual IC Time Burden (Hours)	1,048,483	193,592	854,891
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.