Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instructions and Supporting Regs.(CMS-R-5

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0454 can be found here:

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Information Collection (IC) Details

IC Title:	Physician Certifications/Recertifications in Skilled Nursing Facilities Manual Instructions and Supporting Regs.(CMS-R-5	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 424.20(a) through (d)

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: 966,353	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	966,353	-1,431,275	2,397,628
Annual IC Time Burden (Hours)	80,529	-119,193	199,722
Annual IC Cost Burden (Dollars)	0	0	0

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