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Hospice Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24 (CMS-R-249)

IC 8476 under ICR 201011-0938-002 · OMB 0938-0758.

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

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Hospice Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24 (CMS-R-249)
 
No Modified
 
Mandatory
 
42 CFR 413.24 42 CFR 413.20

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-R-249 Hospice Medicare Cost Report Forms Hospice MCR Forms.XLS Yes Yes Fillable Fileable
Instruction Hospice MCR Instructions.doc Yes Yes Printable Only

Health Health Care Services

 

2,303 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  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 2,303 0 0 365 0 1,938
Annual IC Time Burden (Hours) 405,328 0 0 64,240 0 341,088
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Hospice ECR Specs Hospice ECR Specs.XLS 10/19/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.