Information Collection

Hospitals and Health Care Complex Cost Report (CMS-2552-10)

IC 7814 under ICR 201308-0938-011 · OMB 0938-0050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-2552-10 Hospitals and Health Care Complex Cost Report (CMS-2552-10)	Form and Instruction
CMS-2552-10 Hospitals and Health Care Complex Cost Report R3P240F.pdf	Form and Instruction
CMS-2552-10 Hospitals and Health Care Complex Cost Report pr2_40.pdf	Form and Instruction
CMS-2552-10 Hospitals and Health Care Complex Cost Report R3P240S.pdf	Form and Instruction

IC Title:

Hospitals and Health Care Complex Cost Report (CMS-2552-10)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 413.24 42 CFR 413.20

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-2552-10	Hospitals and Health Care Complex Cost Report	R3P240F.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-2552-10	Hospitals and Health Care Complex Cost Report	pr2_40.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-2552-10	Hospitals and Health Care Complex Cost Report	R3P240S.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,171

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: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,171	-3	6,174
Annual IC Time Burden (Hours)	4,153,083	-2,019	4,155,102
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.