Home Health Agency Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, 413.106

Home Health Agency Cost Report and Supporting Regulations

OMB: 0938-0022

IC ID: 7766

Information Collection (IC) Details

View Information Collection (IC)

Home Health Agency Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, 413.106
 
No Modified
 
Mandatory
 
42 CFR 413.24 42 CFR 413.20 42 CFR 413.106

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-1728-94 Home Health Agency Cost Report Certification and Settlement Summary R16p232f1.pdf Yes Yes Fillable Printable
Instruction pr2_32_.doc Yes No Printable Only

Health Health Care Services

 

11,563 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 11,563 0 0 4,084 0 7,479
Annual IC Time Burden (Hours) 2,613,238 0 0 922,984 0 1,690,254
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

© 2024 OMB.report | Privacy Policy