Information Collection

Conditions for Coverage for Rural Health Clinics -- (New RHC Mid Level Practitioner)

IC 190716 under ICR 201309-0938-024 · OMB 0938-0334.

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Information Collection (IC) Details

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IC Title:	Conditions for Coverage for Rural Health Clinics -- (New RHC Mid Level Practitioner)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 491.9 42 CFR 491.10 42 CFR 491.11

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: 867	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 Potential Violation of the PRA
Annual Number of Responses for this IC	867	668	199
Annual IC Time Burden (Hours)	8,670	6,680	1,990
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.