Skilled Nursing Facility and Silled Nursing Facility Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, and 413.106

Skilled Nursing Facility and Skilled Nursing Facility Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, and 413.106

OMB: 0938-0463

IC ID: 8084

Information Collection (IC) Details

View Information Collection (IC)

Skilled Nursing Facility and Silled Nursing Facility Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, and 413.106
 
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-2540-10 SKILLED NURSING FACILITY AND SKILLED NURSING FACILITY HEALTH CARE COMPLEX COST REPORT R5p241F.pdf Yes Yes Fillable Fileable Signable
Instruction pr2_41.pdf Yes No Printable Only

Health Health Care Services

 

14,185 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 14,185 0 -1,516 0 0 15,701
Annual IC Time Burden (Hours) 2,865,370 0 -306,232 0 0 3,171,602
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-2540-10 Crosswalk [Added Worksheet] CMS-2540 Crosswalk.xlsx 07/13/2011
Instruction, Section 4195 - Crosswalk pr2_4195 Crosswalk.doc 07/14/2011
Instructiom, Section 4105 - Crosswalk pr2_4100_to_4107 Crosswalk.doc 07/14/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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