Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...

(CMS-359/360) Comprehensive Outpatient Rehabilitation Facility (CORF) Certification and Survey Forms

OMB: 0938-0267

IC ID: 7917

Information Collection (IC) Details

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Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-360 COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY SURVEY REPORT CMS-360 (with expire XX).pdf Yes Yes Fillable Fileable
Form and Instruction CMS-359 Comprehensive Outpatient Rehab Facility Request Form CMS-359 (with expire XX).pdf Yes Yes Fillable Fileable

Health Health Care Services

 

50 0
   
State, Local, and Tribal Governments
 
   0 %

  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 50 0 0 8 0 42
Annual IC Time Burden (Hours) 123 0 0 -14 0 137
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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