Hospital Discharges Detailed Notice of Discharge

Hospital Notices: IM / DND (CMS-10065/10066)

OMB: 0938-1019

IC ID: 179807

Information Collection (IC) Details

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Hospital Discharges Detailed Notice of Discharge
 
No Modified
 
Mandatory
 
42 CFR 422.622 42 CFR 405.1206

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS_10066_DNDinstructions_2022_OSORA.pdf No   Paper Only
Form and Instruction CMS-10065/10066 Detailed Notice of Discharge CMS_10066_DND_2022_OSORA.pdf No   Paper Only

Health Health Care Services

 

4,312 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 44,712 0 0 4,409 0 40,303
Annual IC Time Burden (Hours) 44,712 0 0 4,409 0 40,303
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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