Information Collection Request
Physician Certifications/Recertification's in Skilled Nursing Facilities Manual Instruction (CMS-R-5)
ICR 202212-0938-007 · OMB 0938-0454 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0454 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 CMS-R-5 - Supporting Statement Part A-Clean_kb#121922.docx |
Supporting Statement A | Uploaded 2022-12-19 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 43658 |  Physician Certifications/Recertifications |
Modified | ||
| 190006 | Physician Initial Certification |
Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0454 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201912-0938-016 |
| Agency Tracking No | CM-FFS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |