Information Collection Request
(CMS-437A and 437B) Rehabilitation Unit Criteria Work Sheet and Rehabilitation Hospital Criteria Work Sheet and Supporting Regulations
ICR 202303-0938-006 · OMB 0938-0986 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-437 A Rehabilitation Unit Criteria Work Sheet and Rehabilitation Hospital Criteria Work Sheet and Supporting Regulations at 42 CFR 412.20-412.30 (CMS-437A&B) |
Form and Instruction | Modified | Missing upstream |
 Responses to Comments.11.18.22.docx |
Supplementary Document | Uploaded 2023-03-31 | Repair queued |
| CMS 437A-B.SupportingStatementPart A. 4-20-23.docx |
Supporting Statement A | Uploaded 2023-04-20 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8848 |  Rehabilitation Unit Criteria Work Sheet and Rehabilitation Hospital Criteria Work Sheet and Supporting Regulations at 42 CFR 412.20-412.30 (CMS-437A&B) |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0986 |
| Type of Information Collection | Reinstatement with change of a previously approved collection |
| Previous ICR Reference No | 201906-0938-011 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |