Skilled Nursing Facility and Skilled 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

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Form
Form
Information Collection (IC) Details

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Skilled Nursing Facility and Skilled 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
Instruction R1P249i.pdf Yes No Fillable Printable
Form CMS-2540 Skilled Nursing Facility and Skilled Nursing Facility Healthcare Complex Cost Report (CMS-2540-24) R1P249f.xlsx Yes Yes Fillable Fileable

Health Health Care Services

 

14,189 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 14,189 0 -297 0 14,486 0
Annual IC Time Burden (Hours) 2,866,178 0 -59,994 0 2,926,172 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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