Information Collection Request

Conditions of Participation for Critical Access Hospitals and Supporting Regulations (CMS-10239)

ICR 202410-0938-012 · OMB 0938-1043 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10239 (0938-1043). CAHs Supporting Statement (final 11-15-24).docx Supporting Statement A Uploaded 2024-11-15 Repair queued
CMS-10239 Supporting Statement 10.15.24 final.docx Supporting Statement A Uploaded 2024-10-16 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
271615 42 CFR 485.649(c) New
271614 42 CFR 485.649(b)(2) New
271613 42 CFR 485.649(a)(2) New
271612 42 CFR 485.641(d)(4)(ii) New
271611 42 CFR 485.641(d)(4) New
271609 42 CFR 485.641(d)(4) New
271608 42 CFR 485.640(d)(2) New
271607 42 CFR 485.640(d)(1) New
271606 42CFR485.616(c)(40)(iv) New
233699 42CFR485.635(a) Removed
195096 42CFR485.635(f) Removed
183848 42CFR485.645(d) Removed
183847 42CFR485.643(a-b) Removed
183846 42CFR485.641 Modified
183845 42CFR485.635(c)(3) Removed
183844 42CFR485.631 Removed
183843 42CFR485.618 (e)(1) Modified
183842 42CFR485.623(d)(4) Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2027 36 Months From Approved
79,589 0 0
877,522 0 0
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 79,589 0 0 -39,878 0 119,467
Annual Time Burden (Hours) 877,522 0 0 843,617 0 33,905
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No