Hospitals and Health Care Complex Cost Report (CMS-2552-10)

Documents and Forms

Document Name Document Type
Form 2552-10 Hospitals and Health Care Complex Cost Report (CMS-2552-10) Form
2552-10 Instructions.docx Instruction
2552-10 Hospital and Health Care Complex Cost Report 2552-10 Form.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Hospitals and Health Care Complex Cost Report (CMS-2552-10)	Agency IC Tracking Number:	2552-10

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 413.24 42 CFR 413.17 42 CFR 413.20

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2552-10	Hospital and Health Care Complex Cost Report	2552-10 Form.xlsx		Yes	Yes	Fillable Fileable
Instruction			2552-10 Instructions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,044	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,044	-31	6,075
Annual IC Time Burden (Hours)	4,079,700	-14,850	4,094,550
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.