Information Collection

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

IC 7814 under ICR 202506-0938-007 · OMB 0938-0050.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2552-10 Hospitals and Health Care Complex Cost Report (CMS-2552-10)	Form
Form 2552-10 Hospital and Health Care Complex Cost Report Hospitals and Health Care Complex Cost Report (CMS-2552-10)	Form
2552-10 Instructions.docx	Instruction
2552-10 Instructions.docx	Instruction
2552-10 Hospital and Health Care Complex Cost Report 2552-10 Form.xlsx	Form
2552-10 Hospital and Health Care Complex Cost Report 2552-10 Form.xlsx	Form

IC Title:

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2552-10				Yes	Yes	Fillable Fileable
Instruction					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 %

table that charts list of burden
	Approved	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

table that charts IC Documents
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.

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