OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 0938-1043 · HHS/CMS.

OMB 0938-1043

This is a reinstatement of the information collection request that expired on March 31, 2024. The previous iteration of this OMB No. 0938-1043 (approved March 25, 2021) had a burden of 33,905 annual hours. For this requested reinstatement, with changes, the total annual burden hours for industry is 894,922 hours and the annual burden costs are $73,650,118. The increase in burden hours from the prior package is primarily due to new information collections associated with new CoPs for CAHs outlined in the two CMS rules referenced below. The new CoPs include multiple information collection requirements that are one-time burdens for developing new policies and protocols and ongoing reporting requirements, such as daily or biweekly reporting of respiratory illnesses as well as maternal deaths. The reasons for the increased information collections are discussed in more detail in the rules and are summarized later in this package.

The latest form for Conditions of Participation for Critical Access Hospitals and Supporting Regulations (CMS-10239) expires 2027-11-30 and is listed under ICR 202410-0938-012.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
CMS-10239 (0938-1043). CAHs Supporting Statement (final 11-15-24).docxSupporting Statement A
CMS-10239 Supporting Statement 10.15.24 final.docxSupporting Statement A
42 CFR 485.649(c) Information collection
42 CFR 485.649(b)(2) Information collection
42 CFR 485.649(a)(2) Information collection
42 CFR 485.641(d)(4)(ii) Information collection
42 CFR 485.641(d)(4) Information collection
42 CFR 485.641(d)(4) Information collection
42 CFR 485.640(d)(2) Information collection
42 CFR 485.640(d)(1) Information collection
42CFR485.616(c)(40)(iv) Information collection
42CFR485.635(a) Information collection
42CFR485.635(f) Information collection
42CFR485.645(d) Information collection
42CFR485.643(a-b) Information collection
42CFR485.641 Information collection
42CFR485.635(c)(3) Information collection
42CFR485.631 Information collection
42CFR485.618 (e)(1) Information collection
42CFR485.623(d)(4) Information collection

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202410-0938-012 Reinstatement with change of a previously approved collection 2024-10-16
202011-0938-005 Revision of a currently approved collection 2020-11-10
201810-0938-011 Revision of a currently approved collection 2018-10-24 Comment filed on proposed rule and continue
201708-0938-024 Extension without change of a currently approved collection 2017-08-30 Approved without change
201403-0938-015 Revision of a currently approved collection 2014-03-28 Approved with change
201011-0938-004 Revision of a currently approved collection 2010-11-02 Approved with change
200802-0938-003 New collection (Request for a new OMB Control Number) 2008-02-25 Approved without change

OMB Details

42CFR485.623(d)(4)

Federal Enterprise Architecture: Health - Health Care Services