OMB control number

Hospice Conditions of Participation (CMS-10277)

OMB 0938-1067 · HHS/CMS.

OMB 0938-1067

The CoPs and accompanying requirements specified in the regulations are used by Federal or State surveyors as a basis for determining whether a hospice qualifies for approval or re-approval under Medicare. CMS and the healthcare industry believe that the availability to the hospice of the type of records and general content of records, which this regulation specifies, is standard medical practice, and is necessary in order to ensure the well-being and safety of patients and professional treatment accountability.

The latest form for Hospice Conditions of Participation (CMS-10277) expires 2029-02-28 and is listed under ICR 202508-0938-020.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
CMS-10277-Supporting Statement.docx	Supporting Statement A
Hospice Conditions of Participation 418.22(b) Certification Form Development	Information collection
Hospice Conditions of Participation 418.58(a)(2) ID new measures	Information collection
Hospice Conditions of Participation 418.114 (b)(3)(i)(B)	Information collection
Hospice Conditions of Participation 418.110 (o)(4)	Information collection
Hospice Conditions of Participation 418.76(b)(4) Newly certified Facilities	Information collection
Hospice Conditions of Participation 418.76(b)(4) Existing Facilities	Information collection
Hospice Conditions of Participation 418.56(c)	Information collection
§418.24(c) Addendum Form Development	Information collection
§418.24(c) Addendum Form Completion	Information collection
Hospice Conditions of Participation 418.108(c)(3)	Information collection
Hospice Conditions of Participation 418.58(a)(2) Organize QAPI Data	Information collection
Hospice Conditions of Participation 418.58 (a)(2) Document Analysis	Information collection
Hospice Condition of Participation 418.58(a)(2) Collect and record data	Information collection
Hospice Conditions of Participation 418.58(a)(2) Develop QAPI program	Information collection
Hospice Conditions of Participation 418.108(c)(1)	Information collection
Hospice Conditions of Participation 418.52(b)(4)	Information collection
Hospice Condtions of Participation 418.52(a)(1)	Information collection
Hospice Conditions of Participation 418.28(d) develop revocation form	Information collection
Hospice Conditions of Participation 418.24(b) explain election statement	Information collection
Hospice Conditions of Participation 418.28(d) explain revocation form	Information collection
Hospice Conditons of Participation 418.24 develop election form	Information collection
Hospice Conditions of Participation 418.22(b)(5)	Information collection
Hospice Condition of Participation (418.22(b)(4)	Information collection
Hospice Conditions of Participation 418.22(b)(3)	Information collection
Hospice Conditions of Participation 418.114 (d) Newly Certified Facility	Information collection
Hospice Conditions of Participation 418.114 (d)	Information collection
Hospice Conditions of Participation 418.112(e)(3)	Information collection
Hospice Conditions of Participation (418.110 (o)(2) newly certified facilities	Information collection
Hospice Conditions of Participation 418.110(n)(11) and (n)(15)	Information collection
Hospice Conditions of Participation 418.106 (e)(2)(i)(C)	Information collection
Hospice Conditions of Participation 418.78(a)(c)(d) and (e)	Information collection
Hospice Conditions of Participation 418.76(d)(2)	Information collection
Hospice Conditions of Participation 418.56(b)	Information collection
Hospice Conditions of Participation (418.52(a)(3)	Information collection

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202604-0938-016	Revision of a currently approved collection	2026-06-01
202508-0938-020	Reinstatement with change of a previously approved collection	2025-08-28
202104-0938-008	Extension without change of a currently approved collection	2021-04-16	Comment filed on proposed rule and continue
202103-0938-005	Revision of a currently approved collection	2021-03-01	Approved without change
202005-0938-006	Revision of a currently approved collection	2020-05-13	Comment filed on proposed rule and continue
201911-0938-003	Revision of a currently approved collection	2019-11-20	Approved without change
201809-0938-005	Revision of a currently approved collection	2018-09-25	Comment filed on proposed rule and continue
201803-0938-001	Reinstatement without change of a previously approved collection	2018-03-16	Approved with change
201406-0938-002	Reinstatement with change of a previously approved collection	2014-06-23	Approved without change
201011-0938-017	Revision of a currently approved collection	2010-11-30	Approved without change
201008-0938-012	Revision of a currently approved collection	2010-08-19	Comment filed on proposed rule and continue
200906-0938-010	New collection (Request for a new OMB Control Number)	2009-06-15	Approved without change

OMB Details

Hospice Conditions of Participation (418.52(a)(3)

Federal Enterprise Architecture: Health - Health Care Services