Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Home Health Agency survey and Deficiencies Report, Home Health Functional Assessment Instrument and Supporting Regulations in 42 CFR Part 484.10 - 42 CFR Part 484.52 Migrated 13994 19884 0 Form HCFA-1572
Form HCFA-1515
Total burden requested under this ICR: 13994 19884 0  
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