Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Intermediate Care Facility for the Mentally Retarded or Persons with Related Conditions ICF/MR Survey Report Form (3070G-I) Modified 6446 19338 0 Form and Instruction CMS-3070G Intermediate Care Facilities for Individuals with Intellectual Disabilities Survey Report
Form and Instruction CMS-3070H Intermediate Care Facilities for Individuals with Intellectual Disabilities Deficiencies Report
Total burden requested under this ICR: 6446 19338 0  
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