View Information Collection (IC)

View Information Collection (IC)

Pressure Ulcer Submissions
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10409 LTCH Admission CARE Item Set LTCH Admission CARE Item Set 12-09-2011.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10409 LTCH Expired CARE Item Set LTCH Expired CARE Item Set 12-09-2011.pdf Yes No Fillable Fileable
Form and Instruction CMS-10409 LTCH Planned Discharge CARE Item Set LTCH Planned Discharge CARE Item Set 12-09-2011.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10409 LTCH Unplanned Discharge CARE Item Set LTCH Unplanned Discharge CARE Item Set 12-09-2011.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

435 200
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 263,000 263,000 0 0 0 0
Annual IC Time Burden (Hours) 43,500 43,500 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.