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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-1043
ICR Reference No:
201403-0938-015
Status:
Historical Active
Previous ICR Reference No:
201011-0938-004
Agency/Subagency:
HHS/CMS
Agency Tracking No:
21626
Title:
Conditions of Participation for Critical Access Hospitals and Supporting Regulations
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
08/26/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/28/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2017
36 Months From Approved
08/31/2014
Responses
150,493
0
143,994
Time Burden (Hours)
24,443
0
23,615
Cost Burden (Dollars)
0
0
0
Abstract:
This information collection package is a revision of the approved information collection requirements. With this submission, we have updated our estimates to reflect the current number of facilities and the current BLS salary information. The information collection requirements, as discussed in the attached supporting statement, are needed to implement the Medicare CoPs for 1,233 CAHs.
Authorizing Statute(s):
US Code:
42 USC 1395x(e) and (mm)
Name of Law: Part E - Miscellaneous Provisions
US Code:
42 USC 1395hh
Name of Law: Regulations
US Code:
42 USC 1395aa
Name of Law: Use of State Agencies to determine compliance by providers of services with CoPs
US Code:
42 USC 1395(a)(8)
Name of Law: Conditions of and Limitations on Payment for Services
US Code:
42 USC 1320b-8
Name of Law: Hospital Protocols for Organ Procurement and Standards for Organ Procurement Agencies
US Code:
42 USC 1302
Name of Law: Rules and Regulations
US Code:
42 USC 1395i-4(a-f)
Name of Law: Medicare Rural Hospital Flexibility Program
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
78 FR 77135
12/20/2013
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 14711
03/17/2014
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
42CFR485.618
42CFR485.623(d)(4)
42CFR485.631
42CFR485.635(c)(3)
42CFR485.635(f)
42CFR485.641
42CFR485.643(a-b)
42CFR485.645(d)
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
150,493
143,994
0
6,499
0
0
Annual Time Burden (Hours)
24,443
23,615
0
828
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
This package has been updated to reflect the current number of facilities and the current BLS salary information.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Denise King 410 786-1013 Denise.King@cms.hhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
03/28/2014
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