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View ICR - OIRA Conclusion

OMB Control No: 0938-1043	ICR Reference No: 201708-0938-024
Status: Historical Active	Previous ICR Reference No: 201403-0938-015
Agency/Subagency: HHS/CMS	Agency Tracking No: 21626
Title: (CMS-10239) Conditions of Participation for Critical Access Hospitals and Supporting Regulations
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/02/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/30/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved	01/31/2018
Responses	118,252	0	150,493
Time Burden (Hours)	24,183	0	24,443
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): 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 1395x(e) and (mm) Name of Law: Part E - Miscellaneous Provisions
   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

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	118,252	150,493	-32,241
Annual Time Burden (Hours)	24,183	24,443	-260
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This package has been updated to reflect the current number of facilities and the current BLS salary information. The salary estimates includes estimated fringe benefits and overhead at 100%. The number of facilities decreased from 1,331 to 1,215 and the annual burden hours decreased from 24,443 to 24,183 hours and the cost increased from $907,847.19 a year to $1,700,478.13 a year.

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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