Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Hospice Certification of Terminal Illness (418.22): Completion of Attestation Form New 457382 3812 0
Hospice Certification of Terminal Illness (418.22): Including Benefit Periods New 1733663 14447 0
Hospice Certification of Terminal Illness (418.22, first year): Development of Attestation Form New 3429 2572 0
Hospice Conditions of Participation (418.106) Modified 2872 72524 0
Hospice Conditions of Participation (418.110 - annual) Modified 2872 47943 0
Hospice Conditions of Participation (418.110 - first year) Modified 2872 153039 0
Hospice Conditions of Participation (418.112) Modified 2872 39389 0
Hospice Conditions of Participation (418.114 - annual) Modified 2872 14047 0
Hospice Conditions of Participation (418.114 - first year) Modified 2872 19293 0
Hospice Conditions of Participation (418.52) Modified 2872 138489 0
Hospice Conditions of Participation (418.56) Modified 2872 692152 0
Hospice Conditions of Participation (418.76) Modified 2872 5983 0
Hospice Conditions of Participation (418.78) Modified 2872 156524 0
Total burden requested under this ICR: 2223194 1360214 0  
To view an IC, click on IC Title