Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Hospice Condition of Participation (418.22(b)(4) and (b)(5) Modified 2792054 23268 0
Hospice Condition of Participation 418.58 Phase 2 data entry New 3071838 204789 0
Hospice Conditions of Participation (418.110 (n) new hospice program Modified 54 2160 0
Hospice Conditions of Participation (418.52(a)(3) Modified 1535919 127993 0
Hospice Conditions of Participation 418.100(e) New 3897 311760 0
Hospice Conditions of Participation 418.106(a) and (e) Modified 4607757 383980 0
Hospice Conditions of Participation 418.108(c)(1) New 354626 31176 0
Hospice Conditions of Participation 418.110(m) New 1018 764 0
Hospice Conditions of Participation 418.110(n) training Modified 2036 5429 0
Hospice Conditions of Participation 418.112(e)(3) Modified 476135 79356 0
Hospice Conditions of Participation 418.114 (b) Modified 15432 61728 0
Hospice Conditions of Participation 418.114 (d) Modified 17486 2914 0
Hospice Conditions of Participation 418.22(b)(3) Modified 2021745 168479 0
Hospice Conditions of Participation 418.22(b)(4) Modified 95 95 0
Hospice Conditions of Participation 418.24 explain election form New 1048044 262011 0
Hospice Conditions of Participation 418.28 develop revocation form New 95 24 0
Hospice Conditions of Participation 418.28 explain revocation form New 77719 6477 0
Hospice Conditions of Participation 418.52(b) New 77940 77940 0
Hospice Conditions of Participation 418.56(b) and (c) Modified 3070838 1023625 0
Hospice Conditions of Participation 418.58 Phase 1 New 440 1320 0
Hospice Conditions of Participation 418.58 Phase 2 aggregate/data analysis New 62352 233820 0
Hospice Conditions of Participation 418.58 Phase 3 New 3897 11691 0
Hospice Conditions of Participation 418.76(b)(c) and (d) Modified 7794 8119 0
Hospice Conditions of Participation 418.78(a)(c)(d) and (e) Modified 35073 212387 0
Hospice Conditons of Participation 418.24 develop election form New 95 95 0
Hospice Condtions of Participation 418.52(a) New 110 880 0
Total burden requested under this ICR: 19284489 3242280 0  
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