Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
484.100(a) - existing Modified 12602 1046 0
484.100(a) - new agencies Modified 455 455 0
484.105(h) Modified 14 21 0
484.105(h) - existing Modified 7630 3815 0
484.110(a) - content of clinical records Modified 17751840 1473403 0
484.50(a) existing agencies Modified 12602 12602 0
484.50(a) new agencies Modified 14 112 0
484.50(e) Modified 534100 44330 0
484.60(a) New 1775340 296482 0
484.60(a) care planning Modified 14276110 1184917 0
484.60(c) New 1775340 147353 0
484.60(e) New 3550680 1182376 0
484.65(d) New 3052 3052 0
484.65(e) - quality assessment and performance Modified 7630 30520 0
484.70 New 50408 50408 0
484.80(a) Modified 25204 2100 0
484.80(b) - home health aide classroom and practical training Modified 25204 2100 0
484.80(c) - compentency evaluation Modified 25204 2100 0
484.80(d) - in-service training Modified 302448 25103 0
Total burden requested under this ICR: 40135877 4462295 0  
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