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) Unchanged 3143155 26192 0
Hospice Condition of Participation 418.58 Phase 2 data entry Unchanged 3185488 423340 0
Hospice Conditions of Participation (418.110 (n) new hospice training program Unchanged 38 1520 0
Hospice Conditions of Participation (418.52(a)(3) Unchanged 1592388 132699 0
Hospice Conditions of Participation 418.100(e) Unchanged 4473 357840 0
Hospice Conditions of Participation 418.106 (e) Unchanged 1587527 132293 0
Hospice Conditions of Participation 418.108(c) Unchanged 317583 53676 0
Hospice Conditions of Participation 418.108(c)(3) Unchanged 317583 26833 0
Hospice Conditions of Participation 418.110(m) Unchanged 1133 850 0
Hospice Conditions of Participation 418.110(n) documentation Unchanged 18128 1511 0
Hospice Conditions of Participation 418.110(n) training Unchanged 1133 4532 0
Hospice Conditions of Participation 418.112(e)(3) Unchanged 545706 63501 0
Hospice Conditions of Participation 418.114 (b) Unchanged 17712 70848 0
Hospice Conditions of Participation 418.114 (d) Unchanged 21656 3069 0
Hospice Conditions of Participation 418.22(b) Unchanged 280 280 0
Hospice Conditions of Participation 418.22(b)(3) Unchanged 2344934 195411 0
Hospice Conditions of Participation 418.24 explain election form Unchanged 1236443 309111 0
Hospice Conditions of Participation 418.28 develop revocation form Unchanged 280 70 0
Hospice Conditions of Participation 418.28 explain revocation form Unchanged 80011 6668 0
Hospice Conditions of Participation 418.52(b) Unchanged 80514 80514 0
Hospice Conditions of Participation 418.56(b) and (c) Unchanged 3184776 1060101 0
Hospice Conditions of Participation 418.58 Phase 1 Unchanged 1120 3360 0
Hospice Conditions of Participation 418.58 Phase 2 aggregate/data analysis Unchanged 71568 261468 0
Hospice Conditions of Participation 418.58 Phase 3 Unchanged 4473 13419 0
Hospice Conditions of Participation 418.76(c) and (d) Unchanged 8946 9318 0
Hospice Conditions of Participation 418.78(a)(c)(d) and (e) Unchanged 40257 243779 0
Hospice Conditons of Participation 418.24 develop election form Unchanged 280 280 0
Hospice Condtions of Participation 418.52(a) Unchanged 285 2280 0
§418.24(b) Modification New 4465 2232 0
§418.24(c) Addendum New 913318 152220 0
Total burden requested under this ICR: 18725653 3639215 0  
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