Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Long Term Care Data Set Unchanged 204936 145831 0 Form and Instruction CMS-10409 LCDS version 5.00 Admission
Form and Instruction CMS-10409 LCDS version 5.00 Expired
Form and Instruction CMS-10409 LCDS version 5.00 Planned Discharge
Form and Instruction CMS-10409 LCDS version 5.00 Unplanned Discharge
Total burden requested under this ICR: 204936 145831 0  
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