Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Home Health Agency Survey and Deficiencies Report Modified 3833 1917 142778 Form and Instruction CMS-1572 Home Health Agency And Deficiences Report
Form and Instruction CMS-1572 Home Health Agency and Deficiencies Report
Total burden requested under this ICR: 3833 1917 142778  
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