Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Long Term Care Data Set Modified 226940 187735 0 Form and Instruction CMS-10409 LCDS version 5.2 Admission
Form and Instruction CMS-10409 LCDS version 5.2 Expired
Form and Instruction CMS-10409 LCDS version 5.2 Planned Discharge
Form and Instruction CMS-10409 LCDS version 5.2 Unplanned Discharge
Form and Instruction CMS-10409 Social Determinants of Health
Total burden requested under this ICR: 226940 187735 0  
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