Comprehensive Outpatient Rehabilitation Facility (corf) Eligibility And Survey Forms And Information Collection Requirement In 42 Cfr 485.56, 485.58, 485.60, 485.66, And....

COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF) ELIGIBILITY AND SURVEY FORMS AND INFORMATION COLLECTION REQUIREMENT IN 42 CFR 485.56, 485.58, 485.60, 485.66, AND....

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0267 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF) ELIGIBILITY AND SURVEY FORMS AND INFORMATION COLLECTION REQUIREMENT IN 42 CFR 485.56, 485.58, 485.60, 485.66, AND....	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	HCFA-359,	No	No
Form	HCFA-360,	No	No
Form	HCFA-R-55	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	162	0	162
Annual IC Time Burden (Hours)	77,539	77,013	526
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.