[Federal Register Volume 62, Number 67 (Tuesday, April 8, 1997)]
[Notices]
[Page 16863]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-8949]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-643]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Health Care Financing 
Administration (HCFA), Department of Health and Human Services, has 
submitted to the Office of Management and Budget (OMB) the following 
proposal for the collection of information. Interested persons are 
invited to send comments regarding the burden estimate or any other 
aspect of this collection of information, including any of the 
following subjects: (1) The necessity and utility of the proposed 
information collection for the proper performance of the agency's 
functions; (2) the accuracy of the estimated burden; (3) ways to 
enhance the quality, utility, and clarity of the information to be 
collected; and (4) the use of automated collection techniques or other 
forms of information technology to minimize the information collection 
burden.
    Type of Information Collection Request: Reinstatement, without 
change, of previously approved collection for which approval has 
expired; Title of Information Collection: Hospice Survey and 
Deficiencies Report Form and Supporting Regulations 42 CFR Sections 
488,488.26(c), 442.30(a)(4), 442, Subpart B, C, D, E and F; Form No.: 
HCFA-643; Use: The survey report form and supporting regulations are 
needed to ensure provider compliance with Medicare and Medicaid 
conditions of participation. In order to participate in the Medicare 
program, a hospice must meet certain Federal health and safety 
conditions of participation. The survey report form will be used by 
State surveyors to record data about a hospice's compliance with 
Federal health and safety conditions in order to initiate the 
certification or recertification process. Frequency: Annually; Affected 
Public: State, Local or Tribal Govt, Federal Govt; Number of 
Respondents: 2,150; Total Annual Responses: 2,150; Total Annual Hours: 
5,375.
    To obtain copies of the supporting statement for the proposed 
paperwork collections referenced above, access HCFA's WEB SITE ADDRESS 
at http://www.hcfa.gov/regs/prdact95.htm, or to obtain the supporting 
statement and any related forms, E-mail your request, including your 
address and phone number, to P[email protected], or call the Reports 
Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 30 days of this notice directly to the HCFA Paperwork Clearance 
Officer designated at the following address: OMB Human Resources and 
Housing Branch, Attention: Allison Eydt, New Executive Office Building, 
Room 10235, Washington, D.C. 20503.

    Dated: March 26, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources, Health Care Financing Administration.
[FR Doc. 97-8949 Filed 4-7-97; 8:45 am]
BILLING CODE 4120-03-P