Information Collection

Hospitals and Health Care Complex Cost Report (CMS-2552-96)

IC 7814 under ICR 200802-0938-004 · OMB 0938-0050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0050 can be found here:

Documents and Forms

Document Name Document Type
P152_36Inst.zip Instruction
R17P236f.zip Other-CMS-2552-96
CMS-2552-96 Revisions - Crosswalk from old to new.doc CMS-2552-96 Revisions - Crosswalk from old to new IC Document
R17P236s.zip R17P236s IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Hospitals and Health Care Complex Cost Report (CMS-2552-96)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 413.20 42 CFR 413.24

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			P152_36Inst.zip		No	No	Paper Only
Other-CMS-2552-96			R17P236f.zip		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,175	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,175	64	6,111
Annual IC Time Burden (Hours)	4,090,474	43,692	4,046,782
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
CMS-2552-96 Revisions - Crosswalk from old to new	CMS-2552-96 Revisions - Crosswalk from old to new.doc	02/15/2008
R17P236s	R17P236s.zip	02/15/2008

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