Information Collection

Hospitals and Health Care Complex Cost Report (CMS-2552-10)

IC 7814 under ICR 201509-0938-009 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form CMS-2552-10 Hospitals and Health Care Complex Cost Report (CMS-2552-10) Form
CMS-2552-10_COST REPORT INSTRUCTIONS.docx Instruction
CMS-2552-10 COST REPORT WORKSHEET CMS-2552-10_COST REPORT WORKSHEET.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Hospitals and Health Care Complex Cost Report (CMS-2552-10)	Agency IC Tracking Number:	2552-10

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 413.24 42 CFR 413.20

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CMS-2552-10	COST REPORT WORKSHEET	CMS-2552-10_COST REPORT WORKSHEET.xlsx		Yes	Yes	Fillable Fileable
Instruction			CMS-2552-10_COST REPORT INSTRUCTIONS.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,157	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: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,157	-14	6,171
Annual IC Time Burden (Hours)	4,143,661	-9,422	4,153,083
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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