OMB control number
Medicare and Medicaid Programs: Conditions of Participation for Home Health Agencies (HHA) (CMS-10539)
OMB 0938-1299 ยท HHS/CMS.
OMB 0938-1299
Home health agencies are required to maintain certain documentation within their own agency records that demonstrates compliance with specific Conditions of Participation for the Medicare program. This documentation is maintained on-site for use in the home health agency survey process.
The latest form for Medicare and Medicaid Programs: Conditions of Participation for Home Health Agencies (HHA) (CMS-10539) expires 2021-02-28 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
Supplementary Document |
Supporting Statement A |
CMS-10539 - Attachment A - Response to 60-day comment.docx
484.65(b)&(c) All Historical Document Collections
| Reinstatement with change of a previously approved collection | 2025-09-24 | ||
|
Approved without change |
Revision of a currently approved collection | 2021-01-19 | |
|
Approved with change |
Existing collection in use without an OMB Control Number | 2017-12-08 | |
|
Withdrawn |
New collection (Request for a new OMB Control Number) | 2017-01-25 | |
|
Comment filed on proposed rule |
New collection (Request for a new OMB Control Number) | 2015-07-10 |
OMB Details
484.50(a) new agencies
Federal Enterprise Architecture: Health - Health Care Services