Testing of Revised OASIS Instrument for Home Health Quality Measures & Data Analysis

Forms and Documents

Document Name	Status
Form CMS-10238 Testing of Revised OASIS Instrument for Home Health Quality Measures & Data Analysis Form and Instruction	New
CMS-10238.OASIS Supp State- Part B_07_16_07.doc Supporting Statement B	2007-11-05
CMS-10238 OASIS-C change table.pdf Supplementary Document	2007-11-05
CMS-10238 Response to OASIS-C Public Comments.doc Supplementary Document	2007-11-05
OASIS Supp State - Part A_03_06_08-TRK Changes.doc Supporting Statement A	2008-03-21

IC Document Collections

IC ID	Document Title	Status
182822	Testing of Revised OASIS Instrument for Home Health Quality Measures & Data Analysis Form and Instruction	New

ICR Details

OMB Control No: 0938-1040	ICR Reference No: 200711-0938-011
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Testing of Revised OASIS Instrument for Home Health Quality Measures & Data Analysis
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/25/2008
	Date Received in OIRA: 11/21/2007
Terms of Clearance: The purpose of the $1000 per agency and the additional payments to off-hours home health staff is essentially remuneration for services provided as data collectors for the study. This approach is justified by the fact that these collections are in parallel to ‘typical’ required reporting to CMS for which agencies are remunerated indirectly as part of the Medicare reimbursement process and by the fact that the HH staff are essentially working for CMS’s contractor during off-hours to the HH agency.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2011	36 Months From Approved
Responses	11	0	0
Time Burden (Hours)	298	0	0
Cost Burden (Dollars)	11,205	0	0

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Abstract: The purpose of the proposed data collection is to test a revised version of the Outcome and Assessment Information Set (OASIS) data set with actual users in a home health environment in order to assess 1) the validity and reliability of new and revised OASIS items; and 2) the impact of changes to the OASIS instrument on burden. The upcoming OASIS revision is an opportunity for CMS to respond to input on potential refinements and enhancements of the OASIS instrument solicited from HHAs, industry associations, consumer representatives, researchers and other stakeholders.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 41328	07/27/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 59293	10/19/2007
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Testing of Revised OASIS Instrument for Home Health Quality Measures & Data Analysis	CMS-10238, CMS-10238	CMS-10238 - OASIS Instrument ,   CMS-10238 - OASIS Instrument (Revised)

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	11	0	0	11	0	0
Annual Time Burden (Hours)	298	0	0	298	0	0
Annual Cost Burden (Dollars)	11,205	0	0	11,205	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a one-time test possible revisions to the OASIS instrument.

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Annual Cost to Federal Government: $190,378

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/21/2007

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