OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD)

ICR 201310-0938-013 · OMB 0938-1140 · Historical Active

Forms and Documents
Document
Name
Status
Form and Instruction
 Modified
Supplementary Document
2013-10-30
Supporting Statement A
2013-10-30
IC Document Collections
IC ID
Document
Title
Status
197759 Modified
ICR Details
0938-1140 201310-0938-013
Historical Active 201109-0938-006
HHS/CMS 20789
Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD)
Revision of a currently approved collection   No
Regular
Approved without change 01/15/2014
Retrieve Notice of Action (NOA) 10/30/2013
  Inventory as of this Action Requested Previously Approved
01/31/2015 36 Months From Approved 09/30/2014
6,396,416 0 884,492
6,608,971 0 913,884
0 0 0
Skilled Nursing Facilities (SNFs) will be required to submit a Change of Therapy (COT) Other Medicare Required Assessment (OMRA) to administer the payment rate methodology. This additional assessment is subject to the Paperwork Reduction Act. The burden associated with this is the SNF staff time required to complete the COT OMRA for the Minimum Data Set (MDS), SNF staff time to encode, and SNF staff time spent in transmitting the data.
US Code: 42 USC 1395yy(e) Name of Law: Payment to Skilled Nursing Facilities for Routine Costs
   PL: Pub.L. 105 - 33 4432(a) Name of Law: Prospective Payment for Skilled Nursing Facilities
  
None
0938-AR65 Final or interim final rulemaking 78 FR 47936 08/06/2013
  78 FR 26438 04/06/2013
78 FR 47936 08/06/2013
No
  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 6,396,416 884,492 0 5,511,924 0 0
Annual Time Burden (Hours) 6,608,971 913,884 0 5,695,087 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This package incorporates all PPS assessment item sets. When we presented NO/SO for PRA consideration for FY 2011, the form was used as a proxy for the NP, NS, NOD and NSD Item sets inasmuch as it included all MDS payment items which were required to be considered under the PRA. According to CASPER, there were 15,376 skilled nursing facilities certified to participate in the Medicare program during FY 2012. We had previously estimated 14,266 facilities. We are also adjusting the number of responses per respondent from 62 to 416. Additionally, we are adding Item O0420 to the MDS 3.0 form as discussed in RIN 0938-AR65 (CMS-1446-F). We do not believe this action will cause any measurable adjustments to our burden estimates. Consequently, we are not revising the associated estimates.
$0
No
No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/30/2013