(CMS-10282) Comprehensive Outpatient Rehabilitation Facilites (CORFs) Conditions of Participation (CoP) and Supporting Regulations

Forms and Documents

Document Name	Status
Form CMS-10282 CORF Survey Report - Form 360 Form and Instruction	Removed
Form CMS-10282 CORF Request for Certification Form - CMS-359 Form and Instruction	Removed
CMS-10282 Final Supporing Statement 8-11-17 clean.docx Supporting Statement A	2017-08-11

IC Document Collections

IC ID	Document Title	Status
209506	CORF Survey Report - Form 360 Form and Instruction	Removed
209505	CORF Request for Certification Form - CMS-359 Form and Instruction	Removed
192450	42 CFR 485.66(b)(1), (2), and 3(i),(ii) Untilization review plan	Modified
192447	42 CFR 485.64(a)(1),(2),(3), (4), (b)(1) and (2) Disaster procedures	Removed

ICR Details

OMB Control No: 0938-1091	ICR Reference No: 201702-0938-019
Status: Historical Active	Previous ICR Reference No: 201311-0938-030
Agency/Subagency: HHS/CMS	Agency Tracking No: 20940
Title: (CMS-10282) Comprehensive Outpatient Rehabilitation Facilites (CORFs) Conditions of Participation (CoP) and Supporting Regulations
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/15/2017
	Date Received in OIRA: 02/27/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved	08/31/2017
Responses	235	0	628
Time Burden (Hours)	3,055	0	8,076
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this package is to request Office of Management and Budget (OMB) approval of the collection of information requirements for the conditions of participation (CoPs) that comprehensive outpatient rehabilitation facilities (CORFS) must meet to participate in the Medicare Program.

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Authorizing Statute(s): US Code: 42 USC 1395x(cc) Name of Law: Comprehensive Outpatient Rehabilitation Facility (CORFs) Services
  

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:
	81 FR 91175	12/16/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 11470	02/23/2017
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
42 CFR 485.66(b)(1), (2), and 3(i),(ii) Untilization review plan
CORF Request for Certification Form - CMS-359	CMS-10282	CORF Request for Certification to Participate in the Medicare Program
CORF Survey Report - Form 360	CMS-10282	CORF Survey Report
42 CFR 485.64(a)(1),(2),(3), (4), (b)(1) and (2) Disaster procedures

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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	235	628	0	-393	0	0
Annual Time Burden (Hours)	3,055	8,076	0	-5,021	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The number of of Medicare certified CORFs have decreased.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

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: 02/27/2017

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