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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) (CMS-10387)

ICR 201809-0938-009 · OMB 0938-1140 · Historical Active

Forms and Documents
Document
Name
Status
Form and Instruction
 Modified
Supporting Statement A
2018-12-21
Supplementary Document
2018-10-10
IC Document Collections
IC ID
Document
Title
Status
197759 Modified
ICR Details
0938-1140 201809-0938-009
Historical Active 201805-0938-004
HHS/CMS CM-FFS
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) (CMS-10387)
Revision of a currently approved collection   No
Regular
Approved without change 02/12/2019
Retrieve Notice of Action (NOA) 10/11/2018
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved 02/29/2020
4,905,042 0 6,563,344
4,169,286 0 5,580,885
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.
PL: Pub.L. 105 - 33 4432(a) Name of Law: Prospective Payment for Skilled Nursing Facilities
   US Code: 42 USC 1395yy(e) Name of Law: Payment to Skilled Nursing Facilities for Routine Costs
  
None
0938-AT24 Final or interim final rulemaking 83 FR 39162 08/08/2018
  83 FR 21018 05/08/2018
83 FR 39162 08/08/2018
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 4,905,042 6,563,344 0 -2,029,606 371,304 0
Annual Time Burden (Hours) 4,169,286 5,580,885 0 -1,727,207 315,608 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Changing Regulations
In past calculations of PPS assessments (April 2017 Supporting Statement), we did not include the PPS discharge assessment in our counts because, while a required assessment, it was not originally created or used for payment purposes and thus was exempt from PRA consideration. However, because we are requiring the PPS discharge assessment a for payment purposes, as outlined in CMS-1696-F, we believe that the past counts (April 2018- RUG-IV) are relevant to the burden and cost estimates for PDPM. Thus, we are including these assessments in our calculations. There will be a decrease in total number of responses because we will no longer require all of the PPS assessments currently required. Similarly, the total annual hour burden estimate is decreased because of the reduced number of assessments.
$0
No
    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.
10/11/2018