Information Collection Request
Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the Collection of Data Related to the Patient Driven Payment Model and the Skilled Nursing Facility QRP (CMS-10387)
ICR 202304-0938-012 · OMB 0938-1140 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1140 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form and Instruction |
Modified |
Supplementary Document | 2023-04-19 |
Supporting Statement A | 2023-04-19 |
Form CMS-10387 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)
PRA Disclosure Statement_v1.18.11.docxIC Document Collections
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 Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1140 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202206-0938-012 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |