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Federal forms, ICRs, and supporting documents

OMB control number

Physician Certifications/Recertification's in Skilled Nursing Facilities Manual Instruction (CMS-R-5)

OMB 0938-0454 ยท HHS/CMS.

OMB 0938-0454

Medicare, Skilled Nursing Facilities. 42 CFR 424.20 requires SNFs to keep record of physician certifications and recertification of information such as the need for care and services, estimated duration of the SNF stay, and plan for home care.

The latest form for Physician Certifications/Recertification's in Skilled Nursing Facilities Manual Instruction (CMS-R-5) expires 2023-04-30 and can be found here.

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Physician Certifications/Recertifications

Federal Enterprise Architecture: Health - Health Care Services