OMB control number

Long Term Care Hospital (LTCH) Quality Reporting Program (CMS-10409)

OMB 0938-1163 · HHS/CMS.

OMB 0938-1163

The Centers for Medicare & Medicaid Services (CMS) is requesting approval of revisions to the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Version 5.2 that will be effective October 1, 2026.

The latest form for Long Term Care Hospital (LTCH) Quality Reporting Program (CMS-10409) expires 2027-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10409 Long Term Care Data Set Form and Instruction
CMS_10409_Supporting_Statement_LCDS_v5.3_508.docx Supporting Statement A
Long Term Care Data Set Form and Instruction

All Historical Document Collections

202505-0938-009	Revision of a currently approved collection	2025-05-28
202408-0938-006	Revision of a currently approved collection	2024-08-30
202406-0938-002 Comment filed on proposed rule and continue	Revision of a currently approved collection	2024-06-17
202309-0938-011 Approved without change	Revision of a currently approved collection	2023-09-22
202305-0938-006 Comment filed on proposed rule and continue	Revision of a currently approved collection	2023-05-31
202204-0938-008 Approved without change	Extension without change of a currently approved collection	2022-04-26
202111-0938-016 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-11-30
202009-0938-012 Approved without change	No material or nonsubstantive change to a currently approved collection	2020-09-24
201910-0938-002 Approved without change	Revision of a currently approved collection	2019-10-22
201905-0938-012 Comment filed on proposed rule and continue	Revision of a currently approved collection	2019-05-28
201812-0938-009 Approved without change	Revision of a currently approved collection	2018-12-13
201805-0938-011 Comment filed on proposed rule and continue	Revision of a currently approved collection	2018-05-17
201708-0938-012 Approved with change	Revision of a currently approved collection	2017-08-16
201706-0938-007 Comment filed on proposed rule and continue	Revision of a currently approved collection	2017-07-05
201605-0938-020 Approved without change	Extension without change of a currently approved collection	2016-05-31
201304-0938-004 Approved without change	Revision of a currently approved collection	2013-04-12
201208-0938-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-08-07
201202-0938-003 Approved with change	New collection (Request for a new OMB Control Number)	2012-02-13