SNF Resident Assessment MDS Data and Supporting Regulation 42 CFR 413.343 and 424.32

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Forms and supporting documents for this ICR

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Information collection document groups

IC ID	Collection	Type	Status	Form
8417	SNF Resident Assessment MDS Data and Supporting Regulation 42 CFR 413.343 and 424.32	Form	Migrated

ICR Details

OMB Control No: 0938-0739	ICR Reference No: 199808-0938-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: SNF Resident Assessment MDS Data and Supporting Regulation 42 CFR 413.343 and 424.32
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 08/31/1998
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/13/1998
	Date Received in OIRA: 08/14/1998
Terms of Clearance: Approved for use through 4/99 under the condition that HCFA includes the following in the next submission for OMB review: 1) a more thorough explanation of why increased coding burden isn't attributed to this rule rather than to the HCFA-1500 (see HCFA's response to comments for OMB, second paragraph); 2) a preliminary reassessment of SNF burdens and compliance with the enhanced resident assessment requirements; and 3) completion of Question 14 of OMB 83-I and more thorough discussion in the Supporting Statement.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/1999	04/30/1999
Responses	204,000	0	0
Time Burden (Hours)	3,865,885	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Skilled Nursing Facilities (SNFs) are required to submit the resident assessment data as described at 42 CFR 483.20 in the manner necessary to administer the payment rate methodology described in 42 CFR 413.337. Pursuant to sections 4204(b) and 4214(d) of OBRA 1987, the current requirements related to the submission and retention of resident assessment data fro the 5th, 30th and 60th days following admission, necessary to administer the payment rate methodology described in 413.337, is subject to the Paperwork Reduction Act. The burden associated with this is the SNF staff time required to complete..

Emergency Justfication:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
SNF Resident Assessment MDS Data and Supporting Regulation 42 CFR 413.343 and 424.32	HCFA-R-250

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ICR Summary of Burden

table that charts list 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	204,000	0	0	204,000	0	0
Annual Time Burden (Hours)	3,865,885	0	0	3,865,885	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

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: 08/14/1998

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