SNF Resident Assessment MDS Data -- 42 CFR 413.343 and 424.32

ICR 199902-0938-002

OMB: 0938-0739

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0739 199902-0938-002
Historical Active 199808-0938-007
HHS/CMS
SNF Resident Assessment MDS Data -- 42 CFR 413.343 and 424.32
Extension without change of a currently approved collection   No
Regular
Approved without change 04/09/1999
Retrieve Notice of Action (NOA) 02/03/1999
Approved for use through 4/2000 under the conditions that HCFA: 1) revisits each of OMB's clearance remarks dated 10/13/98; 2) immediately incorporates all disclosure statements mandated by the Paperwork Reduction Act of 1995 and for the public record, submits to OMB the revised forms/instructions; and 3) reassesses confidentiality/privacy policy for these data, where appropriate consistent with HCFA's amendments to privacy policies for the home health OASIS data set.
  Inventory as of this Action Requested Previously Approved
04/30/2000 04/30/2000 04/30/1999
204,000 0 204,000
3,865,885 0 3,865,885
0 0 0

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 for 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 the....

None
None


No

1
IC Title Form No. Form Name
SNF Resident Assessment MDS Data -- 42 CFR 413.343 and 424.32 HCFA-R-250

  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 204,000 204,000 0 0 0 0
Annual Time Burden (Hours) 3,865,885 3,865,885 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
02/03/1999


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