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SNF Resident Assessment MDS Data and Supporting Regulation 42 CFR 413.343 and 424.32
SNF Resident Assessment MDS Data and Supporting Regulation 42 CFR 413.343 and 424.32
OMB: 0938-0739
IC ID: 8419
OMB.report
HHS/CMS
OMB 0938-0739
ICR 200002-0938-008
IC 8419
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0739 can be found here:
2009-04-02 - Extension without change of a currently approved collection
2006-03-28 - Extension without change of a currently approved collection
Documents and Forms
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no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
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IC Title:
SNF Resident Assessment MDS Data and Supporting Regulation 42 CFR 413.343 and 424.32
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
HCFA-R-250
Yes
Yes
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
17,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
204,000
0
0
0
0
204,000
Annual IC Time Burden (Hours)
5,696,218
0
1,830,333
0
0
3,865,885
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.