Information Collection

SNF Resident Assessment MDS Data and Supporting Regulations at 42 CFR 413.337, 413.343 and 424.32, and 483.20

IC 8422 under ICR 200603-0938-009 · OMB 0938-0739.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0739 can be found here:

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Information Collection (IC) Details

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IC Title:	SNF Resident Assessment MDS Data and Supporting Regulations at 42 CFR 413.337, 413.343 and 424.32, and 483.20	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	R-250				Yes	Yes

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,719,118	2,061,259	2,657,859
Annual IC Time Burden (Hours)	3,284,247	643,876	2,640,371
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.