Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10246 CMS-10246.coordinator_guide_inst	Form	New	Available
Form CSM-10246 CMS-10246.coordinator_guide_HHA	Form	New	Available
Form CMS-10246 CMS-10246.revised_cru_forms	Form	New	Available
Form CMS-10246 CMS-10246.nterview_hha_finance	Form and Instruction	New	Available
Form CMS-10246 CMS-10246.interview_inst_mgmt	Form and Instruction	New	Available
Form CMS-10246 CMS-10246.interview_inst_finance	Form and Instruction	New	Available
Form CMS-10246 CMS-10246.interview_inst_admin	Form and Instruction	New	Repair queued
Form CMS-10246 CMS-10246.interview_hha_mgmt	Form and Instruction	New	Available
Form CMS-10246 CMS-10246.interview_hha_admin	Form and Instruction	New	Available
CMS-10246.Supporting Statement Part B.doc	Supporting Statement B	Uploaded 2007-11-29	Available
CMS-10246.CRU_Change_Spreadsheet20071119.xls	Supplementary Document	Uploaded 2007-11-29	Available
CMS-10246.omb_response_16nov2007 (2).doc	Supplementary Document	Uploaded 2007-11-29	Available
CMS-10246.Supporting Statement Part A.doc	Supporting Statement A	Uploaded 2007-11-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
183149	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews - Site Coordinator)	Form	New	CMS-10246.coordinator_guide_inst
183149	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews - Site Coordinator)	Form	New	CMS-10246.coordinator_guide_HHA
183148	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Staff Time Logs)	Instruction	New
183148	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Staff Time Logs)	Form	New	CMS-10246.revised_cru_forms
183147	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)	Form and Instruction	New	CMS-10246.nterview_hha_finance
183147	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)	Form and Instruction	New	CMS-10246.interview_inst_mgmt
183147	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)	Form and Instruction	New	CMS-10246.interview_inst_finance
183147	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)	Form and Instruction	New	CMS-10246.interview_inst_admin
183147	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)	Form and Instruction	New	CMS-10246.interview_hha_mgmt
183147	Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)	Form and Instruction	New	CMS-10246.interview_hha_admin

ICR Details

OMB Control No: 0938-1038	ICR Reference No: 200712-0938-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/20/2008
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/20/2007
Terms of Clearance: Approved consistent with memo dated 3/7/2008.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2011	36 Months From Approved
Responses	61,589	0	0
Time Burden (Hours)	28,783	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This demonstration is intended to address problems with the current Medicare payment systems for post-acute care services, including those for Long Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), Skilled Nursing Facilities (SNFs), and Home Health Agencies (HHAs). Each of these four types of providers currently has a separate prospective payment system (PPS) with its own case-mix groups, payment units, and rates.

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Authorizing Statute(s): PL: Pub.L. 109 - 171 5008 Name of Law: Deficit Reduction Act of 2005
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 48645	08/24/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 67603	11/29/2007
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews - Site Coordinator)	CSM-10246, CMS-10246	CMS-10246.coordinator_guide_HHA ,   CMS-10246.coordinator_guide_inst
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)	CMS-10246, CMS-10246, CMS-10246, CMS-10246, CMS-10246, CMS-10246	CMS-10246.interview_hha_admin ,   CMS-10246.interview_hha_mgmt ,   CMS-10246.interview_inst_admin ,   CMS-10246.interview_inst_finance ,   CMS-10246.interview_inst_mgmt ,   CMS-10246.nterview_hha_finance
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Staff Time Logs)	CMS-10246	CMS-10246.revised_cru_forms

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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	61,589	0	0	61,589	0	0
Annual Time Burden (Hours)	28,783	0	0	28,783	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The data collected using the CRU instruments and staff interview protocols during the Post-Acute Care Payment Demonstration will be used by CMS to develop a setting neutral post-acute care payment model as mandated by Congress. The data will be used in conjunction with data collected in the CARE instrument to characterize patient severity of illness and level of function in order to predict resource use, post-acute care discharge placement, and beneficiary outcomes. CMS will use the data from the CRU and the CARE instruments to examine the degree to which it is possible to predict beneficiary resource use and outcomes based on patient severity of illness.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 12/20/2007

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