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Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration
OMB: 0938-1038
IC ID: 183147
OMB.report
HHS/CMS
OMB 0938-1038
ICR 200712-0938-006
IC 183147
( )
Documents and Forms
Document Name
Document Type
Form CMS-10246
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)
Form and Instruction
CMS-10246 CMS-10246.interview_hha_admin
CMS-10246.interview_hha_admin_16nov2007.doc
Form and Instruction
CMS-10246 CMS-10246.interview_hha_mgmt
CMS-10246.interview_hha_mgmt_16nov2007.doc
Form and Instruction
CMS-10246 CMS-10246.interview_inst_admin
CMS-10246.interview_inst_admin_16nov2007.doc
Form and Instruction
CMS-10246 CMS-10246.interview_inst_finance
CMS-10246.interview_inst_finance_16nov2007.doc
Form and Instruction
CMS-10246 CMS-10246.interview_inst_mgmt
CMS-10246.interview_inst_mgmt_16nov2007.doc
Form and Instruction
CMS-10246 CMS-10246.nterview_hha_finance
CMS-10246.nterview_hha_finance_16nov2007.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews non-cru)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
CMS-10246
CMS-10246.interview_hha_admin
CMS-10246.interview_hha_admin_16nov2007.doc
Yes
Yes
Fillable Fileable
Form and Instruction
CMS-10246
CMS-10246.interview_hha_mgmt
CMS-10246.interview_hha_mgmt_16nov2007.doc
Yes
Yes
Fillable Fileable
Form and Instruction
CMS-10246
CMS-10246.interview_inst_admin
CMS-10246.interview_inst_admin_16nov2007.doc
Yes
Yes
Fillable Fileable
Form and Instruction
CMS-10246
CMS-10246.interview_inst_finance
CMS-10246.interview_inst_finance_16nov2007.doc
Yes
Yes
Fillable Fileable
Form and Instruction
CMS-10246
CMS-10246.interview_inst_mgmt
CMS-10246.interview_inst_mgmt_16nov2007.doc
Yes
Yes
Fillable Fileable
Form and Instruction
CMS-10246
CMS-10246.nterview_hha_finance
CMS-10246.nterview_hha_finance_16nov2007.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
Post Acute Care Payment Reform / Continuity of Assessment Record and Evaluation (PAC-CARE), System No. 09-70-0569
FR Citation:
72 FR 55225
Number of Respondents:
12
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
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
12
0
12
0
0
0
Annual IC Time Burden (Hours)
36
0
36
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.