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Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews - Site Coordinator)
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration
OMB: 0938-1038
IC ID: 183149
OMB.report
HHS/CMS
OMB 0938-1038
ICR 200712-0938-006
IC 183149
( )
Documents and Forms
Document Name
Document Type
Form CSM-10246
Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews - Site Coordinator)
Form
CSM-10246 CMS-10246.coordinator_guide_HHA
CMS-10246.coordinator_guide_HHA_16nov2007.doc
Form
CMS-10246 CMS-10246.coordinator_guide_inst
CMS-10246.coordinator_guide_inst_16nov2007.doc
Form
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 - Site Coordinator)
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
CSM-10246
CMS-10246.coordinator_guide_HHA
CMS-10246.coordinator_guide_HHA_16nov2007.doc
Yes
Yes
Fillable Fileable
Form
CMS-10246
CMS-10246.coordinator_guide_inst
CMS-10246.coordinator_guide_inst_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:
138
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
138
0
138
0
0
0
Annual IC Time Burden (Hours)
13,386
0
13,386
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.