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Federal forms, ICRs, and supporting documents

Information Collection

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

IC 183149 under ICR 200712-0938-006 · OMB 0938-1038.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Information Collection (IC) Details

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Cost and Resource Utilization (CRU) Data Collection for the Medicare Post Acute Care Payment Reform Demonstration (Interviews - Site Coordinator)
 
No New
 
Voluntary
 

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

Health Health Care Services

Post Acute Care Payment Reform / Continuity of Assessment Record and Evaluation (PAC-CARE), System No. 09-70-0569  72 FR 55225

138 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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

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