Minimum Data Set for Swing Bed Hospitals and Supporting Regulations in 42 0FR 413.114(a)(2) and 413.343(a) (CMS-10064)

Minimum Data Set (MDS) For Swing Bed Hospitals and Supporting Regulations in 42 CFR 483.20 and 413.337

Documents and Forms

Document Name Document Type
Form CMS-10064 Minimum Data Set for Swing Bed Hospitals and Supporting Regulations in 42 0FR 413.114(a)(2) and 413.343(a) (CMS-10064) Form
sbmanual112005-RUG53.pdf Other-Manual
CMS-10064 MINIMUM DATA SET (MDS) For Swing Bed Hospitals snfpps_swmds.pdf Form

Information Collection (IC) Details

IC Title:	Minimum Data Set for Swing Bed Hospitals and Supporting Regulations in 42 0FR 413.114(a)(2) and 413.343(a) (CMS-10064)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 413.114(a)(2) 42 CFR 413.343(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CMS-10064	MINIMUM DATA SET (MDS) For Swing Bed Hospitals	snfpps_swmds.pdf		Yes	Yes	Paper Only
Other-Manual			sbmanual112005-RUG53.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 143	Number of Respondents for Small Entity: 128

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	15,015	15,015
Annual IC Time Burden (Hours)	97,598	97,598
Annual IC Cost Burden (Dollars)	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.