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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
OMB: 0938-0872
IC ID: 8693
OMB.report
HHS/CMS
OMB 0938-0872
ICR 200809-0938-009
IC 8693
( )
Documents and Forms
Document Name
Document Type
sbmanual112005-RUG53.pdf
Other-Manual
CMS-10064 MINIMUM DATA SET (MDS) For Swing Bed Hospitals
snfpps_swmds.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
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:
Modified
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
Other-Manual
sbmanual112005-RUG53.pdf
Yes
Yes
Paper Only
Form
CMS-10064
MINIMUM DATA SET (MDS) For Swing Bed Hospitals
snfpps_swmds.pdf
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
338
Number of Respondents for Small Entity:
34
Affected Public:
Private Sector
Private Sector:
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
35,490
0
0
-57,299
0
92,789
Annual IC Time Burden (Hours)
230,685
0
0
179,371
0
51,314
Annual IC Cost Burden (Dollars)
0
0
0
-100,000
0
100,000
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.