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SNF Resident Assessment MDS Data and Supporting Regulations at 42 CFR 413.337, 413.343 and 424.32, and 483.20

IC 8422 under ICR 200904-0938-002 · OMB 0938-0739.

Documents and Forms
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Other-Form page 3
Other-Form page 4
Other-Form page 5
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Information Collection (IC) Details

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SNF Resident Assessment MDS Data and Supporting Regulations at 42 CFR 413.337, 413.343 and 424.32, and 483.20
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 413.337 42 CFR 413.343 42 CFR 424.32 42 CFR 483.20

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-R-250 MDS Medicare PPS Assessment Form MDS20MDSAllForms 31.pdf Yes Yes Paper Only
Other-Form page 2 MDS20MDSAllForms 32.pdf Yes Yes Paper Only
Other-Form page 3 MDS20MDSAllForms 33.pdf Yes Yes Paper Only
Other-Form page 4 MDS20MDSAllForms 34.pdf Yes Yes Paper Only
Other-Form page 5 MDS20MDSAllForms 35.pdf Yes Yes Paper Only

Health Health Care Services

 

14,302 1,583
   
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 3,647,010 0 0 -1,072,108 0 4,719,118
Annual IC Time Burden (Hours) 2,572,236 0 0 -712,011 0 3,284,247
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.