Information Collection

Medicare and Medicaid Programs OASIS Collection Requirements (Data collection)

IC 43666 under ICR 200904-0938-014 · OMB 0938-0760.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0760 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-R-245 Medicare and Medicaid Programs OASIS Collection Requirements (Data collection) Form and Instruction
CMS-R-245 CMS-R-245.OASIS Instrument CMS-R-245 OASIS-C PRA - OASIS-C Ver12.1 2-24-2009.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medicare and Medicaid Programs OASIS Collection Requirements (Data collection)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 484.55 42 CFR 484.205 42 CFR 484.245 42 CFR 484.250

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-R-245	CMS-R-245.OASIS Instrument	CMS-R-245 OASIS-C PRA - OASIS-C Ver12.1 2-24-2009.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Home Health Agency (HHA) Outcome and Assessment Information Set (OASIS), HHS/CMS/CMSO (System # 09-70-0522)	FR Citation: 72 FR 63906

Number of Respondents: 10,170	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	14,777,010	2,799,409	11,977,601
Annual IC Time Burden (Hours)	14,858,370	5,875,169	8,983,201
Annual IC Cost Burden (Dollars)	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.