Information Collection Request

Medicare and Medicaid Programs OASIS Collection Requirements as Part of the CoPs for HHAs and Supp. Regs. in 42 CFR 48.55, 484.205, 484.245, 484.250

ICR 200908-0938-002 · OMB 0938-0760 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-R-245 Medicare and Medicaid Programs OASIS Collection Requirements (Data collection) Form and Instruction Modified Available
Form CMS-R-245 Medicare and Medicaid Programs OASIS Collection Requirements (Training) Form and Instruction Modified Available
CMS-R-245.Justification for Nonmaterial Change.doc Justification for No Material/Nonsubstantive Change Uploaded 2009-08-04 Available
OASIS-C Ver 12 3 6 15 09a CORRECTION LIST.pdf Supplementary Document Uploaded 2009-08-04 Available
OASIS-C Ver12 3 for 508_061509a-508.pdf Supplementary Document Uploaded 2009-08-04 Available
CMS-R-245_OASIS-C_PRA_Revised_Supporting_Statement_2-25-2009[1].pdf Supporting Statement A Uploaded 2009-08-04 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
43666 Medicare and Medicaid Programs OASIS Collection Requirements (Data collection) Form and Instruction Modified
180130 Medicare and Medicaid Programs OASIS Collection Requirements (Training) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2012 07/31/2012 07/31/2012
14,960,070 0 14,960,070
15,590,610 0 15,590,610
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 14,960,070 14,960,070 0 0 0 0
Annual Time Burden (Hours) 15,590,610 15,590,610 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No