COT Preparation, Coding and Transmission

Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2012 - Change of Therapy OMRA

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1140 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10387 COT Preparation, Coding and Transmission Form and Instruction
CMS-10387 Nursing Home and Swing Bed OMRA (NO/SO) Item Set MDS3 0_NO_SO_OMRA-Other_ProposedSNFChanges_20110503.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	COT Preparation, Coding and Transmission	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 413.343 42 CFR 413.337 42 CFR 424.32 42 CFR 483.20

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10387	Nursing Home and Swing Bed OMRA (NO/SO) Item Set	MDS3 0_NO_SO_OMRA-Other_ProposedSNFChanges_20110503.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,266	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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	884,492	884,492
Annual IC Time Burden (Hours)	913,884	913,884
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.