Medicare and Medicaid OASIS Collection Requirements (Data collection)

OASIS Collection Requirements as Part of the CoPs for HHAs and Supporting Regulations

⚠️ Notice: This information collection may be referencing outdated material.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 OASIS Collection Requirements (Data collection) Form and Instruction
CMS-R-245 OASIS-C1 Revised OASIS-C 1. 09.27.13. 508.pdf Form and Instruction
OASIS Burden Calculations.09.30.13.docx OASIS Burden Calculations IC Document
Attachment A. OASIS C to C1 Items Timepoints and Uses.10-01-13.pdf OASIS-C to Draft OASIS C-1 - Items, Timepoints and Uses Crosswalk IC Document
OASIS-C1 Revisions since 60 day PRA package filing. 10.01.2013.docx Crosswalk IC Document

Information Collection (IC) Details

IC Title:	Medicare and Medicaid 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 42 CFR 484.20

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-R-245	OASIS-C1	Revised OASIS-C 1. 09.27.13. 508.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: 12,014	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	Previously Approved
Annual Number of Responses for this IC	17,268,890	796,555	16,472,335
Annual IC Time Burden (Hours)	15,224,141	-1,251,867	16,476,008
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
OASIS Burden Calculations	OASIS Burden Calculations.09.30.13.docx	11/25/2013
OASIS-C to Draft OASIS C-1 - Items, Timepoints and Uses Crosswalk	Attachment A. OASIS C to C1 Items Timepoints and Uses.10-01-13.pdf	11/25/2013
Crosswalk	OASIS-C1 Revisions since 60 day PRA package filing. 10.01.2013.docx	11/25/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.