Information Collection

Medicare and Medicaid Programs OASIS Collection Requirements (Training)

IC 180130 under ICR 201502-0938-004 · OMB 0938-0760.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-R-245 OASIS-C1/ICD-9 Medicare and Medicaid Programs OASIS Collection Requirements (Training)	Form and Instruction
CMS-R-245 OASIS-C1/ICD-9 Attachement C Final-OASIS-C1-ICD-9-Version-Item-Set-effective-01-01-2015.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-R-245				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12,014

Number of Respondents for Small Entity: 12,014

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	12,014	12,014
Annual IC Time Burden (Hours)	96,112	96,112
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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