Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD) (CMS-10387)
ICR 201809-0938-009
OMB: 0938-1140
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1140 can be found here:
Skilled Nursing Facility
(SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed
Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD,
NSD) (CMS-10387)
Skilled Nursing Facilities (SNFs) will
be required to submit a Change of Therapy (COT) Other Medicare
Required Assessment (OMRA) to administer the payment rate
methodology. This additional assessment is subject to the Paperwork
Reduction Act. The burden associated with this is the SNF staff
time required to complete the COT OMRA for the Minimum Data Set
(MDS), SNF staff time to encode, and SNF staff time spent in
transmitting the data.
PL:
Pub.L. 105 - 33 4432(a) Name of Law: Prospective Payment for
Skilled Nursing Facilities
US Code:
42 USC 1395yy(e) Name of Law: Payment to Skilled Nursing
Facilities for Routine Costs
In past calculations of PPS
assessments (April 2017 Supporting Statement), we did not include
the PPS discharge assessment in our counts because, while a
required assessment, it was not originally created or used for
payment purposes and thus was exempt from PRA consideration.
However, because we are requiring the PPS discharge assessment a
for payment purposes, as outlined in CMS-1696-F, we believe that
the past counts (April 2018- RUG-IV) are relevant to the burden and
cost estimates for PDPM. Thus, we are including these assessments
in our calculations. There will be a decrease in total number of
responses because we will no longer require all of the PPS
assessments currently required. Similarly, the total annual hour
burden estimate is decreased because of the reduced number of
assessments.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form CMS-10387 Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD)
CMS-10387 - Supporting Statement A (version 1)_including IPA numbers_v2....docx
Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD)