Information Collection Request

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 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
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) Form and Instruction Modified Available
CMS-10387 - Supporting Statement A (version 1)_including IPA numbers_v2....docx Supporting Statement A Uploaded 2018-12-21 Available
Crosswalk for Changes to MDS 3.0_PRA_July 2018.docx Supplementary Document Uploaded 2018-10-10 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
197759 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) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved 02/29/2020
4,905,042 0 6,563,344
4,169,286 0 5,580,885
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 4,905,042 6,563,344 0 -2,029,606 371,304 0
Annual Time Burden (Hours) 4,169,286 5,580,885 0 -1,727,207 315,608 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No