Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the Collection of Data Related to the Patient Driven Payment Model and the Skilled Nursing Facility QRP (CMS-10387)

ICR 201909-0938-013

OMB: 0938-1140

Federal Form Document

ICR Details
0938-1140 201909-0938-013
Historical Active 201905-0938-002
HHS/CMS CCSQ
Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the Collection of Data Related to the Patient Driven Payment Model and the Skilled Nursing Facility QRP (CMS-10387)
Revision of a currently approved collection   No
Regular
Approved with change 11/22/2019
Retrieve Notice of Action (NOA) 09/26/2019
  Inventory as of this Action Requested Previously Approved
11/30/2022 36 Months From Approved 02/28/2022
4,905,042 0 4,905,042
4,169,286 0 4,169,286
0 0 0

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.

US Code: 42 USC 1395yy(e) Name of Law: Payment to Skilled Nursing Facilities for Routine Costs
   PL: Pub.L. 105 - 33 4432(a) Name of Law: Prospective Payment for Skilled Nursing Facilities
  
None

0938-AT75 Final or interim final rulemaking 84 FR 38728 08/07/2019

  84 FR 17620 04/25/2019
84 FR 38728 08/07/2019
Yes

  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 4,905,042 0 0 0 0
Annual Time Burden (Hours) 4,169,286 4,169,286 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$3,164,707
No
    No
    No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 [email protected]

  No

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.
09/26/2019


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