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 202304-0938-012

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1140 can be found here:

Forms and Documents

Document Name	Status
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
PRA Disclosure Statement_v1.18.11.docx Supplementary Document	2023-04-19
CMS-10387-MDS-Supporting-Statement-A_v11_clean 4-18-23.docx Supporting Statement A	2023-04-19

IC Document Collections

IC ID	Document Title	Status
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