Long Term Care Data Set

Long Term Care Hospital (LTCH) Quality Reporting Program (CMS-10409)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1163 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10409 Long Term Care Data Set Form and Instruction
CMS-10409 LCDS version 5.1 Admission LTCH-CARE-Data-Set-Version-5.1-Admission_v2.docx Form and Instruction
CMS-10409 LCDS version 5.1 Expired LTCH-CARE-Data-Set-Version-5.1-Expired_v3.docx Form and Instruction
CMS-10409 LCDS version 5.1 Planned Discharge LTCH-CARE-Data-Set-Version-5.1-Planned-Discharge_v2.docx Form and Instruction
CMS-10409 LCDS version 5.1 Unplanned Discharge LTCH-CARE-Data-Set-Version-5.1-Unplanned-Discharge_v2.docx Form and Instruction
Crosswalk-LCDS-5.0-to-5.1.doc.docx Crosswalk IC Document

Information Collection (IC) Details