Inpatient Rehabilitation Assessment Instrument and Data Set for PPS for Inpatient Rehabilitation Facilities (CMS-10036)

Forms and Documents

Document Name	Status
Form CMS-10036 Inpatient Rehabilitation Facility - Patient Assessment Instrument Form and Instruction	Modified
CMS-10036-Supporting-Statement-A-4.2_8-29-23.docx Supporting Statement A	2023-08-29
Response to Comments on the Burden Estimates for the FY 2024 IRF QRP Proposals.docx Supplementary Document	2023-08-29

IC Document Collections

IC ID	Document Title	Status
210555	Inpatient Rehabilitation Facility - Patient Assessment Instrument Form and Instruction	Modified

ICR Details

OMB Control No: 0938-0842	ICR Reference No: 202308-0938-017
Status: Received in OIRA	Previous ICR Reference No: 202304-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Inpatient Rehabilitation Assessment Instrument and Data Set for PPS for Inpatient Rehabilitation Facilities (CMS-10036)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/29/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2025
Responses	799,448	672,345
Time Burden (Hours)	1,188,810	1,187,475
Cost Burden (Dollars)	0	0

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Abstract: The Centers for Medicare & Medicaid Services (CMS) is requesting approval of revisions to the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) Version 4.1 that will be effective on October 1, 2024. On April 7, 2023 the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) (88 FR 20950) which proposes modifications to the collection of quality reporting data in the Inpatient Rehabilitation Facility Quality Reporting Program (IRF QRP). Specifically, CMS proposes to adopt two new measures and remove three measures from the IRF QRP. Per the NPRM, CMS proposes to require IRFs to start collecting assessment data using the IRF-PAI Version 4.2 for IRF patients beginning October 1, 2024.

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Authorizing Statute(s): PL: Pub.L. 105 - 1 4421 Name of Law: Prospective Payment for Inpatient Rehab Hospital Services
   PL: Pub.L. 111 - 148 3004 Name of Law: Quality Reporting for Long-Term Care Hospitals, etc.
   US Code: 42 USC 1395ww(jX2)(d) Name of Law: Prospective Payment for Inpatient Rehab Services
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV04	Final or interim final rulemaking	88 FR 50956	08/02/2023

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Inpatient Rehabilitation Facility - Patient Assessment Instrument	CMS-10036	IRF- PAI version 4.2

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ICR Summary of Burden

	Total Request	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	799,448	672,345	0	127,103	0	0
Annual Time Burden (Hours)	1,188,810	1,187,475	0	1,335	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Since the IRF PAI 4.1 was approved, new information demonstrates a change in both the number of IRFs and the number of IRF-PAI assessments completed per IRF. The number of IRFs has increased from 1,115 to 1,133, and the average number of IRF-PAI assessments completed annually by each IRF has increased from 366 to 454 annually under current requirements to report data on Medicare fee-for-service and Medicare Advantage patients receiving IRF services. Beginning with the FY 2026 IRF QRP, IRFs will report data on all patients regardless of payer, and the number of IRF-PAI assessments completed by each IRF is estimated to increase from 454 to 691 assessments per year. Although we estimate no change in the amount of time it would take to complete a single IRF PAI 4.2 as compared to the IRF PAI 4.1, the changes in total IRFs and total IRF-PAI assessments will change the burden associated with the IRF-PAI 4.2. As finalized, the burden will increase from 1,187,475 hours across all IRFs to 1,188,810 hours across all IRFs beginning October 1, 2024 [(1,187,475 – (1,133 IRFs x 2.26 hours decrease/IRF for FY 2025 IRF QRP) = 1,184,914)]; [(1,184,914 + (1,133 IRFs x 3.44 hours increase/IRF for FY 2026 IRF QRP) = 1,188,810)].

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Annual Cost to Federal Government: $3,218,683

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/29/2023

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