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

ICR 202505-0938-009

OMB: 0938-1163

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2025-05-27
IC Document Collections
IC ID
Document
Title
Status
201171 Modified
ICR Details
0938-1163 202505-0938-009
Received in OIRA 202408-0938-006
HHS/CMS CCSQ
Long Term Care Hospital (LTCH) Quality Reporting Program (CMS-10409)
Revision of a currently approved collection   No
Regular 05/28/2025
  Requested Previously Approved
36 Months From Approved 12/31/2027
136,650 226,940
185,101 187,735
0 0

The Centers for Medicare & Medicaid Services (CMS) is requesting approval of revisions to the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Version 5.2 that will be effective October 1, 2026.

PL: Pub.L. 111 - 148 3004 Name of Law: Quality reporting for LTCHs, inpatient rehabilitation hospitals, and hospice programs
  
PL: Pub.L. 111 - 148 3004 Name of Law: Quality reporting for LTCHs, inpatient rehabilitation hospitals, and hospice programs

0938-AV45 Proposed rulemaking 90 FR 18002 04/30/2025

No

1
IC Title Form No. Form Name
Long Term Care Data Set CMS-10409, CMS-10409, CMS-10409, CMS-10409 LCDS version 5.3 Admission ,   LCDS version 5.3 Expired ,   LCDS version 5.3 Planned Discharge ,   LCDS version 5.3 Unplanned Discharge

  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 136,650 226,940 0 -90,290 0 0
Annual Time Burden (Hours) 185,101 187,735 0 -2,634 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
As a result of the FY 2026 IPPS/LTCH proposed rule proposed the collection of quality reporting data, the total burden associated with each LCDS submission will decrease by 0.025 hours per LCDS, 8 hours per LTCH and 2,634 hours for all LTCHs. We estimate a decrease in the amount of time it will take to complete a single LCDS Version 5.3 as compared to the previously approved package. If finalized, the burden will decrease from 86 minutes to 84.5 minutes beginning October 1, 2026. Since the approval of the LCDS V5.2, The number of LTCHs submitting assessments has not changed and remains at 330. LTCHs are submitting approximately 130,050 admission assessments, and 6,503 expired assessments. As a result of these changes, we estimate an overall decrease in burden hours for LTCHs. Specifically, the burden hours will decrease by 2,634 hours [187,735 hours – 185,101 hours].

$3,039,427
No
    No
    No
Yes
No
No
Yes
Denise King 410 786-1013 [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.
05/28/2025


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