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)
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
Comment filed on proposed rule and continue
08/18/2025
07/17/2025
In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
11/30/2025
36 Months From Approved
11/30/2025
3,469,183
0
3,469,183
2,861,351
0
2,861,351
0
0
0
The Minimum Data Set (MDS) is a uniform instrument used in every Medicare/Medicaid certified nursing home in the United States to assess resident condition. It was developed in response to the Landmark Institute of Medicine (IOM) Report on Nursing Home Quality in 1987 where the MDS was seen as a critical component in efforts to improve the quality of care in nursing homes. The Omnibus Reconciliation Act of 1987 (OBRA 1987) also set forth new provisions for Medicare and Medicaid related to new standards for care in the nursing home setting. From its inception, the MDS was intended to serve several purposes:
(1) Collect data to inform care plans
(2) To generate quality indicators to evaluate nursing homes and guide improvement interventions
(3) To serve as a data source for nursing home payment systems.
Pursuant to sections 4204(b) and 4214(d) of OBRA 1987, the current requirements related to the submission and retention of resident assessment data are not subject to the Paperwork Reduction Act (PRA), but it has been determined that requirements for SNF staff performing, encoding and patient assessment data necessary administer the payment rate methodology described in 413.337, are subject to the PRA.
The SNF QRP was established in CMS-1622-F (August 4, 2015; 80 FR 46390) and began collecting data from SNFs in fiscal year (FY) 2016 using the MDS. As described in section 1899B (b)(1)(B) of the Social Security Act (the Act), SNFs are required to submit standardized patient assessment data with respect to the following categories:
⢠Functional Status
⢠Cognitive Function
⢠Special Services, Treatments, and Interventions
⢠Medical Conditions and Comorbidities
⢠Impairments
⢠Other categories deemed necessary and appropriate by the Secretary
Both the Patient Driven Payment Model (PDPM) in the SNF PPS and the SNF QRP collect data through the MDS 3.0. The PDPM was described and adopted for SNFs and Swing Beds in CMS-1696-F (August 8, 2018; 83 FR 39162).
This package is a request for a revision to the current Minimum Data Set (MDS) assessment instrument for the Skilled Nursing Facility (SNF). This package represents a request from the Centers for Medicare & Medicaid Services (CMS) to implement the MDS 3.0 v1.18.11 beginning October 1, 2023 to October 1, 2026 in order to meet the requirements of policies finalized in the Federal Fiscal Year (FY) 2020 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) final rule (CMS-1718-F, RIN 0938-AT75). A PRA package was submitted at the time of the finalized policies and approved on 11/22/2019, but the compliance date for the finalized policies (10/01/2020) was delayed due to the COVID-19 public health emergency (PHE). Please note, however, the burden was never retracted, and the implementation of the instrument was simply delayed. While there has been no change in assessment-level burden since the approval of the MDS 3.0 v1.17.2, there has been a change in total burden since 2019 when the package was originally approved due to a decrease in the number of MDS assessments completed and a change in the hourly rate for clinicians completing the assessment.
PL:
Pub.L. 105 - 33 4432(a)
Name of Law: Prospective Payment for Skilled Nursing Facilities
US Code:
42 USC 1395yy(e)
Name of Law: Payment to Skilled Nursing Facilities for Routine Costs
Since the MDS 3.0 v1.19.1 was approved, CMS has removed one standardized patient assessment data element from the discharge assessment for the SNF QRP and removed MDS items that are not needed for case-mix adjusting the SNF per diem payment for PDPM but were not accounted for in the FY 2019 SNF PPS final rule (83 FR 39165 through 39265). We also continue to monitor the number of SNFs and the number of beneficiaries seeking SNF services. After an increase in SNF admissions in the years following the COVID-19 public health emergency, the total number of SNFs and the number of individuals admitted to SNFs for skilled services has decreased as represented by the 19.7% decrease in the total number of assessments reported in this ICR from the previous ICR.
Finally, we also updated the data submission system to the iQIES for the SNF QRP. This was a replacement of the legacy QIES ASAP data submission system and imposes no additional requirements or burden on the part of SNFs.
These updates resulted in the following changes to the current burden estimate:
â¢A decrease of 218 SNFs, with the current number at 15,253.
â¢This ICR estimates 1,589,560 SNF PPS 5-day assessments, a decrease of 158,252 assessments over the last approved package.
â¢This ICR estimates 1,112,822 SNF PPS Discharge assessments, a decrease of 525,119 assessments over the last approved package.
â¢This ICR estimates 82,015 SNF PPS IPA assessments, a decrease of 1,415 assessments over the last approved package.
As a result of these changes (see Table 6), the total annual hour burden across facilities has decreased by 178,377 hours (2,861,351 minus 2,682,974), and the annual cost burden across facilities has decreased by $12,504,227.70 ($209,755,274.80 minus $197,251,047.10).
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.
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)