OMB control number

Comprehensive Outpatient Rehabilitation Facility (CORF) Certification and Survey Forms (CMS-359/360)

OMB 0938-0267 · HHS/CMS.

OMB 0938-0267

In order to participate in the Medicare program as a CORF, providers must meet federal conditions of participation. The certification form is needed to determine if providers meet at least preliminary requirements. The survey form is used to record provider compliance with the individual conditions and report findings to CMS.

The latest form for Comprehensive Outpatient Rehabilitation Facility (CORF) Certification and Survey Forms (CMS-359/360) expires 2028-09-30 and is listed under ICR 202505-0938-015.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form CMS-360 COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY SURVEY REPORT	Form and Instruction
Form CMS-359 Comprehensive Outpatient Rehab Facility Request Form	Form and Instruction
Form CMS-359 Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...	Form and Instruction
Supporting Statement A for CMS 359 & 360. 12.05.24.docx	Supporting Statement A
Supporting Statement A for CMS 359 & 360. 12.05.24.docx	Supporting Statement A
Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...	Form and Instruction
Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...	Form and Instruction
Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202505-0938-015	Reinstatement with change of a previously approved collection	2025-06-04
202009-0938-003	Reinstatement with change of a previously approved collection	2020-09-11
201603-0938-013	Extension without change of a currently approved collection	2016-03-21	Approved with change
201209-0938-005	Revision of a currently approved collection	2012-09-18	Approved with change
200906-0938-007	Extension without change of a currently approved collection	2009-06-15	Approved with change
200604-0938-005	Extension without change of a currently approved collection	2006-04-19	Approved without change
200301-0938-009	Extension without change of a currently approved collection	2003-01-21	Approved without change
199912-0938-002	Extension without change of a currently approved collection	1999-12-02	Approved without change
199610-0938-008	Extension without change of a currently approved collection	1996-10-29	Approved without change
199311-0938-002	Revision of a currently approved collection	1993-11-01	Approved without change
199103-0938-014	No material or nonsubstantive change to a currently approved collection	1991-03-01	Approved with change
199009-0938-002	Reinstatement with change of a previously approved collection	1990-09-04	Approved without change
198805-0938-009	Revision of a currently approved collection	1988-05-26	Approved without change
198710-0938-005	Revision of a currently approved collection	1987-10-29	Approved without change
198509-0938-020	No material or nonsubstantive change to a currently approved collection	1985-09-20	Approved with change
198410-0938-006	Reinstatement with change of a previously approved collection	1984-10-12	Approved without change
198409-0938-026	No material or nonsubstantive change to a currently approved collection	1984-09-28	Approved with change
198210-0938-005	New collection (Request for a new OMB Control Number)	1982-10-26	Approved without change