OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Reform of Requirements for Long-Term Care Facilities (CMS-10573)

OMB 0938-1363 · HHS/CMS.

OMB 0938-1363

Long term care facilities are required to maintain certain documentation within their own agency records that demonstrates compliance with specific requirements for participation in the Medicare and Medicaid programs. This documentation is maintained on-site for use in the long term care facility survey process. In this submission, we are revising the information collection request to add information collection requirements for the nursing services requirements at §483.35 and revise the existing information collection requirements for the facility assessment requirements at §483.70(e) (new §483.71).

The latest form for Reform of Requirements for Long-Term Care Facilities (CMS-10573) expires 2026-08-31 and is listed under ICR 202407-0938-017.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
CMS-10573 response to comments 06.26.2024.docx Supplementary Document
CMS-10573 Supporting Statement (Updates for CMS-3442-F) 07.22.2024 clean.docxSupporting Statement A
483.71(b) Information collection
483.35(b) Information collection
483.80(h) Information collection
483.80(g) Information collection
483.80(d)(3)(vi) & (vii) Information collection
483.80(d)(3)(iv) Information collection
483.80(d)(3)(ii) & (iii) Information collection
483.80(d)(3). Information collection
483.85(e) Information collection
483.80(a) Information collection
483.71 Information collection
483.60(c)(4) Information collection
483.25(n)(2) Information collection
483.21(c) Information collection
483.21(b)(2)(ii) Information collection
483.21(a) Information collection
483.15(c)(4) Information collection
485.10(g)(17) Information collection
483.10(c)(2) Information collection
483.75(a) Information collection

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202407-0938-017 Revision of a currently approved collection 2024-07-25 Approved without change
202407-0938-014 Revision of a currently approved collection 2024-07-25 Withdrawn and continue
202206-0938-011 Revision of a currently approved collection 2022-06-09 Approved with change
201901-0938-005 Existing collection in use without an OMB Control Number 2019-06-14 Approved without change

OMB Details

483.75(a)

Federal Enterprise Architecture: Health - Health Care Services