Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20 New 187170 132011 0 Form CMS-R-250 MDS Medicare PPS Assessment Form
Other-Form page 2
Other-Form page 3
Other-Form page 4
Other-Form page 5
MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20 New 765 540 0 Form CMS-R-250 MDS Medicare PPS Assessment Form
Other-Form page 2
Other-Form page 3
Other-Form page 4
Other-Form page 5
SNF Resident Assessment MDS Data and Supporting Regulations at 42 CFR 413.337, 413.343 and 424.32, and 483.20 Modified 3647010 2572236 0 Form CMS-R-250 MDS Medicare PPS Assessment Form
Other-Form page 2
Other-Form page 3
Other-Form page 4
Other-Form page 5
Total burden requested under this ICR: 3834945 2704787 0  
To view an IC, click on IC Title