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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data and Supporting Regulations in 42 CFR 412 Subpart P
Removed
0
0
0
Form
CMS-10036
IRF PAI Instrument
Instruction
Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data and Supporting Regulations in 42 CFR 412 Subpart P
Removed
0
0
0
Form
CMS-10036
IRF PAI Instrument
Instruction
Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data and Supporting Regulations in 42 CFR 412 Subpart P (CMS-10036)
Removed
0
0
0
Form
CMS-10036
IRF PAI Instrument
Instruction
Inpatient Rehabilitation Facility-Patient Assessment Instrument
New
359000
197080
0
Form and Instruction
CMS-10036
Voluntary/Mandatory Items for Proposed DRAFT IRF-PAI Version 1.2 (Proposed DRAFT Effective October 1, 2014) Assessment Quality Indicator Items- Sect 3004 IRF Quality Reporting Program
Form and Instruction
CMS-10036
IRF-PAI Instrument
Total burden requested under this ICR:
359000
197080
0
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