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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-0739
ICR Reference No:
200904-0938-002
Status:
Historical Active
Previous ICR Reference No:
200603-0938-009
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/24/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/02/2009
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2012
36 Months From Approved
06/30/2009
Responses
3,834,945
0
4,719,118
Time Burden (Hours)
2,704,787
0
3,284,247
Cost Burden (Dollars)
0
0
0
Abstract:
Skilled Nursing Facilities (SNFs) are required to submit the resident assessment data as described at 42 CFR 483.20 in the manner necessary to administer the payment rate methodology described in 42 CFR 413.337. Pursuant to sections 4204(b) and 4214(d) of OBRA 1987, the current requirements related to the submission and retention of resident assessment data for the 5th, 30th, 60th and 90th days following admission, necessary to administer the payment rate methodology described in 413.337, are subject to the Paperwork Reduction Act. The burden associated with this is the SNF staff time required to complete the Minimum Data Set (MDS), SNF staff time to encode, and SNF staff time spent in transmitting the data.
Authorizing Statute(s):
US Code:
42 USC 1395yy
Name of Law: Payment to Skilled Nursing Facilities for Routine Service Costs
PL:
Pub.L. 105 - 33 4432(a)
Name of Law: Prospective Payment for Skilled Nursing Facilities
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AJ65
Final or interim final rulemaking
64 FR 41684
07/30/1999
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
73 FR 76034
12/15/2008
30-day Notice:
Federal Register Citation:
Citation Date:
74 FR 9819
03/06/2009
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20
CMS-R-250
MDS Medicare PPS Assessment Form
MPAF Data and Supporting Regulations in 42 CFR Sections 413.337, 413.343, 424.32 and 483.20
CMS-R-250
MDS Medicare PPS Assessment Form
SNF Resident Assessment MDS Data and Supporting Regulations at 42 CFR 413.337, 413.343 and 424.32, and 483.20
CMS-R-250
MDS Medicare PPS Assessment Form
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
3,834,945
4,719,118
0
0
-884,173
0
Annual Time Burden (Hours)
2,704,787
3,284,247
0
0
-579,460
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Bonnie Harkless 4107865666
Common Form ICR:
No
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
04/02/2009
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