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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:
0938-0842
ICR Reference No:
201402-0938-016
Status:
Historical Active
Previous ICR Reference No:
201106-0938-001
Agency/Subagency:
HHS/CMS
Agency Tracking No:
21520
Title:
Inpatient Rehabilitation Assessment Instrument and Data Set for PPS for Inpatient Rehabilitation Facilities
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
07/03/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/28/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
07/31/2017
36 Months From Approved
02/28/2015
Responses
359,000
0
486,550
Time Burden (Hours)
197,080
0
413,568
Cost Burden (Dollars)
0
0
0
Abstract:
We are requesting approval for revisions to the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI. This is the assessment instrument that inpatient rehabilitation facilities are required to submit in order for CMS to administer the payment rate methodolgy under the IRF PPS described in 42 CFR 412 Subpart P. The burden associated with this requirement is the staff time required to complete, encode, and transmit the data from the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI). The burden associated with transmitting the IRF-PAI is not being included in this revision, since the requirement for IRFs to transmit the data is unaffected by the proposed revision to the assessment instrument. We are proposing to replace the current pressure ulcer assessment data items in the Quality Indicator section of the IRF-PAI with a new set of pressure ulcer data items. The proposed new pressure ulcer data elements are more comprehensive than in use on the current version of the IRF-PAI. The proposed new pressure ulcer items are similar to those collected through the Minimum Data Set 3.0 (MDS 3.0), which is a reporting instrument that is used in nursing homes. The current MDS 3.0 pressure ulcer items evolved as an outgrowth of CMS' work to develop a standardized patient assessment instrument, now referred to as the CARE (Continuity Assessment Records & Evaluation) We further propose to add a new measure known as the "Percent of Patients/Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine" (NQF #0680) to the IRF quality reporting program beginning on October 1, 2014. We propose to collect the data for this measure using a set of data elements that is very similar to those collected through the Minimum Data Set 3.0 (MDS 3.0).
Authorizing Statute(s):
PL:
Pub.L. 105 - 1 4421
Name of Law: Prospective Payment for Inpatient Rehab Hospital Services
US Code:
42 USC 1395ww(jX2)(d)
Name of Law: Prospective Payment for Inpatient Rehab Services
PL:
Pub.L. 111 - 148 3004
Name of Law: Quality Reporting for Long-Term Care Hospitals, etc.
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AR66
Final or interim final rulemaking
78 FR 47859
08/06/2013
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Inpatient Rehabilitation Facility - Patient Assessment Instrument
CMS-10036, CMS-10036
Voluntary/Mandatory Items
,
IRF-PAI instrument
Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data and Supporting Regulations in 42 CFR 412 Subpart P
CMS-10036
IRF PAI Instrument
Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data and Supporting Regulations in 42 CFR 412 Subpart P
CMS-10036
IRF PAI Instrument
Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) data and Supporting Regulations in 42 CFR 412 Subpart P (CMS-10036)
CMS-10036
IRF PAI Instrument
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
359,000
486,550
0
-127,550
0
0
Annual Time Burden (Hours)
197,080
413,568
0
-216,488
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The current pressure ulcer assessment data itmes in the Quality Indicator section of the IRF-PAI have been replaced with a new set of pressure ulcer data items. The new data elements are more comprehensive than in use on the currrent version of the IRF-PAI.
Annual Cost to Federal Government:
$2,000,000
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]?
Yes
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
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:
Denise King 410 786-1013 Denise.King@cms.hhs.gov
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:
02/28/2014
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