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View ICR - OIRA Conclusion

OMB Control No: 0938-1163	ICR Reference No: 202309-0938-011
Status: Active	Previous ICR Reference No: 202305-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Long Term Care Hospital (LTCH) Quality Reporting Program (CMS-10409)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/05/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/22/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2025	36 Months From Approved	08/31/2025
Responses	297,053	0	204,936
Time Burden (Hours)	211,381	0	145,831
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	297,053	204,936	92,117
Annual Time Burden (Hours)	211,381	145,831	65,550
Annual Cost Burden (Dollars)	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: No

Burden Reduction Due to:

Short Statement: Since the approval of the LCDS V5.0, new information demonstrates a change in both the number of LTCHs and the number of LCDS’s completed per LTCH. As illustrated in Table 3, the number of LTCHs submitting assessments has decreased from 415 to 330. However, LTCHs are submitting approximately 45,620 more admission assessments and 46,497 discharge assessments across all LTCHs, resulting in an increase of 138.24 (45,620 / 330) admission assessments and 140.9 (46,497 / 330) discharge assessments per LTCH. As a result of these changes, we estimate an overall increase in burden hours for LTCHs. Specifically, the burden hours will increase by 65,550 hours [(0.711592 hours per LCDS x (45,620 admission + 46,497 discharge assessments)) – 145,831 hours].

Annual Cost to Federal Government: $2,994,473

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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? Yes

Agency Contact: Denise King 410 786-1013 Denise.King@cms.hhs.gov