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Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 413.337 42 CFR 413.343 42 CFR 483.20 42 CFR 424.32

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10387 Nursing Home PPS (NP) Item Set MDS3 0_NP_PPS_v1 11 1.pdf Yes Yes Fillable Printable
Form and Instruction CMS-10387 Nursing Home OMRA-Start of Therapy and Discharge (NSD) Item Set MDS3 0_NSD_OMRA-SOT-Dschg_v1 11 1.pdf Yes Yes Fillable Printable
Form and Instruction CMS-10387 Nursing Home and Swing Bed OMRA-Start of Therapy (NS/SS) Item Set MDS3 0_NS_SS_OMRA-SOT_v1 11 1.pdf Yes Yes Fillable Printable
Form and Instruction CMS-10387 Nursing Home OMRA-Discharge (NOD) Item Set MDS3 0_NOD_OMRA-Other-Dschg_v1 11 1.pdf Yes Yes Fillable Printable
Form and Instruction CMS-10387 Nursing Home and Swing Bed OMRA (NO/SO) Item Set MDS3 0_NO_SO_OMRA-Other_v1 11 1.pdf Yes Yes Fillable Printable

Health Health Care Services

 

15,447 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,563,344 0 0 5,884,820 0 678,524
Annual IC Time Burden (Hours) 5,580,885 0 0 4,879,766 0 701,119
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.