View Information Collection Request (ICR) Package
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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:
0938-1163
ICR Reference No:
202408-0938-006
Status:
Active
Previous ICR Reference No:
202406-0938-002
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 with change
Conclusion Date:
12/19/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/30/2024
Terms of Clearance:
Approved consistent with the understanding that the agency will update the race/ethnicity question in this information collection to be in compliance with the updated SPD 15 (effective as of March 28, 2024) in CY 2027 after the FY/CY 2026 payment rulemaking season.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2027
36 Months From Approved
08/31/2025
Responses
226,940
0
297,053
Time Burden (Hours)
187,735
0
211,381
Cost Burden (Dollars)
0
0
0
Abstract:
The Centers for Medicare & Medicaid Services (CMS) is requesting approval of revisions to the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Version 5.2 that will be effective October 1, 2026.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 3004
Name of Law: Quality reporting for LTCHs, inpatient rehabilitation hospitals, and hospice programs
Citations for New Statutory Requirements:
PL: Pub.L. 111 - 148 3004 Name of Law: Quality reporting for LTCHs, inpatient rehabilitation hospitals, and hospice programs
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AV34
Final or interim final rulemaking
89 FR 68986
08/28/2024
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
Long Term Care Data Set
CMS-10409, CMS-10409, CMS-10409, CMS-10409, CMS-10409
LCDS version 5.2 Admission
,
LCDS version 5.2 Expired
,
LCDS version 5.2 Planned Discharge
,
LCDS version 5.2 Unplanned Discharge
,
Social Determinants of Health
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
226,940
297,053
0
-70,113
0
0
Annual Time Burden (Hours)
187,735
211,381
0
-23,646
0
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
As a result of the FY 2025 IPPS/LTCH final rule finalizing the collection of quality reporting data, the total burden associated with each LCDS submission will increase by 0.015 hours per LCDS, 6.41 hours per LTCH and 2,116.55 hours for all LTCHs. Since the approval of the LCDS V5.1, new information demonstrates a change in both the number of LTCHs and the number of LCDS’ completed per LTCH. As illustrated in Table 3, the number of LTCHs submitting assessments has not changed and remains at 330. LTCHs are submitting approximately 18,038 fewer admission assessments and 17,970 fewer discharge assessments across all LTCHs, resulting in a decrease of 54.66 (18,038 / 330) admission assessments and 54.45 (17,970 / 330) discharge assessments per LTCH. As a result of these changes, we estimate an overall decrease in burden hours for LTCHs. Specifically, the burden hours will decrease by 23,646 hours [211,381 hours – 187,735 hours].
Annual Cost to Federal Government:
$3,039,427
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
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:
08/30/2024
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