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)
ICR 201603-0938-003
OMB: 0938-1140
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1140 can be found here:
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)
Reinstatement with change of a previously approved collection
Skilled Nursing Facilities (SNFs) will
be required to submit a Change of Therapy (COT) Other Medicare
Required Assessment (OMRA) to administer the payment rate
methodology. This additional assessment is subject to the Paperwork
Reduction Act. The burden associated with this is the SNF staff
time required to complete the COT OMRA for the Minimum Data Set
(MDS), SNF staff time to encode, and SNF staff time spent in
transmitting the data.
PL:
Pub.L. 105 - 33 4432(a) Name of Law: Prospective Payment for
Skilled Nursing Facilities
US Code:
42 USC 1395yy(e) Name of Law: Payment to Skilled Nursing
Facilities for Routine Costs
When the COT was introduced, we
increased the MDS burden on SNFs by requiring the completion of the
COT OMRA when a SNF resident was receiving a sufficient level of
rehabilitation therapy to qualify for an Ultra High, Very High,
High, Medium, or Low Rehabilitation category and when the intensity
of therapy (as indicated by the total reimbursable therapy minutes
(RTM) delivered, and other therapy qualifiers such as number of
therapy days and disciplines providing therapy) changes to such a
degree that it would no longer reflect the RUG-IV classification
and payment assigned for a given SNF resident based on the most
recent assessment used for Medicare payment. However, with this
current reinstatement of the COT OMRA and updated data for the
current reporting period, we have decreased the burden estimates to
complete this assessment.
$0
No
No
No
No
No
Uncollected
Kayla Williams 410 786-5887
Kayla.Williams@cms.hhs.gov
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:
(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;
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.
Form CMS-10387 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)
CMS-10387 SupportingStatement Part A _COT - Passback5_cm clean.doc
Crosswalk-for-change-to-COT-PRA-June-2015.pdf
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)